Published Saturday, August 15, 2009 in Southeast Community editions of the Arizona Republic as “Political posturing will put pox on health-care debate.”
The health-care debate has hit the Southeast Valley full force.
Rep. Jeff Flake’s town hall meeting at Chandler’s Basha High School included 1,500 people with another 500 turned away due to capacity limitations. Rep. Flake, a strong libertarian, will oppose the health-care bill.
Meanwhile, Congressional representatives like Harry Mitchell, whose votes will be important if health- care reform is to pass have chosen not to schedule town halls.
The reason is politics.
Health care is an important part of our lives, so real concerns motivate many. But those who turn out tend to be more active and ideological voters. We also have coordinated efforts, especially by conservative groups loyal to the G.O.P., to take over forums. Flake wasn’t a target, so he had nothing to fear. Mitchell would have plenty. This is part of an organizing strategy to undermine both Democrats and Health Care reform, and why President Barack Obama had hoped Congress would pass reform before their recess.
Between the Democratic leadership’s desire to rush legislation and the Republican allied interests trying to disrupt town hall gatherings, we’re seeing lots of posturing in preparation for 2010 mid-term elections, but not the honest discussion we need.
The following five statements should guide the debate.
1. Our health care system may provide good care for many, but it’s far too expensive. As a percent of Gross Domestic Product, we pay 17 percent for private and public health care. The rest of the industrialized world spends between 8 and 12 percent.
2. We have inadequate health care security. Many of us are locked to jobs because of employer-provided health insurance. Others can’t afford insurance or have pre-existing conditions for which they can’t get coverage, and they are scared to death of what may happen if their health fails. Bankruptcy from huge medical bills lurks for those whose health does fail.
3. We can’t expect private for profit markets to insure people who lack the ability to pay or are older and too great of a health risk. That’s why government provided health insurance in the form of Medicaid and Medicare exists.
4. We already ration care. We hear lots of fear-mongering about government operated health systems that will let you suffer or even die to save money. But when the insurance company refuses to fund a costly procedure, that’s rationing. When a Harris Interactive survey found last year that two in five Americans with chronic conditions skipped seeing a doctor or taking medicine due to cost, that’s rationing. The question is how we ration, not whether we do so.
5. We rank poorly in health outcomes compared to other industrialized countries. While it’s true that some people with severe diseases do better in the United States, far more people don’t receive basic ongoing care that detects and treats problems early on. We do great on expensive heart surgery, but fall short in making sure people with high blood pressure are diagnosed, monitored and receiving proper treatment.
Health care reform needs to deal with these five elements. We can and should discuss alternatives. We shouldn’t pretend this won’t impact people. Cutting health care costs means lowering incomes, profits or employment, but it frees those resources for other uses, including providing more care for others.
We also have to be willing to listen and compromise. That means Republicans accepting a greater role for government, and Democrats accepting some kind of accountability for controlling costs without impairing performance. They have to be willing to upset constituencies—Democrats with malpractice reform that disturbs trial lawyers, and Republicans with doing what helps the country, not simply positioning for 2010.
Change creates anxieties, but the status quo in health care can’t continue.
Dave Wells of Tempe holds a doctorate in Political Economy and Public Policy and teaches at Arizona State University. Reach him at Dave@MakeDemocracyWork.org. The views are his own.
Health plan opponents make their voices heard
Published: August 3, 2009 http://www.nytimes.com/2009/08/04/health/policy/04townhalls.html?hp
Health care as % of GDP: Graphs and details at http://economix.blogs.nytimes.com/2009/07/08/us-health-spending-breaks-from-the-pack/
Additional fact sheet with references including medially induced bankruptcies: http://www.nchc.org/facts/cost.shtml
Survey comparing health systems (of the public across countries): http://www.reuters.com/article/healthNews/idUSSAT17732020071101
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
The JNC 7 Report
Aram V. Chobanian, MD; George L. Bakris, MD; Henry R. Black, MD; William C. Cushman, MD; Lee A. Green, MD, MPH; Joseph L. Izzo, Jr, MD; Daniel W. Jones, MD; Barry J. Materson, MD, MBA; Suzanne Oparil, MD; Jackson T. Wright, Jr, MD, PhD; Edward J. Roccella, PhD, MPH; and the National High Blood Pressure Education Program Coordinating Committee
41 percent of the population has undiagnosed hypertension. 66 with hypertension don’t meet benchmarks in improving blood pressure: (data is 1999-2000, but appears to be most recently available).
see Table 2.