Food for Thought and Action: The state of the US Healthcare system

Today I went to a town hall meeting at the Benjamin Franklin Reform Democratic Club with Northwest Bronx for Change, where there was a forum on health care reform. The key speaker was none other than Tim Foley, the healthcare blogger for change.org. His speech was practically clearer than my entire Health and Medical Care class last semester. Here's what he said:

There are two Senate committees that work on healthcare reform: the Health, Education, Labor & Pensions Committee (HELP) (that Ted Kennedy and Chris Dodd are on), and the Senate Finance Committee (chaired by Max Baucus, and Chuck Schumer is on this committee). In the House, there is the “tri” committee, which Rep. Rengel is on. The bills are making their way through Congress right now and they will be voting on healthcare reform in the next four weeks. Rep. Eliot Engel is on the Western Hemisphere Subcommittee on the Foreign Affairs Committee, and is also on the Energy & Commerce Committee, Healthcare Subcommittee. He is the senior one out of only two New Yorkers on the committee.

The US spends more than any other country in the world on healthcare – $2.4 trillion – which works out to $800,000/person. Yet our healthcare system is only ranked 37th in the world according to the World Health Organization (2002 report)! This is in comparison to the next highest spender on healthcare – Switzerland – which spends a mere $4500/person. Mind you, they cover all their citizens. People say the US shouldn’t ration its healthcare the way many more socially minded Europeans do, because they don’t want to wait on a line. But at least their citizens are on the line! In the US, healthcare is rationed too – people just don’t talk about it. There are people who unfairly aren’t even allowed onto the line, the way our system is now. The uninsured, the underinsured without jobs, the homeless. Those that have minimum wage jobs that cannot afford better healthcare, and the ones who get laid off from work and subsequently can't afford insurance anymore. They should at least be given the option to “get on the line,” right? If the ability to take care of your health is a universal right.

There are 50 million people without insurance in the US. This does not count the underinsured, which is another 25-30 million people. And 62% of personal bankruptcies involve personal debt. In many of these situations, the people had insurance at the time they spent the last of their life savings on medical costs.

Back in the fall, both Barack Obama and Hillary Clinton advocated for giving us a choice in healthcare insurance: if you like your current private insurance, you could keep it, but if you want to, you should be able to have an option for public insurance. The public plan would be better at controlling costs. Private insurance spends 20-30% of its money on administrative costs, while Medicare only spends 3%. This is because Medicare, being a public option, only wants to make people healthier and doesn’t get a profit. Medicare Advantage, on the other hand, uses 12-15% of its money on these costs, because it is privatized.

Private insurance is tied to your job. Therefore, private insurance companies don’t have a financial incentive to make sure you’re getting the care you need, because you could only be at that job for five years, and then the insurance company won’t care about you anymore. Meanwhile, the public plan presumes you’re a customer for life, so has more of a stake in making sure you stay healthy, because it knows it’ll have to pay for you later on down the road if you get sick. This new National Health Exchange would give a number of plans to choose from, all of which would have the same minimum standard of benefits. There would also be a subsidy based on income. Unfortunately, all of this is unlikely to be enough of an incentive for private insurance to change their business model, and they will still be competing with themselves. 94% of insurance companies in this country have been deemed noncompetitive.

The hope is that this whole plan will be able to compete with private insurance companies.

Hillary Clinton proposed a very good healthcare plan years ago, when she was the First Lady. However, this plan got shot down during the Clinton administration. Obama is still for giving us this option of keeping what we have or switching over to this National Health Exchange plan, but he is worried that there won’t be enough support for it when it gets voted on, and doesn’t want to turn healthcare over to the Republicans again. So, while we are asking for a single-payer system, public plan option, he may compromise on it, just to make sure we get some change and not be back to square one with no change.

Rep. Engel is all for adding coverage for people with HIV before they develop full-blown AIDS. He’s also for providing treatment at home (as I wrote about in my paper from last semester), and providing coverage for pre-existing conditions. He personally knows the perils of insurance companies not covering pre-existing conditions, as his daughter was almost denied insurance based on her childhood diagnosis of pulmonary stenosis. Ted Kennedy is advocating for the inclusion of immigrants, children, and pregnant women. Senator Gillibrand has signed onto the 10 principles of Health Care for America Now!, which is the organization fighting tirelessly for the public option plan.

At this town hall meeting, there were postcards available for us to sign to send to Senators Schumer and Gillibrand. This is what they said:

I want our country to be a place where everyone has access to quality health care, and I would prefer a single-payer approach to health care reform.
However, I also want President Obama to achieve his goal of healthcare reform this year, as a necessary step in his administration’s movement towards pro-people change.
Therefore, I strongly urge you to work for the inclusion of a public plan option at a minimum in the final health care legislation.

There were also postcards that on the front, read: “The citizens of NY demand comprehensive, affordable healthcare for all.” On the postcard, I wrote in some of the information I learned from Tim Foley, and some I already knew from my work on advocating for reform in coverage for nutrition services. It read:

The US has a “sick-care” system.
The US is ranked 37th in health, even though it spends $2.4 trillion on healthcare, more than any other country, by far. We need a choice, an option of a public plan. Private insurance companies have already proven they can’t solve the problem themselves. We need a single-payer approach, and significant dedication to prevention, including medical nutrition therapy and pre-diabetes coverage. Thank you. Kelly Moltzen, kmoltzen@nyu.edu

They need to hear from you too, because you can bet on the insurance companies being on their backs as well - and don't forget those companies have a lot of bargaining money. The National Healthcare Act in the House is HR676, which you can read more about on THOMAS and MedPAC. The bill would: