Proposed health plan to expand coverage

By Miles Bugbee     8/27/09 7:00pm

In the last few months, a Congressman from Maryland was hanged in effigy, a recent GOP vice presidential nominee forecast impending "death panels" - in apparent reference to a provision in a Senate bill written by a fellow Republican - and the eminent physicist Stephen Hawking was drawn into the tumultuous health care reform debate, which has been enveloped by a political black hole of misinformation.Beyond the misleading rhetoric and hyperbolic charges of a "government takeover of health care," our ailing health care system currently faces three central challenges: soaring costs, shrinking coverage and quality of care disparities.

Health care costs now consume 16.6 percent of the U.S.'s GDP and likely will hit 20 percent by 2017, and health insurance premiums are on pace to double in the next seven years. The Census Bureau estimates that nearly 46 million Americans are without health insurance. While America leads the world in life-saving drug patents and high-end specialized care, according to the World Health Organization's general measurements of quality, the American health care system is 37th in the world. Americans, who are not used to chanting, "We're No. 37, we're No. 37!," should know that in this critical field, we rank just one slot above Slovenia.

With the deficit quadrupling this year, policymakers are racing to find ways to "bend the cost curve." The president's budget director has called for "Comparative Effectiveness Research," a data-driven approach to cutting costs, which identifies areas where Medicare often pays double or triple for the same quality of care delivered elsewhere. Innovative programs like CER are essential to pushing the cost curve down.

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While most Americans retain health insurance coverage, nearly one in six do not, and this number is expanding as unemployment lines grow longer. Remote Area Medical, an organization founded to serve desperate needs in developing countries, has come home to help Americans who cannot afford health care. When they recently held a free clinic in California, 1,500 uninsured citizens showed up the first day seeking medical attention.

Focusing on their bottom lines, insurance companies methodically avoid high-risk and high-cost patients. While this may be acceptable in another insurance market, health insurers cover people, who, if uninsured, may not be able to afford a colonoscopy or a mammogram that can detect cancer in its earliest stages.

A government-backed "public option," which would foster greater competition in the health insurance market, is an efficient way of lowering soaring insurance premiums, making health care more affordable for all Americans. However, public health cooperatives, another health insurance reform option, lack the competitive power of the "public option." Whether "co-ops" can effectively lower costs depends on the final wording of the bill.

Seeking to address an issue that has evaded every Democratic predecessor since Harry Truman, President Barack Obama has outlined an eight-point plan to Congress that aims at reducing health care expenses, expanding access to health insurance coverage and protecting care for patients who could be dropped by their insurers. The president's plan would prevent insurance companies from abandoning patients with "pre-existing conditions," cap out-of-pocket expenses for medical emergencies - responsible for a bankruptcy every 30 seconds, according to Harvard University researchers - end cost-sharing for preventive care and issue an emphatic "no" to gender discrimination, annual caps on coverage or dropped coverage because of life-threatening illnesses.

Under this plan, college students can stay on our parents' health plans until they turn 26. The Obama plan also ensures guaranteed renewal of health insurance as long as premiums are paid. The president's plan is moderate, well-reasoned and acutely cognizant of the political environment it inhabits.

In addition to the eight tenets outlined by the president, there is a myriad of other issues that must be considered by policymakers. Members of both parties may find common ground in support of more funding for preventive care, policy solutions to help medical students saddled with debt and incentives to encourage doctors to become primary care providers and practice in rural areas.

Politically, we are at a critical juncture in the health care debate. Nervous Democratic members from competitive districts and "red" states and idealistic progressives hold the power balance in the House and the Senate. Both sides must choose whether to support the failed status quo or some type of compromise, which, while imperfect, will deliver on most of the president's reform objectives.

In 1994, the last effort to ensure universal access to quality, affordable health care died in Congress. With a demographic crisis and the projected insolvency of Medicare less than a decade away, we cannot afford to wait another 15 years for reform. We must act now to reduce costs, expand coverage and improve care. It is time for the misinformation to end.

Myles Bugbee is a Hanszen College sophomore.

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