Sun, Jul. 25, 2004
Contra Costa Times
GUEST COMMENTARY

Rose Ann DeMoro
Time to get serious on health care

FROM ALL THE talk, you'd think universal health care coverage is right around the corner.

Big HMOs, hospital corporations, foundations, business interests, public policy groups, senior organizations and large unions are among those calling for action. Many groups sponsored a national tour this spring to "cover the uninsured," carefully avoiding any mention of solutions.

Airwaves and newspapers are filled with exhortations for action. Seemingly every prestigious scientific institution has published reports detailing the problem.

When the chatter subsides it's time to ask, where's the beef? Since the train wreck that was the Clinton health plan, Congress is no closer to enacting genuine reform and most states are unwilling to go beyond discussing limited, incremental change.

Largely, the stalemate can be tied to the flawed decision to make health care a commodity, wedding our health security to the marketplace and linking health benefits to employment. It's an inherent structure that has not and will not work for most Americans.

Verbal commitments to universal health care are for some a charade, a cover for tinkering with the current system to avoid substantive change.
Typical of such ideas is the notion that people without employer-provided benefits be required to purchase insurance, subsidized for the low income through tax credits, without any financial contribution by the HMOs and insurance giants that would reap gain.

Other proposals include increased public reimbursements to private providers without accountability for their failures to ensure safe care or expand access, limits on the ability of patients harmed by unsafe care to sue for damages, and voluntary price reductions by a pharmaceutical industry that has been indifferent to fair pricing practices.

These approaches would continue the disastrous policies of the past. Conservative think tanks and the health care industry assured us that unleashing the supposed magic of the market would resolve the health care crisis, produce increased access, lower costs and improve quality of care. They've failed on every count.

More than 53 million Americans were uninsured for at least part of the year in 2003, according to a recent survey by the Centers for Disease Control and Prevention. The uninsured obtain less preventive care and are more likely to delay seeking treatment for pneumonia, chest pain and other diseases, reducing the chance for life-saving interventions.

Delayed care, along with predatory pricing by hospital and drug corporations, are helping to produce spiraling costs.

More companies are raising employee co-payments or deductibles, limiting covered services, or dropping benefits entirely, thus accelerating the crisis.

Tens of thousands die each year as a result of preventable hospital errors. Inadequate registered nursing staff causes one-fourth of all preventable deaths and permanent injuries reported to the agency that accredits hospitals.

Americans are more than ready for reform. A national poll last fall found that 62 percent would prefer a universal system to provide health coverage.

The only way to achieve genuine universal coverage is an entirely new paradigm, based on both full access and a single standard of care. Such as system must also offer uniform, comprehensive benefits; safe caregiver staffing; public regulation of corporate health care mergers and closures; priority to health care problems associated with race, gender or socio-economic status; prohibitions on dumping patients into overburdened public hospitals and medical redlining whereby providers only serve the healthiest, and thus least expensive, patients; and new mechanisms to make corporations accountable for funding a more human health care system.

Fundamental overhaul is the only way to transform our current profit and market-driven healthcare industry into a system based on safe, therapeutic care for everyone.