New health care law fails to make the grade

By MARGARET FLOWERS
Capital Times (Madison, Wis.), Nov. 22, 2010

When it comes to health insurance coverage, Wisconsin receives a B in comparison to other states, but only because it’s graded on a curve. The state’s 9.5 percent uninsured rate falls considerably below the national average of 16.7, but that’s not much consolation to residents who remain uninsured or who are covered by skimpy policies with big deductibles and co-pays.

The Census Bureau reports that the number of uninsured in the U.S. jumped 10 percent to 51 million people in 2009. This is the greatest jump since data have been collected. The jump would have been more than 20 percent if not for public programs like BadgerCare.

No other rich nation experiences such high levels of people without access to health care and the resultant suffering and death. For example, a study in the American Journal of Public Health shows that in the United States nearly 45,000 deaths annually can be linked to lack of health insurance. That’s over 120 preventable deaths every day.

Even those who have health insurance are unprotected. A growing number of people have insurance policies that require high co-pays, deductibles and other out-of-pocket expenses. These “cost-sharing” measures are serious obstacles to getting care. The majority of people who go bankrupt from medical bills have insurance when they get sick. Private health insurance is like an umbrella that melts in the rain — it may not be there when you need it most.

Sadly, the new federal health law fails to make the grade. Even the Congressional Budget Office estimates that 23 million people will still lack coverage in 2019 after the health legislation is fully implemented. The Centers for Medicare and Medicaid Services reports that health care costs will rise more quickly under the new law than if there had been no health bill.

A potent example of what to expect occurred when the recent provision preventing health insurers from denying new policies to children with pre-existing conditions kicked in. The day before this protection went into effect, insurers like WellPoint, UnitedHealth Group, Aetna, Cigna and Humana announced that they would no longer offer new policies to individual children.

What can we conclude about the new legislation? It further enriches and empowers the very industries which are at the heart of the problem. As long as private insurers occupy a commanding role in our health system, we will never achieve universal or affordable care. Insurers make money by enrolling the healthy, screening out the sick, denying claims and raising premiums.

There is a solution that receives top marks: a single-payer national health insurance program, commonly referred to as improved Medicare for all. Single-payer means that our health care dollars are pooled in a single public fund that pays for a universal health care system. This is estimated to save $400 billion, which would cover those who need care. Surveys show this approach is supported by two-thirds of the population.

Improved Medicare for all means every person living in the United States would be guaranteed high-quality care from birth to death. Coverage would be comprehensive, including dental care, vision care, mental health services and prescriptions. And the working and middle class would pay less for health care because of the increased efficiency of a single-payer system.

Patients would choose their physician and health facility, and decisions about treatment would be made by patients and their health professionals without interference by insurance company bureaucrats.

While the health care crisis may not be obvious in Madison, the effects are felt in Wisconsin and across the nation. We must work with renewed energy and commitment for a national health program that addresses our fundamental problems. Everybody in, nobody out.

Dr. Margaret Flowers, who spoke recently in Madison, resides in Baltimore and serves as congressional fellow for Physicians for a National Health Program. She is also a board member of Healthcare-Now.

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