HEALTH :: AUGUST 04, 2004

Action needed on health care reform

Question: What do former Presidents Ford, Carter and Bush, the Union of Am-erican Hebrew Congregations, the U.S. Conf-erence of Catholic Bishops, Pfizer drug company, the AARP, AT&T and the United Steelworkers of America all agree on?

Answer: All are members of the National Coalition on Health Care, which issued a report July 20 (to almost no media fanfare) calling for immediate, basic reform in the U.S. health care system.

The report (also signed by a variety of medical and health care organizations, including the American Academy of Family Physicians) does not give any specific plan for how to carry out the needed reforms. The authors say that we need to have a debate to discuss which of a number of possibilities would be best. What won’t do, they say, is putting it off because it’s hard right away to agree on a single reform plan. Debate is needed, they claim, but action is needed even more.

What’s the big rush? Three things. First, we continue to have a growing number of Americans without health insurance. In 2002, there were 43.6 million uninsured. Worse, a full 82 million lacked health insurance for at least part of the time. These people get less care and worse care and have a higher chance of dying.

Second, health costs continue to outstrip inflation. It seems outrageous to many that in 2003, the average insurance premium for a family was $9,068. Well, hold on — by 2006, that number is estimated to be $14,565.

Third, the care all too many Americans receive is of low quality. Half the time, American patients don’t get the correct care that the scientific evidence says they should. Some get too much and some get too little, but harm is done either way.

So what do we need to do? The coalition urged everyone to put aside partisan differences and special interest pleading and grapple with the enormity of the problem for the good of the nation. If we do that, they say that we’ll rally around five basic principles.

— Everyone in the country should have health care coverage.

— We’ve got to manage costs.

— The system must be reformed to make quality and safety top priorities.

— Financing should be equitable. People who can’t afford it should pay less.

— Simplify administration—red tape currently costs the system $300 billion a year.

How do we do all of this? The coalition tries to be even-handed in allowing for market-based reforms and government-led reforms. But to my reading, the definite tilt is for a much larger role for government. The bottom line is that no one on the free-market side has yet come up with a proposal that would guarantee coverage to all Americans, and also save money and simplify administration.

The coalition also argues for reform that’s integrated and systemic — hard to do without an active government role. The system is so interconnected that any partial reform is likely to backfire.

What do we do now that a very distinguished and truly representative group of folks have put our feet to the fire? For starters, we could send this document to both major party presidential candidates and ask them if they’d sign on. If not, what do they have to offer that’s better? It’s significant that despite the urgent national need identified by the coalition, neither party’s candidate has yet proposed anything that would come close to fulfilling all five principles.

The two major parties are fighting for our votes like never before. If every one of us wrote to our U.S. legislators and asked them to sign this document, don’t you think they’d notice?

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