By Rose Ann DeMoro
Sacramento Bee
December 30, 2006

 

As Gov. Arnold Schwarzenegger recovers from his fractured leg, he has access to the finest medical care California has to offer, as he should. But don't all Californians deserve the same degree of medical attention and health care security?

 

In a few days, the governor is expected to unveil a sweeping health care proposal, following the leaders of the Senate and Assembly, who already have proposed changes to the state's dysfunctional system.

 

Yet for all the talk of a "bipartisan" consensus for reform -- following years of inaction despite a worsening crisis -- it appears most options being suggested will exacerbate the problem, retard efforts to achieve genuine reform and further enrich the corporate elite in the health care industry who produced the present shambles.

 

If your head is spinning from reading all the various ideas being thrown around, here's a Cliffs Notes version. Essentially, all the choices can be distilled into two general areas -- patient-based reform with public accountability, or market-based approaches.

 

In the market category fall most of the alternatives being swooned over today by the insurance companies and others invested in pure market-based solutions, the politicians who cater to them and those pundits who counsel us to lower our expectations. Among these proposals are laws to force individuals to purchase their own insurance; starting health savings accounts; and expanded mandates that employers provide benefits for their employees or pay into a pool for coverage for those without insurance.

 

Their common theme is a reliance on commercial mechanisms that created the present crisis by sacrificing quality, affordability and access for private profit. And all these solutions are doomed to repeat that cycle.

 

Consider the current fashion of the moment, the Massachusetts model. Every adult in that state is required to buy insurance coverage by July or face penalties. Subsidies are provided for low-income residents.

 

But the plan has gaping holes. Parents are not obligated to buy insurance for their children. Moderate-income or even middle-income adults who would have to spend hundreds of dollars more each month for full family coverage may choose to gamble with their children's health or just cut back on other basic needs.

 

Further, the plans available to middle-income residents typically have deductibles that can run into thousands of dollars. Consumers are likely to foot the bill for many health care services in addition to the premiums the law would require them to pay. And, in the event of a serious illness or accident, they may find their cut-rate plan abandons them to financial ruin.

 

Consumers are even likely to lose the choice of a physician because they will be forced to pick among the doctors whose services are covered by the low-cost plan they can afford.

 

The Massachusetts plan is loved by the health care industry because it transfers huge pots of public money to private health care corporations.

 

Health savings accounts, marketed as "consumer-directed" solutions because they pair a high-deductible plan with a tax-free personal spending account, are similarly catastrophic. HSAs simply shift the cost of coverage from insurers to individuals, promote rationing of care and do nothing to reduce the number of uninsured.

 

Rather than reduce the bloated 30 percent of every health care dollar spent on administrative overhead and waste, HSAs actually increase administrative costs with servicing fees paid to the financial institutions that are climbing over each other to grab their chunk of this new lucrative market.

 

By contrast, consider the approach in every other industrialized nation in the world: either a national health system with public administration and public hospitals and clinics, or a single-payer system, with one entity that pays for all health care services with adequate funding to the private caregiver, hospital and clinic of the consumer's choice.

 

Poll after poll documents that Americans overwhelmingly support either approach. A single-payer system is not just a dream, it's legislation -- HR 676 in Congress, and a measure in California by Democratic state Sen. Sheila Kuehl of Santa Monica, Senate Bill 840, which was vetoed by Schwarzenegger in September. It will be reintroduced in 2007.

 

While politicians clamor to come up with inferior alternatives, it will be up to all of us to remind them why this country's inferior market-based plans will simply extend our national disgrace.

Bullet Points for Legislators

  • Single Payer saves money.  For the past 20 years, states have commissioned studies on different types of health care systems.   In EVERY case, single payer was shown to be the only way to cover everyone and the only system that saved money and controlled costs.

  • Publicly financed does not mean government run health care.  YOU have publicly finance health coverage, but the government does not make decisions regarding your health care.

  • Cost conscious patients often don't get the care they need.   Most decisions are made by the doctor in concert with the patient, but the patient relies on the doctor's knowledge to make a decision.  Expensive tests and treatments cannot be ordered by the patient, only the doctor.

  • Lifestyle choices are not what is fueling high costs in health care.   The United States ranks low in general health indicators, but high in good health habits.  We smoke less, drink less and consume less animal fat that many other countries with better health indicators and much lower health care costs.

  • Businesses can accurately determine their health care costs and are not subject to unanticipated large premium increases.

  • It will reduce labor costs due to a more efficient way of financing health care, eliminating much wasteful administration.

  • Workers' Compensation costs will be reduced, likely by half, due to the fact that everyone has health coverage and there is no need for the medical portion.

  • It reduces the need for part time employees and provides easier recruiting.  There are no pre-existing conditions or Cobra issues.

  • Eliminates the oversight of health benefits and bargaining health coverage with employees.

  • It creates healthier personnel and more stable employees, reduces absenteeism and eliminates employer health coverage complaints.

  • It reduces employee health related debt and personal bankruptcies.

  • It frees up family income that can be spent on other goods and services, thus stimulating the economy.

Tips for Writing Letters to Editor

Follow guidelines for your local paper (word count, submission instructions, etc.)

Frame your letter in relation to a recent news item Use state specific data whenever possible (let us know if you need help finding some!)

Address counter arguments

Be aware of your audience and emphasize how Medicare for All is good for ALL residents of the state

Criticize other positions, not people Include your credentials (especially if you work in the healthcare field)

Avoid jargon and abbreviations

Don’t overload on statistics and minor details

Cover only one or two points in a single letter

Avoid rambling and vagueness

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