By Lance Dickie
Seattle Times editorial columnist
March 5, 2009
The effort launched by President Obama to overhaul the nation’s health-care system does not match the urgency of the times. He is for change yet to be defined.
In the curious way that policy advances, hard times are the best of times for moving beyond a clumsy, massively expensive private-health-insurance industry the country can no longer afford.
As a crashing economy pushes millions out of their jobs and homes, continuing to link access to medical care to employment is hazardous to the nation’s health. Anxious households reached this conclusion well ahead of the politicians.
Even before the economy turned upside-down, fewer employers offered health insurance. Covered workers paid ever-higher premiums, copays and deductibles for skimpier benefits.
Annual health-care costs soared past inflation rates. Hundreds of private insurers with thousands of plans not only failed at cost containment, they also drove up expenses for clients, doctors, hospitals and patients with obscene administrative overhead.
Obama rolled out his blueprint for health-care reform this week, along with the cabinet-level administrators who will pursue its enactment. They include Kansas Gov. Kathleen Sebelius, nominated as secretary of health and human services, Nancy-Ann DeParle, administration coordinator of health policy, and Peter Orszag, White House budget director.
They are charged by the president to promote broad principles of universal coverage, lower premiums, consumer choice of health plans and ending refusal of coverage for pre-existing conditions. Obama wants a 10-year, $634-billion reserve to “finance fundamental reform of our health-care system that will bring down costs and expand coverage.”
The administration’s approach is narrowly and unacceptably about the status quo, changing the current system of private insurers. The conversation broadened when supporters of single-payer national health insurance were belatedly invited to Thursday’s White House health-care forum.
Single payer covers everyone. Doctors, hospitals and all the medical-care system stay private, but paperwork and bills are routed through and paid by the federal government. Think Medicare.
Advocates include the 12,500 members of Physicians for a National Health Program. Two single-payer plans have patiently awaited their moment for years: H.R. 676, introduced by Rep. John Conyers, D-Mich., and H.R. 1200, introduced by Rep. Jim McDermott, D-WA.
Obama’s stimulus plan pushes back on health-care costs, ending excess payments to Medicare Advantage programs. The newly unemployed get help to hang onto their employer coverage longer. Money flows to health clinics, such as the Community Health Association of Spokane.
As for broader health-care reform, McDermott counsels patience. His experience and frustration go back to the early Clinton years and the administration’s failed reform attempts. The Seattle Democrat is now plainly optimistic. He hears consumers, major employers, unions and medical professionals all say the status quo is unacceptable.
McDermott, freshly back from war-zone trips to Iraq and Afghanistan, said the discussion to come is for the nation to agree everyone will contribute to a common fund that pays for coverage for all.
Potential savings are huge, as are the benefits of keeping a private doctor and every one having one. The national conversation must occur first. McDermott is confident the times are ripe for it to happen.
Lance Dickie’s column appears regularly on editorial pages of The Times. His e-mail address is ldickie@seattletimes.com
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