Obamacare: not enough

Bill Knight column for Thurs., Fri., or Sat., Oct. 24, 25 or 26

Americans for years have been annoyed and angered by escalating health-care costs, declining insurance coverage and millions of neighbors who haven’t been able to get health insurance, and the Affordable Care Act has started to cope with the latter problem.

But it does too little about controlling medical costs, pharmaceutical prices, and the driving force behind much health-care inflation: escalating medical costs and profit-driven insurers.

Amid the Tea Party tantrums about the new law being government taking over the health care too much, the opposite is true: Government hasn't taken over enough of the U.S. health care system.

So it’s too little. But it’s not too late.

There’s a practical approach – a single-payer health-care system. House Resolution 676: Expanded and Improved Medicare for All, is sponsored by U.S. Rep. John Conyers (D-Mich.) and 50 co-sponsors.

The nation has remained a republic with a free-market economy although the federal government for decades has ensured health care for citizens 65 and older. Won’t the country remain strong and free if government ensures health care for citizens younger than 65?

HR 676 would institute a single-payer health care system simply by expanding Medicare to everyone. It would cover everyone for all necessary medical care, including prescriptions, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental (including oral surgery), mental health, home health, physical therapy, rehabilitation (including substance abuse), vision care, hearing, chiropractic, medical equipment, palliative care, podiatric care, and long-term care.

It would end the big speed bump that the newly insured are discovering: co-payments and deductibles. And HR 676 would save hundreds of billions annually by eliminating the high overhead and profits of the private health insurance industry.

“[It’s a] struggle to build a nation where health care is a human right, where this right is not on the negotiating table to be traded against a decent living wage, and where the rich can’t get richer by blocking your ability to get your medicine, to see your doctor, and to have your life saved in a hospital," said Dr. Ed Weisbart, an M.D. and chair of Physicians for a National Health Program.

For employers and unions, “Medicare for All” would remove from negotiations a huge compensation problem: health care costs, which have been part of bargaining since World War II, when that benefit was a way to reward workers during a wartime wage freeze.

Eliminating health care from labor relations would let companies and unions concentrate on bargaining over real wages, hours and working conditions, and pay could rise economically for management, and for employees faster than the cost of living and any taxes needed to support Medicare for All.

Medicare has not been the threat the right-wing says it’s been. It’s popular and effective. However, for people not in Medicare, the threat has been the ridiculous and relentless increase in medical costs including drugs, and insurance premiums, deductibles and co-pays. Americans pay far more than people in other countries, says the International Federation of Health Plans – the United States spends twice as much per capita as other developed nations.

So, insurers pass these ever-rising medical expenses on to employers through more expensive premiums. Employers pass the costs to workers through diminished benefits. The cycle must stop. The buck “starts there,” with consumers, and we cannot continue.

From recent personal experience: I was hospitalized for an infection requiring an antibiotic IV for a couple of days. My bill is $5,600; my adult son broke his nose playing basketball a week before his new job’s benefits started, and anesthesia to deal with a hematoma alone cost him $600 and his final bill for the outpatient procedure is more than $9,000; my Dad needed a stent in one leg, an outpatient procedure that took about an hour. His bill is $50,000. But it's covered by Medicare.

In an open letter to Congress and President Obama, the AARP said, “It is clear that older Americans want the focus of the debate to be on reducing overall health costs.”

Despite the gridlock on Capitol Hill, there are precedents for more and better government involvement than the Affordable Care Act. The concept of controlling costs exists in Medicare reimbursement rates, based on a “sustainable growth rate” (SGR), set up to connect doctors’ pay to growth in the U.S. economy. Further, Medicare already negotiates with drug companies for prescription rebates – but ONLY in Medicare.

Organizing and action are required, and it’s beginning in some quarters. This fall, an Illinois Jobs with Justice chapter endorsed HR 676, according to retired union carpenter David Johnson, a delegate to the chapter from the Illinois Single Payer Coalition.

Again, the Affordable Care Act is too little, but it’s not too late.

[PICTURED: Infographic from Physicians for a National Health Program.]