A historic moment
Debate over health care reform has been raging for more than a year. Claims and counterclaims tend to create more confusion than illumination. However, the recent health care summit at Blair House revealed with clarity the philosophical nature of the conflict.
Obama Democrats believe that adequate health care is a right for all Americans, while Republicans believe it is merely a privilege. Conservative Republicans have consistently opposed any policy that creates an entitlement. They renounced Social Security, Medicare and Medicaid and they unanimously object to the health care reform bill.
A major reason for the Republican objection to health care reform, or any entitlement, is the expense. A government agency to administer the program must be established, and then there is the cost of the benefits. However, according to the Robert Wood Johnson Foundation, the most expensive strategy is to do nothing. The Johnson Foundation study projected that the health care costs for businesses will double within 10 years.
Another concern for conservatives is the public option originally in the congressional bill that would establish a government insurance plan. This was attacked as socialized medicine. With the help of the media, conservatives have been able to persuade many Americans that they should shun any government takeover of health care. This is an odd assertion, since millions of Americans are already covered by health plans that are wholly or partially controlled by the federal government, including Medicare, VHA Health, Medicaid and the Children’s Health Insurance Plan (CHIP).
The reform provisions now under consideration would provide the following remedies to some of the problems:
• Provide insurance for about 30 million Americans who are presently uninsured;
• Prevent insurance companies from refusing to provide coverage to people with pre-existing medical conditions;
• Prevent insurance companies from cancelling anyone’s insurance policy when they become ill;
• Provide financial benefits to small corporations to enable them to provide health insurance for their employees; and
• Subsidize the cost of insurance for low-income families.
When the smoke clears, conservatives’ greatest fear is that the cost of providing health insurance for everyone will exert such pressure on federal resources that the tax cuts they have enjoyed under Pres. George W. Bush will be eliminated. According to the Joint Committee on Taxation and the Congressional Budget Office, the direct cost of those cuts will be $3.7 trillion for the fiscal years 2009-2018.
The fiscal rationale behind health reform is that if everyone is insured, then rates should be lower. Actuarially determined rates in group plans will be lower if a substantial number of young people are part of the pool. Also, with everyone insured, hospitals will not have to pass on to other insured patients the cost of uncompensated emergency room visits.
With everyone insured, no one would face bankruptcy or default on their mortgages because of the cost of catastrophic illness. According to reports, a high incidence of personal bankruptcies is precipitated by unpaid medical bills. Also, the existence of insurance would stimulate effective health maintenance plans.
Obama Democrats are trying to enact the best health reform act they can get. It can be improved later as experience points out its shortcomings.
