By Claudia Chaufan
Viewpoints, Sacramento Bee
March 26, 2010
To those led to believe that, as President Barack Obama claimed, the passage of the health care bill is “comparable to the passage of Medicare and Social Security” and that “every American will be guaranteed high quality, affordable health care coverage” as a result of it, my advice is to hold off on uncorking the champagne.
For one, Social Security and Medicare were public programs that from their inception offered immediate benefits to millions of ordinary Americans, who for the first time could rely on old-age pensions and access health care services that until then had been completely out of reach.
By contrast, this “historic bill,” instead of eliminating the root of our health care woes, further enriches and entrenches a profit-driven health insurance industry that makes money when it succeeds in not paying medical bills.
How so? It forces millions of Americans to buy the insurance industry’s shoddy products or pay a fine, even as it offers eligible ones subsidies – courtesy of taxpayers – to purchase those products.
Sound familiar? It should. The bill consolidates the transfer of wealth from Main Street to Wall Street of the last decades, only second to the recent, similar transfer implemented under the dubious claim that otherwise the economy would disintegrate.
I’m the vice president of the California branch of Physicians for a National Health Program, a group that advocates for a publicly financed, privately delivered national health program.
Some of us have been called party spoilers by continuing to criticize Obama’s health reform plan. Yet here are some facts about the bill that supporters of reform need to consider:
• Millions of middle-income people will be mandated to buy commercial health care policies costing up to 9.5 percent of their income. Yet those policies will cover as little as 60 percent of “covered services,” leaving them vulnerable to financial ruin if they become seriously ill. So yes, over 30 million Americans will be “covered” by this bill, but by an umbrella full of holes under pouring rain.
• People with employer-based coverage will be locked into their plans’ “preferred providers’ networks.” So yes, workers will “keep their plans if they like them” (assuming they can afford the ever-increasing prices and don’t lose their jobs, or their employers don’t drop their plans), yet will have to keep them even if they don’t like them.
• Insurers will be handed at least $447 billion in taxpayer money to subsidize the purchase of these policies, which will further empower the insurance industry and its ability to block future reform.
• Health care costs will continue to skyrocket because the bill will do nothing to reduce the $400 billion wasted every year pushing paper to market thousands of plans and separate people according to eligibility criteria, services covered, etc.
• The much-vaunted insurance regulations – e.g. ending denials on the basis of pre-existing conditions – are riddled with loopholes. For instance, older people can be charged up to three times more than their younger counterparts, and large companies with a predominantly female work force can be charged higher gender-based rates at least until 2017. Policies can still be canceled in case of “fraud or intentional misrepresentation,” the No. 1 excuse insurers use to cancel policies today.
• About 23 million people will remain uninsured nine years out, according to the Congressional Budget Office. That translates into about 23,000 unnecessary deaths annually.
Did it need to be like this? Not at all. All the good provisions in the bill, such as funding community health centers, could have been adopted as stand-alone measures.
Instead, Congress and the Obama administration have chosen to burden ordinary people with a “uniquely American” individual obligation to buy flawed private products.
Social health insurance in the form of single-payer health care will sooner or later have to be adopted, not because it is politically feasible, but because it is inevitable.
As Harvard professor William Hsiao (the brain behind Taiwan’s single-payer system) argued, you can have universal coverage, lower costs, and improve the quality of care, but you need a single-payer system to achieve that.
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Dr. Claudia Chaufan is an assistant professor of health policy and sociology at the University of California, San Francisco.