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October 5, 2009

Getting Sick, Dying Quickly

"It's my duty and pride tonight to be able to announce exactly what the Republicans plan to do for health care in America," announced Rep. Alan Grayson (D-FL) on the House floor Wednesday night. Taking out a chart, he continued, "Here it is.

The Republican health care plan for America: 'don't get sick.' If you have insurance don't get sick, if you don't have insurance, don't get sick; if you're sick, don't get sick. ...

If you do get sick America, the Republican health care plan is this: 'die quickly.'"


The speech generated instant controversy as offended Republicans accused him of degrading "the integrity and proceedings of the House" (even though GOP lawmakers have been making absurdly false claims on the floor about Democratic plans for months). While Grayson later admitted that his hyperbole was "tongue-in-cheek," he stood by his statement and refused to apologize...to the GOP. "I apologize to the dead and their families that we haven't voted sooner," Grayson said, referring to the thousands of Americans who have died because they lacked health insurance. Grayson's comments highlighted a sad truth: Too many Americans get sick and face crippling medical debt as a result of either having no health insurance or having to pay high premiums charged by private insurers. Unfortunately, the Republican solution is to keep the status quo or make the situation even worse.

THE STATUS QUO: Many Americans do indeed die simply because they can't afford medical care. According to a recent Harvard Medical School study, nearly 45,000 Americans die each year -- one person every 12 minutes -- because they are not covered by health insurance. "We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease -- but only if patients can get into our offices and afford their medications," said the study's lead author Dr. Andrew Wilper. Although having private insurance should make this better, high deductibles and other expenses can still result in unaffordable bills. In fact, 78 percent of people who filed for bankruptcy because of medical costs had health insurance, underscoring the importance of not just extending coverage to the uninsured, but also shoring up inadequate coverage. In addition, many people who went into medical bankruptcy had private coverage, "but lost it when they became too sick to work," concluded a Harvard University study. "Nationally, a quarter of firms cancel coverage immediately when an employee suffers a disabling illness; another quarter do so within a year." The "proportion of all bankruptcies attributable to medical problems has increased by 50%" since 2001, and will continue to rise without significant reforms to the health care system.

EXACERBATING THE STATUS QUO: "Just say no! Just say no! Just say no! Now Republicans -- that's going to be our chant from now until Election Day," declared Rep. John Shimkus (R-IL) as recently as August, making clear that he and many of his colleagues want to keep the status quo on health care. "There are no Americans who don't have health care," Rep. Virginia Foxx (R-NC) has said, agreeing with Shimkus. "Everybody in this country has access to health care." There is no unified GOP alternative health care plan (even though on June 17, Missouri Rep. Roy Blunt told reporters that he "guarantee[s] you we will provide you with a bill"). House Minority Whip Eric Cantor (R-VA) recently faced heat from constituents who demanded to know, "What is your substantive proposal to meet these real everyday problems that people have? Where's the beef?" Republicans claim they have introduced 37 health care bills. But as the Center for American Progress has noted, "[E]ight of the ideas have already been incorporated into Democratic legislation; five lie outside the jurisdiction of the relevant committees; and five have been around for more than a decade, so Republicans could have enacted them when they were in power." A close look at the GOP's so-called "principles" shows that they would break-up employer-based coverage, endanger the coverage of Americans with pre-existing conditions, and drive-up health care spending. In the Senate, Republicans have been spending time introducing frivolous amendments to the Finance Committee's legislation, such as Orrin Hatch's (R-UT) amendment to raise the excise tax threshold "for any state with a name that begins with the letter 'U,'" or John Ensign's (R-NV) idea to strike the word "fee" everywhere it appears in the bill and replace with the word "tax."

INSURANCE INDUSTRY CONTROL: The sole group rooting for maintaining the health care status quo is the insurance industry -- and it has managed to get key lawmakers on its side. Sen. Pat Roberts (R-KS) made clear he was one of those individuals when he called for a provision that would allow health insurance lobbyists "at least 72 hours" to read the bill. A recent Center for American Progress Action Fund analysis found that of the 534 amendments that have been offered to the Senate Finance Committee's bill, at least 47 of them directly reflect the health insurance industry's wish list. Indeed, in the last two and a half years, the health insurance industry has spent more than $585 million lobbying Congress to protect its investments in Medicare Advantage, defeat competition from a public option (or even a cooperative), and preserve policies that allow it to attract a disproportionate number of healthy applicants. Predictably, health insurance stocks shot up when the committee voted down two amendments that would have created a public health insurance option, which is favored by the majority of Americans. "We are pleased by the rejection of both the Rockefeller and Schumer amendments," said Tom Currey, president of the National Association of Insurance and Financial Advisors. However, Senate Majority Leader Harry Reid (D-NV) has promised that we "are going to have a public option before this bill goes to the president's desk."

Commentary and Opinion , Health Care | By doctormatt | 6:38 PM

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