The Fight For Health Care Reform Must Continue
As President Obama speaks to Congress and the nation this week in his State of the Union address, I hope he will make clear three important points about health care reform:
- When it comes to the need to make good health care affordable, nothing is different today than it was yesterday.
- It is imperative that we put a down payment on the promise of health care reform today by passing a health reform bill.
- Passing a health reform bill now is just the beginning of health care reform, not the end.
1. When it comes to the need to make good health care affordable, nothing is different today than it was yesterday.
The cost of health insurance and health care keeps rising:
- Since 1999, the average combined cost of health insurance premiums for family coverage paid by employers and workers combined has climbed 131 percent to $13,375 in 2009 (PDF). Meanwhile, the average family income only increased an average of 19 percent between 2000 and 2009 (PDF).
- The total cost of insurance and out-of-pocket medical costs for a typical American family of four in 2009 was $16,771, compared with the 2008 figure of $15,609, a 7.4 percent increase.
- From 2003 to 2007 the percentage of Americans in families with problems paying medical bills increased from 15 to 19 percent, or 57 million Americans.
- If current trends continue, annual health-care costs for employers will rise 166 percent over the next decade — to $28,530 per employee.
The number of people without insurance keeps growing:
- Health insurance premiums have risen so high that experts forecast 52 million Americans will be uninsured in 2010.
- Among the uninsured, 80 percent are in working families (PDF).
- People without health insurance are more likely to delay medical care, to get less care and to die when they get sick. The lack of health coverage causes 45,000 deaths each year in the U.S.
- In 2006, the U.S. economy lost as much as $200 billion because of the poor health and shorter lifespan of the uninsured.
The benefits covered by health insurance keep shrinking:
- Since 2004 employees have had to increase their cash outlays for health insurance copayments and deductibles by 40 percent. The monetary value of employer-based health benefits declined from 2004 to 2007 (PDF) as American families spent more of their own money.
- Sixty percent of people who filed for bankruptcy had medical bills they could not pay. Of those people, more than 75 percent were overwhelmed by medical debts while insured.
- Enrollment in low-premium, high-deductible health insurance plans, known as "consumer-directed health plans," rose to 8 million in 2009 (PDF) as more companies herded workers into the coverage whether they wanted it or not. That is a 250 percent increase since 2006.
2. It is imperative that we put a down payment on the promise of health care reform today by passing a health reform bill.
The fight to guarantee everyone access to good affordable health care in the United States has been raging for decades. As the struggle has intensified and been brought to national prominence in the past year, it is essential that we get the ball of reform rolling by passing a bill now and then continuing the hard work of improving it. Otherwise, it might be another decade or two before health care reform is back on the national agenda as happened after Clinton's reform efforts collapsed.
Even the Senate health reform bill, as imperfect as it is, provides important reforms and new regulations that will improve the access of millions of people to the health care they need.
3. Passing a health reform bill now is just the beginning of health care reform, not the end.
The health insurance regulations and premium subsidies included in the Senate bill (PDF) constitute a good start on reform. Passing those reforms would begin to fulfill the promise of health care as a right for all in the United States. But it is just that, a beginning, not an end.
If the Senate bill is passed, the work must continue to ensure all Americans are covered, health care inflation is brought down, quality is improved and we can all afford the health care we need well into the future.
If the Senate bill is passed immediate fixes can be passed through reconciliation in the Senate. These include:
- Fixing the excise tax.
- Improving the subsidies for people with low incomes.
- Making the health insurance exchange national instead of state-based.
- Adding a public health insurance plan option.
Even that is not the end of reform, however. We need to expand comprehensive affordable health care coverage to everyone. We need more payment reforms to improve the quality of care while lowering its cost. We need to educate people on the fact that quality care does not mean getting lots of expensive tests and treatments, but getting the appropriate test and treatment. Many more changes will be needed as we go forward and adjustments will have to be made as reforms are implemented.