April 22, 2008

Guest Commentary: More insurance will not solve the healthcare crisis

ROSE ANN DEMORO AND ANN HURSTAnyone wondering why healthcare is such a central focus of the presidential race might want to ask Edwina Grayson-Melton of Mt. Sterling, Ky.“My father was self-employed and died with lung cancer at the age of 52,” she says. “He had to liquidate all of his assets, what little he had, to qualify for MA.“My sister-in-law has Huntington’s Disease, a terminal disease. They do not have health insurance. She does not qualify for Social Security after working 10 years in a local shoe factory and then for an employer who did not consider the proper deductions. They also do not qualify for MC/MA unless they liquidate assets or divorce.“The elderly family members have to purchase additional policies in order to pay for medications not covered by MC. My grandparents could not afford medications and had to balance living expenses versus medications ... often doing without medications. How ridiculous.”Sadly, Edwina’s story is not unique. She is one of more than 700 who responded in recent weeks to a National Nurses Organizing Committee/California Nurses Association ad describing the disparity of care available to Vice President Dick Cheney and members of Congress, and the rest of us (www.cheneycare.org).Their stories are a somber reminder of our misguided decision to tether our health to the commercial market. A market that has left 47 million Americans without health coverage, perhaps twice that many with inadequate insurance, and fanned an out-of-control system with skyrocketing costs.It is the reason why the United States spends twice as much per capita on healthcare as any other country in the world, yet, according to a January 2008 study by the London School of Hygiene and Tropical Medicine, the United States ranked worst among 19 industrial nations in preventable deaths.And it makes you wonder why the presidential candidates continue to encourage more reliance on the market and on private insurers who will not reign in those costs, and not guarantee our families receive the care they need when they need it.Sens. Hillary Clinton and Barack Obama have presented comprehensive healthcare proposals, but most of the fireworks have focused on their differing visions of who should be required to buy private health insurance.Mandatory insurance, however, is not universal healthcare, especially when insurers and other healthcare corporations can continue to charge as much as they want, and while insurers can still deny care.Sen. John McCain’s plan offers little beyond the dismal status quo. McCain’s top priorities are tax credits to encourage the uninsured to buy insurance, and increased corporate competition to limit rising costs.But once-a-year tax credits are of little help to those already facing financial distress in an imploding economy at a time when healthcare insurance premiums now average more than $12,000 per family. Not including skyrocketing deductibles, co-pays, drug and hospital charges, and other costs that have made medical bills the leading cause of personal bankruptcy.McCain’s view that increased competition will constrain costs is equally suspect. Under the stewardship of a market-friendly administration the past decade, premiums have jumped 87 percent, far outpacing inflation and wage increases.Insurance companies don’t compete by delivering more care or lowering prices. They compete by harvesting more customers and slashing their costs. The way they cut expenses is paying fewer claims, which is why they call care delivered a “medical loss ratio.”There is another approach, like the one used by all those countries that have fewer preventable deaths. In the United States it would look like an expanded and improved Medicare for all.It guarantees everyone has quality healthcare coverage, and eliminates the waste and bureaucracy reflected in administrative costs of up to 30 percent for private insurers.Perhaps most importantly, it takes decisions about our health out of the hands of insurance companies and their built-in economic incentive to deny care.Surely that is the real reform all Americans deserve. Rose Ann DeMoro is executive director of the 80,000-member California Nurses Association/National Nurses Organizing Committee, and a national vice president of the AFL-CIO. Ann Hurst is a registered nurse in Louisville. Contact them at leo@leoweekly.com