Doctors' group says health-reform doesn't go far enough

By Margaret DeRitter
Kalamazoo Gazette, Sept. 23, 2010

Those who support the health-reform overhaul passed by Congress this year say that new Census Bureau figures on the rising number of uninsured Americans bolster their case that reform is needed.

But the advocacy group Physicians for a National Health Program says the health-reform law — whose main provisions take effect in 2014 — doesn’t go far enough.

PNHP, whose membership includes about 17,000 of the nation’s 660,000 doctors, says the numbers in the Census report support its call for a single-payer, Medicare-type health program for all Americans.

The Census Bureau estimates that the number of uninsured Americans rose by 4.4 million in 2009. A total of 50.7 million people — or nearly one in six Americans — were uninsured in 2009 compared to 46.3 million in 2008, or 16.7 percent of the population compared to 15.4 percent.

The new figures were released Sept. 16 in the Census Bureau’s annual report on the economic well-being of American households.

The jump in uninsured people is the largest one-year increase on record and would have been much higher — more than 10 million — had there not been a huge expansion of public coverage, primarily Medicaid, to an additional 5.8 million people, the PNHP says.

Kaiser Health News reported that the sharpest jumps in the uninsured were in the Midwest and South. Michigan was one of the 10 states with the largest increases in number of uninsured. The others were California, Florida, Texas, Ohio, Georgia, North Carolina, Illinois, Alabama and Pennsylvania.

The biggest jumps in terms of the percentage of uninsured were in Alabama, Oklahoma, Ohio, Missouri, Georgia, Delaware, North Carolina and Florida.

PNHP and the Associated Press both reported that the rise in the number of uninsured was largely the result of a decline in the number of people with employer-provided coverage.

Last year 55.8 percent of the population had employer-based coverage, compared to 58.5 in 2008. That drop was the ninth consecutive year of decline, according to PNHP.

The Wall Street Journal pointed out that the drop in the total number of insured Americans in 2009 suggests that people lost their employer-based benefits at a rate faster than government programs could pick them up.

Robert Greenstein, executive director of the liberal Center on Budget and Policy Priorities, told USA Today that the drop in employer-provided insurance shows the need for state health insurance exchanges, which are to be created under the health-reform law and will have insurers competing for consumers’ business.

“There needs to be some other mechanism for people … to have a way to get coverage, other than through employers,” Greenstein told USA Today.

But Dr. Quentin Young, national coordinator of PNHP, says that even if the new health law works as planned, the Congressional Budget Office has projected that about 50 million people will be uninsured for the next three years and about 23 million people will remain uninsured in 2019. The new Census report, he says, suggests that those projections are likely too low.

“The only way to solve this problem is to insure everyone,” said Young, a retired Chicago doctor. “And the only way to insure everyone at a reasonable cost is to enact single-payer national health insurance, an improved Medicare for all. Single-payer would streamline bureaucracy, saving $400 billion a year on administrative overhead, enough to pay for all the uninsured and to upgrade everyone else’s coverage.”

And so the debate goes on, even among those who agree that the government has an important role to play in health-care reform.

Contact HealthLife editor Margaret DeRitter at mderitter@kalamazoogazette.com or 269-388-8542.

http://www.mlive.com/opinion/kalamazoo/index.ssf/2010/09/column_doctors_group_still_wan.html