Cross-posted at WinningProgressive
Health care is the political issue that matters to me most. My spouse is a young adult who has had cancer for the past nine years. She had no health insurance when she was diagnosed. The political red tape of dealing with the coverage of her care was as caustic and painful for her as the disease itself. Additionally, my father has dementia. I am extremely fortunate that my employer now provides very good health insurance for my spouse and me, and that Medicare is there to take care of my Dad’s medical needs. But I live in fear of what would happen if I lost my job or my employer was no longer able to afford our health insurance plan. In addition, I realize that tens of millions of Americans are nowhere near as lucky as I am, as they do not even have health insurance to worry about losing.
For those of us concerned about health insurance, this is an exciting week. On Thursday a number of major provisions of the historic health insurance reform legislation that President Obama and Congressional Democrats passed earlier this year go into effect. Before we discuss these new provisions, let’s take a look back at how broken the pre-reform health insurance system is. Looking back is important not only because it provides an idea of the size of the problem that President Obama began to address, but also because it provides a clear picture of what Republicans, who have promised to repeal health insurance reform, would try to return our country to if they get back into power.
The numerous inadequacies in our pre-reform health care system can be categorized into four basic categories.
- Denying Coverage to Those Who Need It Most: The entire point of a health insurance system is to make sure that people are able to pay for medical coverage when they are sick. Unfortunately, the pre-reform health insurance system enabled health insurance companies to regularly deny coverage to those people who need it the most. For example, it was legal in 45 states for health insurance companies to deny people coverage for pre-existing conditions. So, if you had cancer or diabetes, a health insurance company could either deny you coverage altogether or deny you coverage for that disease. While that might make sense for health insurance industry profits, it does not make sense for people who are ill. An even worse industry practice is known as rescission, which is when a health insurance company will happily take your premiums until you get sick, and then find an excuse to eliminate your coverage. A 2009 Congressional investigation found that three major insurance companies had avoided paying $300 million in claims by rescinding coverage for 20,000 policyholders after they got sick.
- Escalating Costs: Health care costs in the U.S. are out of control. Our country spent $2.2 trillion on health care in 2009, which is more than 16% of our national economic output. That figure has skyrocketed from only 9.1% in 1980 and 12.3% in 1990. As a society, we now spend an annual average of $7,400 per person on health care, which is almost double what other industrialized nations spend.
- Inadequate Results: It would perhaps be worth spending so much more than the rest of the world on health care if we got better results. But we do not. Instead, the U.S.’s average life expectancy of 78 years old is three years less than France’s 81 years, even though France spends only $3,600 per person per year on health care. In fact, a recent study from the Commonwealth Fund found that in comparison to other industrialized countries, the U.S. ranks last in efficiency, quality, and equity of care.
- Declining Coverage: Despite spending more on health care than any other country on the planet, the U.S. has by far the highest percentage of people who lack coverage. In 2000, there were 39.2 million uninsured Americans. By 2009, that number had increased to 50 million. Approximately 66% of the uninsured are from a household with at least one full-time worker, and an additional 14% are from households with at least one part-time worker. Much of the decline in coverage is due to the fact that fewer employers are covering their employees. In 2000, 66% of employers provided coverage, but by 2009 that number was down to 58.9%. A recent study from Harvard Medical School found that as many as 45,000 Americans die every year due to a lack of health insurance. The uninsured also are more likely to be hospitalized for avoidable health problems because they lack access to preventative care.
In short, the pre-reform health care system in the United States costs too much, achieves too little, covers too few, and does not support people who need it the most. That is why the Democratic reforms that we will be discussing here over the next week are so important.
Do you support the efforts of President Obama and Congressional Democrats to reform our nation’s broken health care system? If so, write a letter to the editor of your local newspaper thanking them and urging your neighbors to make sure that we do not allow the Republicans to turn the clock back on the progress we have made.