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September 9,
2009
Column #1,463
Reforming Health Care
By Mike McManus
First, you might ask, "Why should a column called `Ethics & Religion" take a
stand on a political question such as Health Reform?"
Jesus said, "I have come that you might have life, and have it abundantly." In
today's context, it means that every American deserves access to health care
that he/she can afford. As Ted Kennedy wrote the President: "What we face is
above all a moral issue; at stake are…fundamental principles of social justice
and the character of our country."
Five elements of President Obama's Health Care Reform merit support:
1. Insurance companies should be prohibited from denying coverage to those with
pre-existing conditions, prohibited from either dropping coverage after a
patient submits a big claim or be allowed to set a ceiling on benefits. The
President spoke of Illinois man who "lost coverage in the middle of chemotherapy
because his insurer found that he hadn't reported gallstones that he didn't even
know about. That delayed his treatment and he died."
2. Obama rightly said, "Individuals will be required to carry basic health
insurance - just as most states require you to carry auto insurance." Most of
those without health insurance are younger, gambling that they won't get sick.
Their inclusion will help bring down the cost for others.
3. The cost should be subsidized for lower income people, but not for those with
incomes up to $88,000 for a family of four as House bills require. Such a price
tag is a major reason why the total cost is a staggering $1 trillion over 10
years.
4. Most employers should offer health care for employees, though "95% of all
small businesses…would be exempt from these requirements," the President said.
5. Insurance companies should be allowed to sell policies across state lines.
It is wrong in Alabama that one company has 90% of the business.
On the other hand, this column has opposed "free lunch" politics of both parties
- endless tax breaks by Republicans and trillion dollar health plans by
Democrats. Even those earning $30,000 can afford to pay part of the cost of
health care.
Obama said "Under our plan no federal dollars will be used to fund abortions."
Sadly, that is simply not correct. House committees defeated 11 attempts to prohibit using
public funds for abortion.
Reasonable people will disagree on whether abortion is morally right or wrong,
but there has been a consensus in America since passage of the Hyde Amendment in
1976 that public funds should not subsidize it. Polls reveal opposition to
public funding by 2-1 to 3-1.
During the campaign, President Obama championed passage of a "Freedom of Choice
Act" to "provide all essential services, including reproductive services." His
campaign confirmed that "reproductive services" included abortions. Won't he
fulfill his campaign promise?
Most important, Obama acknowledged that "reforming medical malpractice laws can
help bring down the cost of health care," a position Republicans have urged, and
Democrats have opposed. He only proposed "demonstration projects," however. The
CEO of a southern hospital told me, "Defensive medicine due to fear of being
sued costs between $50 - $100 billion annually." A more serious commitment by
Obama might win Republican votes.
Encouragingly, Obama proposed a $900 billion program, $100 billion less than the
least expensive House bill. However, he claimed the bill "will not add a dime to
our deficits." How will it be paid for? He said, "Reducing waste and
inefficiency in Medicare and Medicaid will pay for most of this plan." That
simply is not credible.
More fundamentally, the President claims his bill will slow the growth of health
care costs. How is that possible when he is substantially expanding health care
entitlements to 30 million people? Increased demand for a fixed number of
doctors and hospitals will drive up costs.
Finally, with the long-term bankruptcy of Medicare in the near future, plus this
$900 billion bill, it is essential to end "fee for service" medicine, in which
doctors and hospitals are paid for each service rendered.
A better answer is move all Americans into prepaid group practice. My family
has been part of Kaiser-Permanente for 25 years. We have paid a flat fee, which
did rise over time, but have had full health care from physicians who are paid a
salary. My life has twice been saved by Kaiser's timely care. Pre-paid group
practice offers quality care at a reasonable price.
On balance, however, a Health Care Reform bill should be passed, especially if
its costs are trimmed, malpractice reform is added, and the President decides to
live up to his new pledge to explicitly prohibit public funding of abortion.
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