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:: Reforming health care reform
Getting government on our side
By David Hoppe
From the very start, it was clear the debate over health care reform would define whose side the federal government was really on. We were going to find out whether the government was for big business - in particular, the insurance and pharmaceutical industries - or for us.
Last week, as the first phase of the new health care reforms took hold, it became more apparent than ever that the winners in this first round of reform weren't we the people.
Several new provisions went into effect on Thursday, September 23. They included requirements that insurers fully cover preventive care like immunizations, mammograms and colonoscopies. Children with pre-existing conditions, like asthma, cancers or hemophilia, cannot be denied coverage under the reforms. Insurance companies are not allowed to cap the amount a person can be paid during their lifetime, and insurers must also increase their annual limits on health benefits.
These are all reasonable adjustments to insurers' business practices. They are based on the real life experiences people have with health care. They are intended to make private insurance a more effective tool in helping to cope with the financial wreckage that can come with a bad diagnosis.
As anyone who's ever had such a diagnosis knows, the trouble with many private insurance plans is that they cost a lot of money but have a way of disappearing when they're needed the most. Although the number of uninsured Americans was frequently invoked during the health care debate, the number of Americans who are under-insured, paying through the nose for policies that leave them in the lurch at the worst possible times, is even greater.
So these tweaks to the health insurance business model were designed to add value to the product and help some Americans maintain a semblance of financial stability in the face of challenges to their well-being.
But even these common sense provisions were drafted with plenty of loopholes - and the insurance companies began exploiting them before the ink President Obama used to sign the legislation was dry.
First, the insurance companies began raising their premiums in advance of the legislation kicking in. According to the Kaiser Family Foundation and the Health Research and Educational Trust, American workers are paying nearly $4,000 a year for family coverage, $482 more in 2010 than in 2009. Total premiums for family coverage, taking into account both employee and employer contributions this year, is higher than it's ever been: $13,770.
Then last week, some insurers indicated that they are simply going to stop offering policies that cover children. This way they can't be required to cover kids with pre-existing conditions.
This, sadly, is the result of a legislative strategy that was more concerned with propping up an outdated, self-serving industry that reserves itself the right to withdraw its services when those services are most needed. It's like paying for an army that goes AWOL at the sound of gunfire.
So last week's health care kick-off date was greeted with a sigh rather than a round of applause.
It is tempting to blame President Obama for this. Why, ask progressives, did he take a single payer option off the table? His strategy of allowing senators beholden to insurance companies and big pharma to draft the legislation was a terrible miscalculation. Real reform was and is worth fighting for.
But it's also doubtful Obama could have overcome the vampiric relationship existing between health care moguls and many members of Congress. It was hard not to look for fang marks on Republican John Boehner's throat last week, when he stared into a camera and said with a straight face that the United States has the best health care system in the world. According to a study commissioned by, of all people, the Business Roundtable, a group of CEOs, American health care lags behind services provided in Canada, Japan, Britain, Germany and France. The reason? Our out-of-control costs. Since 1999, Kaiser reports family premiums for employer-sponsored health insurance increased 131 percent. If Boehner and his cronies think repealing Obamacare will make this better, they need to tell us better for whom.
We know the answer to that: Health, Inc. Ironically, our only hope for real reform lies in the shameless mendacity of health insurance executives and congressional tools like Boehner. Their price gouging, service cuts and other forms of barely disguised sabotage to the public interest could do what last winter's legislative shambles refused to face and drive home the need for a public health insurance option or, better still, Medicare for everyone. The only way the market can work in our favor is to change it. Let the government negotiate health care prices on behalf of we the people of the United States. If, as the Supreme Court says, corporations count as people, let the people count as an enormous customer to be courted and competed for. When that happens, health care CEOs won't be as rich, but the rest of us will be feeling much better.