Thursday, January 7, 2010

145. Healthcare reform is necessary

That healthcare stocks rose in anticipation of Republican Scott Brown's victory in the Massachusetts Senate race says everything one needs to know about who benefits from the present healthcare system. It is this corporate interest in healthcare that has prevailed-one that thwarts progress, denies coverage and lets people die. Consider the following address to Congress on healthcare:

"Millions of Americans are just a pink slip away from losing their health insurance, and one serious illness away from losing all their savings. Millions more are locked into the jobs they have now just because they or someone in their family has once been sick and they have what is called the preexisting condition. And on any given day, over 37 million Americans -- most of them working people and their little children -- have no health insurance at all.

And in spite of all this, our medical bills are growing at over twice the rate of inflation, and the United States spends over a third more of its income on health care than any other nation on Earth. And the gap is growing, causing many of our companies in global competition a severe disadvantage. There is no excuse for this kind of system. We know other people have done better. We have no excuse. My fellow Americans, we must fix this system and it has to begin with congressional action."

You might be surprised to know that these are not the words of President Barack Obama; rather, they are the words of former President Bill Clinton made on September 22, 1993.

It's been over sixteen years and almost nothing has changed.

In 2000, the World Health Organization ranked the United States 37th in healthcare in comparison to other healthcare systems in the world. In 2004, Timothy Stoltzfus Jost wrote this in the Journal of Law, Medicine and Ethics:

"All other developed countries of the world (other that the United States) including developed countries in Western Europe, Asia, North and South America, and on the Pacific Rim, provide healthcare for all or most of their residents. Although private health care products are available for purchase on a voluntary basis in virtually every country, no other developed country relies on private insurance as does the United State to provide coverage for its population. All developed countries have recognized that voluntary private insurance cannot cover everyone, and have developed some form of public health insurance."

Well . . . every developed country except one.

There is no denying that reforming healthcare is a difficult, even an overwhelming task. There are billions of dollars at stake; it's very complicated, with plenty of intricacies and interests. It should not be surprising that those with the most to lose, those that have preyed on the American healthcare system for decades to the tune of millions in profits, would fight the hardest. Healthcare corporations, pharmaceutical companies and insurance companies not only influence politicians (both Republicans and Democrats) through election donations and lobbying, they also make millions for their shareholders through the financial incentive not to pay claims or not to insure those that have preexisting conditions.

It is interesting to note, and maybe surprising to some, that private insurance administrative costs can exceed twenty percent, while government can be as low as three percent. Interesting and surprising, but it makes perfect sense. Private insurance companies have an incentive not to pay claims, to create huge salaries for the directors and returns for their shareholders. Government insurance has no incentive to deny coverage, only to prevent fraud. There are no profits, unreasonable salaries or ridiculous bonuses.

It stands to reason that any piece of legislation so large, and so complicated, would not be completely agreeable to anyone. Obviously, with so many ideologies and interests, it would be impossible to make everyone happy. This realization has been the basis of the Republican opposition to the bill.

With that, I've grown tired of the argument made by Republican politicians that, "yes, we need healthcare reform, but . . ." In addition to the reasonable concerns, there has been an unfortunate amount of political propaganda by Republicans, the right wing media and special interest groups. The propaganda includes not only inaccuracies about specifics like illegal immigration and "death panels," it also provides the normal rhetoric about socialism. The worst from the right has made this debate personal, bordering on hate-directed squarely at President Obama.

The healthcare reform proposed is far from perfect, and there are aspects of it that frustrate me. Personally, I would like a complete overhaul of the system, a start from scratch. However, the question really is whether or not we are better with this reform or without it. Will this reform increase the access and decrease the cost of healthcare in America? Will more people be covered; will there be fewer deaths and bankruptcies?

Arguments about specifics are largely about the politic interest of Republicans and the financial interests of large healthcare corporations. It is not that they are not important, and should not be negotiated and compromised to the extent possible-they should-rather it is that it is being used to create anxiety, misconceptions and anger. It is selfish and, at times, ridiculous.

The most legitimate concern stemming from the proposed legislation is the concern for the national debt. However, it is a matter of priorities and Congressman Dennis Kucinich may have said it best, "The United States is going deeper and deeper into debt. We have money for Wall Street and money for war but we don't have money for work . . . for healthcare. We have to start asking ourselves, ‘Why is it that war is a priority but the basic needs of people in this country are not?'"

The bottom-line is that we have the wealth and ability to provide quality healthcare for everyone. We need Republicans and Democrats, rich and poor, corporations and nonprofits, and blacks and whites to put aside their interests, differences and prejudices to get this done.

After World War II, England decided that healthcare would be a right for their citizens. If healthcare reform fails, it is likely that we will spent nearly a century in the dark ages by the time meaningful reform is realized.

But at least healthcare stocks will be up.

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