Where's the Outrage?

Over four years ago Sen. John Edwards, during a debate with Darth Vader VP Dick Cheney, talked about the two Americas. When Sen. Edwards ran for president in 2008, he also talked about the two Americas. He was talking about the very rich and everybody else. When you look at this debate they were having over healthcare, the debate has been characterized as a moral issue for covering those who don’t have healthcare. We’re talking about the poor or the working poor. I think it’s a lot more than that.

I think John Edwards was partially right. I think that America is really divided into three distinct groups: the poor, the rich and those of us who are in between. I like to talk about those of us who have “adequate health insurance.” For 90% of the medical ailments that may come up during our lifetime, these folks who have “adequate” health insurance will be fine. Their health insurance will suit them just fine. If you have a ruptured appendix, an uncomplicated heart attack or a gallbladder attack, your insurance will cover you and you’ll be back on the job in no time. On the other hand, if you’re in a major car crash and have a head injury or you have a significant pelvic fracture requiring prolonged rehabilitation, your insurance may only cover part of your overwhelming expenses.

An article in the New York Times, published yesterday, is unfortunately the typical variety of sensational case report which dominates the healthcare discussion. This article, which is probably accurate, describes the personal pain and suffering that medical bankruptcy has bestowed upon several people. The article never pulls back and shows us the whole picture. What do all the medical bankruptcies in the United States do to our economy? What happens when thousands of Americans have to sell their homes because of a medical bankruptcy? According to recent study, medical bankruptcies affect about two million Americans every year. (I’m not sure how you define “affect” in this context.) Average out-of-pocket expense is over $11,000 before bankruptcy. Remember, these are Americans who have insurance.

This is what the healthcare debate is about. It’s about fighting for you and me. It’s about fighting for all Americans. We need universal healthcare. We need a public system that will cover all Americans. No more medical bankruptcies. We need a system that is not going to bleed us dry. We need a system that will improve our healthcare and help us live happier, healthier, longer lives.

“Underinsurance is the great hidden risk of the American health care system,” said Elizabeth Warren, a Harvard law professor who has analyzed medical bankruptcies. “People do not realize they are one diagnosis away from financial collapse.”

Here’s how we get there. Medicare and Medicaid will be rolled into this universal healthcare. The federal government will be allowed to negotiate with pharmaceutical companies and medical product companies, both of which will drive down costs. Primary care physicians will be paid to take care of a population of patients. They will be given added incentives if their population of patients who are in fact healthier at ,the end of every year (better sugar control in their diabetic patients, better blood pressure control in the hypertensive patients and better weight control in their overweight patients — these are just a few examples). Patients who adhere to their doctors regiments and lose weight, stay on a strict diet and monitor their sugars will necessarily be given tax rebates. All of this will be driven by proven medical data. The medical studies will be paid for by the $700 billion that we will save by excluding insurance. Patients can still choose their own doctors and go to their own hospitals.

Finally, there are some who have bemoaned the fact that insurance companies have been made the villains. Insurance companies, for the most part, deserve their reputations. Even with complete universal healthcare coverage, insurance companies will still have a viable product to sell to the wealthy. They will sell supplemental insurance. Universal healthcare will be driven by the best medical data that is available. For those Americans who want treatment outside of these constraints, supplemental insurance may be able cover some of these costs.

For me, the bottom line is doing the right thing for America. The right thing is universal healthcare.

Update: An interesting article on healthcare reform was sent to me by a good friend. I’ve been arguing that healthcare reform, universal health care, makes sense for a number of reasons. I’ve tried to stay away from finger-pointing and name-calling. It is clear that over the years the insurance and pharmaceutical industries have made huge profits. These these profits are not huge compared to Halliburton or Exxon-Mobil, but they are large compared to historical standards. Robyn Blumner, writing for the Columbus Dispatch, argues that the government is the only thing that can keep these large insurance companies honest. She is probably correct. We need more than simple regulation since, as we saw seen during the Bush administration, even the best written regulations can be ignored by an industry-friendly government.

Update II: DemFromCT has a great update on the Daily Kos of a new poll that was released from Quinnipiac. It is clear that most Americans want a public option. In spite of what Joe Scarborough said the other day that all ABC/Washington Post polls were skewed, in every single poll that I have seen recently supports a favorable public option. Are they all skewed? Interestingly, in the Quinnipiac poll, 72% of Americans didn’t want to pay any more than $500 per year for this public option. To me, this clears up the debate significantly. This means universal healthcare. This is the only option in which Americans don’t put out any more out-of-pocket expense. Any public-private option will cost billions if not trillions of dollars. So where’s the problem?

Update III: I meant to write about Sen. Kay Hagan over the weekend. Talking Points Memo had an article which suggested that Sen. Hagan was holding up universal healthcare and the public option in the Senate.

Here’s Senator Hagan’s contact information:
WASHINGTON, DC OFFICE
521 Dirksen Senate Office Building
Washington, DC 20510
Phone: 202-224-6342
Fax: 202-228-2563

RALEIGH OFFICE
310 New Bern Avenue
Raleigh, NC 27601
Phone: 919-856-4630
Fax: 919-856-4053

We need to call, write and fax.

Tags: Economy, Healthcare, Obama administration // 7 Comments »