By Rose DeMoro
Sunday, February 10, 2008
With the presidential contest closing in on Texas, voters may well wonder how to distinguish among the various candidates on health care, which — at least on the Democratic side — has been one of the hottest issues of debate.
The central difference is on the role of insurance. Why does this matter?
Listen to Lyle Schiele of Dallas.
“As an owner/operator in the trucking industry, I was contracted to a major trucking company. I purchased my health insurance at what was to me an enormous monthly cost of $760 through that company.
“In February ’06 I had some minor chest pains. Doctors found clogged coronary arteries and treated them with stents in two locations. As a result of this diagnosis and treatment, I was medically disqualified from trucking for 90 days. As a contractor, I wasn’t covered by COBRA and therefore lost my health insurance.
“After returning to trucking as an owner/operator and applying with several different insurance companies, I found none would sell me any. Recently, as a matter of necessity, I sold my truck and went to work as a driver with a company, primarily for the health insurance benefit.
“I was not looking for a handout. I don’t mind paying my own way. But I am no longer given that opportunity. The ‘American Dream’ of owning and operating one’s own business and success based on one’s ability and performance has been taken away. Because of the health insurance issue I can no longer operate as an independent again.”
Lyle is one of hundreds who responded to a California Nurses Association/National Nurses Organizing Committee ad describing the disparity of care available to Vice President Cheney and members of Congress and the rest of us (www.cheneycare.org).
His story is not unique. One in six insured adults has substantial problems paying medical bills, one report noted last year, and 42 percent told Zogby-UPI pollsters that their insurer had refused to pay a medical bill.
Yet, selling us more insurance — without ending insurance industry price gouging or the callous, all too routine denials of care — is at the heart of the leading candidates’ proposals in both parties.
Republicans mainly emphasize tax incentives and further unleashing a market that has already ushered in an 87 percent increase in insurance premiums alone the past decade, not counting the co-pays, deductibles and other staggering costs.
Top Democrats favor a more comprehensive approach with expanded public programs for children and the poor. But only Sen. Hillary Clinton is pushing an “individual mandate,” the requirement for everyone to buy insurance with no meaningful controls on its cost or assurances that you won’t be denied care when you need it.
Sen. Barack Obama says people don’t have insurance not because they don’t want it, “but because they can’t afford it.” He has a point.
A Kaiser Family Foundation 2007 survey found that family premiums now average $12,106 — not including all the add-ons.
Clinton’s argument that Obama is “leaving out” people by objecting to the mandate, and that requiring everyone to buy insurance constitutes “universal health care” is disingenuous.
“Having” insurance is not the same as being able to use it. You’re only being mandated to purchase the premiums; they’re not mandating the insurance companies to make sure you get the care you need.
Clinton has also criticized Obama for his past comments about a real alternative to an insurance-based system. In 2003 Obama called himself “a proponent of single-payer, universal healthcare coverage . . . everybody in, nobody out” — essentially an expanded and improved Medicare for all.
It’s a system, with some nuances, in place in every other Western country, and it works. A January, study by the London School of Hygiene and Tropical Medicine, for example, found the U.S. ranked worst among 19 industrial nations in preventable deaths.
Those results should make such a system a model for the U.S., not a campaign attack point.
What Obama says now, as he did again in a recent debate in South Carolina, is “if I were designing a system from scratch, I would set up a single-payer system.”
We are starting from scratch. Our present system has hit rock bottom, as Lyle and so many others can attest. Our families deserve no less.
Rose Ann DeMoro is executive director of the 80,000-member California Nurses Association/National Nurses Organizing Committee and a national vice president of the AFL-CIO.