The stakes for ordinary American workers and families that are riding on the expected House vote on health-care reform this weekend -- possibly today -- could not be higher. At issue is whether Congress will at last impose reasonable controls on the health-insurance and medical industries to secure affordable health coverage for virtually every American.
If the House approves the bill, it will move to the Senate for final approval. If approved there, it will at last end the widening, haunting and inhumane prospect of early death and medical bankruptcies that plague every American who faces the loss of insurance coverage when one suffers severe illness, disease or disability.
At its core, the vote comes down to a quintessentially moral issue -- an issue which is paramount in the only industrially advanced nation in the world that remains without universal health care.
The root life-or-death issue
The root question is whether America will become a nation which continues a race to the bottom under the present terms of a medical and insurance industry complex whose practices throw sick and dying Americans under the bus every day.
If Americans want to live and work under that darkening specter -- where the healthy (so long as they remain healthy) are cherry-picked by insurance giants for coverage, and those with "pre-existing" medical conditions are denied coverage and care -- they should love the philosophy of the Republicans who are beating the band against reform.
Members of the party-of-no have united in lock-step against reform and promise to keep erecting obstacles to its implementation. Never mind the dismal annual trend of soaring costs that keep ballooning health insurance premiums far beyond the rate of inflation, and worsen the human cost both of care given, and care denied, every year.
Americans want key reforms
Ironically, a strong majority of Americans, as confirmed by a number of polls, want all the key elements of health-care reform -- community flat rates and an end to pre-existing conditions, exclusions, annual and lifetime limits on reimbursements, and arbitrary termination of insurance when policy holders become ill.
Scared by disinformation
The only reason some respondents say they oppose the overall reform bill is that they just keep falling for the broadside propaganda assaults that Republicans and the insurance industry keep throwing against reform. If skeptical Americans could cull the untruths spewed non-stop by Republicans, Tea-Partiers and the cable talking heads who vilely distort the financial and medical benefits, they would find all the multiple benefits in reform that they desire.
For starters, it will cost less in the first 10 years -- and significantly less over the long term -- than keeping the skyrocketing status quo system that now plagues the nation. The authoritative, nonpartisan, independent Congressional Budget Office -- the scorekeeper of costs for both parties' initiatives in Washington -- issued a report Wednesday which confirms that.
It shows that under reforms in the House legislation that Democrats are expected to vote on today, federal health care spending would cost $138 billion less than spending under current in the next 10 years, and $1.2 trillion less in the following decade. That means that the $940 billion cost of reform over the next 10 years would be significantly cheaper than the $1.078 trillion cost of keeping the status quo.
In addition, it would secure coverage for 32 million uninsured Americans (whose indigent care is now shifted to the policy premiums of the insured), and keep insurance affordable and secure for everyone who has insurance now. If would keep insurance bureaucrats from controlling your doctors and sentencing the ill to death by denying coverage. It also would let Americans who like their current policies and physicians keep what they've got, and provide them a secure option if they get laid off from their job or disabled, or if their company -- as many businesses have been doing for years -- decide they just can't afford to keep offering a company subsidized policy.
Why anyone would be against such a reform is a mystery. But Republican propaganda, false though it is, scares people because they don't know the facts.
Truths the GOP hides
Take the GOP charge that reform would slash $400 billion-to-$500 billion out of Medicare. In fact, it would pull most that sum out of the pockets of for-profit insurers to which Republicans gratuitously gave taxpayer-financed subsidies, taken from Medicare's budget, to entice them to compete against Medicare. They did that two simple reasons: to reward their insurance industry backers, and to begin cutting, and to eventually terminate, Medicare proper in favor of for-profit companies.
Conveyance of these lucrative subsidies, put into force under the Medicare Modernization Act of 2003 to kick off the Medicare prescription drug benefit, made it sweetly profitable for private insurers to lure seniors out of Medicare proper into their so-called Advantage programs. But benefits of the Advantage programs, like the private insurers' prescription drug formularies, vary widely, and are subject to random change throughout the policy year.
Moreover, they weakened Medicare proper by cutting its budget. Putting these funds back into Medicare proper would enable it to improve provider reimbursements and policy benefits, and to eliminate the huge doughnut hole in prescription drug coverage. Those are all good reasons to cut the Medicare's profit subsidies to private insurers and to strengthen coverage under Medicare proper.
Reform for fairness, security
Along with this change, Medicare also would at last be allowed to bargain with pharmaceutical companies for lower prices, and to create a basic comprehensive drug formulary that would better serve all Medicare enrollees.
Bringing accountability to the insurance industry and curbing its vast abuses is by itself worth reform for every American family. But building in other efficiencies, and bringing all Americans under insurance coverage by requiring and helping subsidize the purchase of insurance for all working families, will bring the greater lasting benefit of near-universal coverage.
For health care security, lower overall costs, systemic efficiencies, lower overhead for companies and greater job mobility for Americans now afraid to change jobs for fear of losing insurance -- the benefits of reform are just too great to leave on the table.
Democrats should approve reform, and Republicans should be ashamed for vilifying and hampering the humane and cost-effective quest to bring Americans the undeniably great benefit of the beginning of universal health care in America.