By Dr. Susanne L. King
April 28, 2010
The passage of the “health insurance” bill has been a huge political success for President Obama and the Democrats and has been compared to the historic passage of Medicare and Social Security. Unfortunately, this bill is not in the same league as those successful programs, which provide medical and financial security to every elderly and disabled American. This is not a “health care” bill; it is a “health insurance” bill, which will hand out $447 billion in taxpayer money to insurance companies as subsidies to purchase inadequate insurance products. And the bill will require millions of Americans to buy these substandard products. The insurance companies are the big winners in this legislation.
We did not need to create this scenario to obtain the useful measures in the bill, like additional funding for community health centers, expansion of Medicaid, reduction of the “donut hole” in prescription drug coverage for Medicare patients, and allowing young adults to stay on their parents’ health insurance plans until age 26. These fixes could have been done separately. Instead, they were inserted into a 2,000-page bill that will further enrich and empower the insurance industry.
Sen. Max Baucus recently praised his aide, Elizabeth Fowler, former vice president of the giant health insurer Wellpoint, for her pivotal role in crafting this legislation. While middle class families were struggling to pay their escalating health insurance premiums, rising deductibles and co-payments, Wellpoint’s profits increased by $2.3 billion in 2009, 91 percent more than the previous year. Not content with this level of profiteering, Wellpoint’s subsidiary, Anthem Blue Cross of California, seeks to increase profits even more by raising its premiums by an astounding 39 percent this year.
Wall Street loves the law. Mutual fund analysts say it is beneficial for health industry stocks, particularly for pharmaceutical and medical equipment companies, because there are no “onerous cost controls.” Health insurance company stocks continue their upward trend, and CEO salaries remain astronomical.
In addition to the bill’s handout to the insurance industry, this legislation has many shortcomings:
* Twenty three million people will remain uninsured, which translates into 23,000 unnecessary deaths every year.
* Millions of middle-income people will have to buy health insurance policies, costing up to 9.5 percent of their income, but covering an average of only 70 percent of their medical expenses, because of high deductibles and co-payments.
* People with employer-based coverage will still not be able to choose their doctors and hospitals, and eventually face steep taxes on their benefits as the cost of insurance grows.
* Health care costs will continue to skyrocket, as we have seen here in Massachusetts after the passage of Chapter 58, which did nothing to contain costs.
* The insurance regulations are riddled with loopholes, as one might expect when insurers helped to craft the bill. For example, older people will be charged three times more than their younger counterparts, and large companies that have more female workers will continue to pay higher rates until 2017.
The American people did not have to be saddled with an expensive package of individual mandates, taxes on workers’ health plans, sweetheart deals with insurers and Big Pharma, and a perpetuation of our current dysfunctional and unsustainable system. President Obama did not seize his chance to inherit the mantles of Presidents Roosevelt and Johnson, with their historic fashioning of legislation for Social Security and Medicare. This bill’s passage reflects political considerations, not sound health care policy.
Sooner or later, our nation will have to adopt a single-payer national insurance program, an improved Medicare for all. We could save $400 billion annually in administrative costs, enough to provide comprehensive coverage for everyone. And only a single-payer system provides the tools for cost control, like bulk purchasing, negotiated fees, global hospital budgeting, and capital planning.
Polls show that almost two-thirds of the American public supports this approach, and a recent survey shows that 59 percent of U.S. doctors do as well. Inevitable price increases by the insurance industry will expand the popularity of the single-payer movement. Ultimately we will have a national health insurance program. Single-payer health care is the only coverage that is universal, comprehensive, and affordable.
Susanne L. King, M.D. is a Lenox, Mass.-based practitioner.