Open Letter on Health Care to Ohio Rep. Bill Hayes

By Brad Cotton, M.D.
Circleville (Ohio) Herald, Aug. 17, 2011

Rep. Hayes, I write you this open letter in response to your Circleville Herald column of 10 August, “Health Care Close to Home.”

I sincerely invite you to spend a shift or two with me in the emergency department to see and feel face to face the desperation of the tens of thousands of down-home Ohioans without access to health care.

These are not slackers or persons who just wish to freeload on your tax dollars, they are our neighbors and friends, the barber who cuts your hair, the server who waits on you, the clerk in the that large store. Often they are working two jobs trying to make ends meet, while cutting back on their own medicines to save for kid’s school supplies.

Come and feel the pain of real persons suffering and dying in your district having been abandoned by profitable insurance companies, whose profit margins are at record levels (“Health Insurers Make Record Profits as Many Postpone Care,” New York Times, 14 May 2011).

Like you, I too have problems with the Patient Protection and Affordable Care Act (PPACA), called “Obamacare” by detractors when “Romneycare” is in fact more accurate, as the PPACA is modeled after Massachusetts health care reform signed by Republican Gov. Mitt Romney in 2006.

I have problems with the PPACA not because of your concern that it is a government program controlled by inaccessible, far-away elected representatives, but because it keeps in place private health insurance companies controlled by even more inaccessible, often dishonest, and even farther away corporate boardrooms that I can’t even un-elect.

Dishonest a strong word? The Associated Press article “Insurers Allegedly Provided Inaccurate Medical-Loss Ratios” of 27 July notes several Florida insurance companies took advantage of lax oversight under Gov. Rick Scott, falsely claiming they spent funds on children’s Medicaid when in fact they pocketed the cash. Scott, a tea party favorite, presided as CEO of the Hospital Corporation of America/ Columbia Health Care when his company was fined one of the largest penalties ever levied by the federal government for insurance fraud.

Rep. Hayes, your column infers that the PPACA removes local choices that “are best handled by the people closest to home who know the situation best.” Ask your constituents how much honest close to home help they received from their health insurance company.

Rep. Hayes, Ohioans health is at risk not because of too much government, but of too little. We the people have failed to demand that our elected representatives appropriately oversee and regulate Wall-Street-traded health insurance giants that increase their bottom line by not keeping their word on the promise they offer: financial security in the face of illness.

Wendell Potter, former Cigna public relations officer turned whistleblower and author of “Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans,” warns, “One of the secrets to achieving these [record profits] is what the insurers euphemistically call ‘medical management.’ That often translates into denied claims and denied coverage for doctor-ordered care. The fewer claims they pay and the more procedures they refuse to pay for, the more money is left over for investors to put in their pockets. … It’s to the insurer’s advantage for it to be complicated and confusing and hard to deal with insurance companies. They profit as a result of the confusion.”

Private for-profit health insurance companies, these are the real death panels.

Rep. Hayes, for the sake of all Ohioans I urge you to support HB 287, the “Ohio Health Security Act,” introduced by Reps. Bob Hagan and Mike Foley. HB 287 would move Ohio closer to a single-payer model, shown throughout the industrialized world to be the most cost-effective and compassionate.

Vermont has just passed single payer – no one in Vermont will die for lack of health insurance. The prestigious American Journal of Public Health, December 2009, published “Health Insurance and Mortality in U.S. Adults,” estimating that 45,000 Americans die yearly from lack of health insurance. This does not include those who die as a result of denied claims. Some of these deaths are your constituents.

Rep. Hayes, until we reach single payer you can save the lives of many Ohioans by reining in the worst of health insurance company abuses by supporting the PPACA. Under these reforms no Ohioan can be denied insurance for pre-existing conditions, no neighbor of ours will find their insurance taken away when their care threatens company profits.

Arbitrary denials of claims by insurers will, for the first time, be subject to appeal, as will premium increases. Insurers will be forced to spend at least 80-85 percent of all premiums collected on direct patient care. Under the Patient Protection and Affordable Care Act, more Ohioans will live, certainly the best “down-home” neighborly gift we can give.

Brad Cotton, M.D., is an emergency physician and a member of Physicians for a National Health Program (