Reform Now or Regret Later
September, 2009
by Shadi Bushra
It has long been a vague and distant goal of the left to reform the healthcare system. But now, the dream seems closer than ever to realization. With record high uninsured and skyrocketing costs, it is the ideal time to play catch-up with the rest of the world’s developed nations by guaranteeing health care for all citizens.
Regardless of the differences between ideological poles on how to address the crisis, what can be agreed upon is that reform of some sort is necessary for America’s long-term viability.
At the moment, there are 47 million Americans without health insurance. If one of their children get sick, they’ll scrape up the money for the treatment. If they fall seriously ill, they face bankruptcy to combat the disease. If they are in a car accident or other immediately life-threatening situation they brave the lines of the emergency room for taxpayer-provided care.
However this intervention by government only at the most dire stages of care is both inefficient and inadequate. By giving the uninsured no recourse but to utilize emergency rooms, an inordinate amount of local and state budgets are earmarked to support these overcrowded emergency rooms turned clinics. Any form of preventative care would ultimately reduce the burden on the taxpayer.
An equally pressing problem is that of underinsured Americans. Most tragic is that most underinsured don’t realize that they have insufficient coverage until they need to make a claim, often a costly one. Companies are also known to cancel entire policies due to a single misstep in the initial application process, regardless of whether or not that mistake is even related to the cancer or other terminal illness. Entire families can lose their coverage. A Congressional investigation has shown that the practice saved three large insurers $300 million in five years.
In other words, it has cost the ill and the ailing, the health care providers, and taxpayers $300 million over five years.
A common misconception is that only the poor are unable to obtain coverage, however there are other barriers such as “pre-existing conditions.” In addition to charging higher premiums, some will outright refuse to cover someone for an unrelated “pre-existing condition.” For example, having contracted hay fever may prevent one from receiving care for any respiratory illness. According to an August study done by the Health and Human Services, one in ten people with cancer were unable to find health insurance, and 6% lost their coverage after being diagnosed.
Nine states allow insurers to deny coverage to victims of domestic abuse, citing it as a “pre-existing condition.”
Despite also having to cope with gaps in coverage and rising premiums, America’s seniors are virtually the only demographic with universal care. However, according to a New York Time article from August, Medicare will cost Washington $480 billion this year. That is, 13% of the federal budget and nearly 3.5% of our GDP. To call it unsustainable is an understatement; the White House has predicted the Medicare fund will run out in 2017. It has long been known that the retirement of the baby boom generation after 2010 will strain the program; by 2018 there will be an estimated 30% increase in the number of beneficiaries.
An even greater threat comes from rising health costs; average spending per beneficiary will increase 50% over the same period.
Medicaid, whose enrollment is tied not to a naturally aging population but to economic conditions which push families into the lower income brackets it serves, is now experiencing record enrollment as well. A 2008 Actuarial Report by the Department of Health and Human Services on the financial outlook of Medicaid reported that Medicaid provides care to an estimated one of every six Americans, at a cost of $333 billion in 2007.
Between Medicare and Medicaid, then, one-fifth of the federal budget is already dedicated to providing coverage to those shunned by the private sector. Reform may be the opportunity to reduce this burden while widening the net of coverage.
America is the only wealthy, developed, industrialized nation that does not ensure the health of its citizens. Despite spending more of our GDP on healthcare than any other nation, our system is ranked 37th by the World Health Organization (WHO). If there is any endeavor worth its cost, it is not ill-conceived invasions, returning to the moon, or subsidizing defense contractors; it is the sustainable, healthy, equitable growth of our nation.
If the insurance companies are willing to provide comprehensive care at affordable rates, all the better. But since over seventy years of employer-based healthcare have proven otherwise, there clearly needs to be an option outside of the private sector.
Whether this turns into a government-run healthcare system, or simply greater support for the working class in the form of subsidies and insurance regulations is open for debate; what is not is the fact that our current system of health care has utterly failed the 75 million un- and underinsured Americans.
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