Health care reform — the buzz phrase that has been on everyone's lips and on the front page of all major newspapers since early in the summer. However, despite the headlines and the promises of politicians, we are dangerously close to failing, once again, to produce coherent, lasting health care reform.
The debate over reforming the American health care system started long before this past June, the presidential race in 2008 or even the 1990s. Theodore Roosevelt's campaign platform in 1912 included universal health care coverage and other radical positions including women's suffrage and more adequate workers' compensation programs. In Franklin Delano Roosevelt's New Deal, implementation of a government-run health plan to complement unemployment insurance and social security programs was discussed but never came to fruition. Harry Truman and John F. Kennedy both pushed for healthcare reform, but a fear of socialized medicine quickly brought the debate to an end. Health care reform advocates won a victory in 1965 with the creation of Medicare and Medicaid, extending coverage to elderly, poor, blind and disabled Americans.
Since then, very few components of the American health system have been changed or updated, aside from the creation of the Children's Health Insurance Program in 1997 and the controversial passage of Medicare Part D, whereby Medicare was extended to cover prescription drugs in 2003. President Obama campaigned on promises of reforming America's health care system, and Republicans and Democrats alike in the House and the Senate noted that the system was broken, and also promised change.
So what went wrong?
We've all heard the numbers: 46 million Americans are uninsured. National health care expenditures for 2009 will total about $2.5 trillion. The average family currently pays $12,300 for coverage. Something obviously needs to be done. However, ever-present political pressures have caused the existing bills in the House and the Senate to be marked up and ripped apart. This is how the political process works, but we need to be careful in making sure that if health care reform does indeed pass, it is something meaningful that will address the flaws in the system. In order to live up to what has been promised and sought after for years, this elusive health care reform should make coverage more affordable and provide options for American citizens who do not have insurance, including those who were previously denied coverage for pre-existing conditions.
Unfortunately, these basic tenets that should be included in any health care reform bill are now in jeopardy, as Republican voices have clung to a few sticking points. Besides the plainly ridiculous accusations, which I will not discuss here, Republicans have complained about the lack of tort reform and the claim that small businesses will go bankrupt if a health bill includes language mandating that employers provide coverage for their employees.
A focus on frivolous malpractice suits and the large awards handed out by juries for punitive and pain and suffering damages as a primary driver of health care costs makes sense, but oversimplifies the problem. Health care costs are high for many reasons, one of which is sky-high malpractice insurance costs. However, the state of Michigan's cap on medical malpractice awards has left malpractice insurance costs virtually unchanged. Additionally, despite numerous studies of the cost savings of tort reform proposals, no complementary studies have been undertaken to assess how quality of care for patients would change.
As for the claim that small businesses will not be able to handle mandatory coverage for their employees without going bankrupt, different plans provide different ways to deal with this very real and important issue. Obama's original health plan provided tax credits to help alleviate the financial burden. Specifically, one bill in the House gives a 50 percent credit for small businesses that employ fewer than 25 people who on average make less than $40,000 a year to put toward premiums. More importantly, small businesses are strained because they want to offer health care but cannot, since costs are so high. Fixing soaring health costs would significantly help.
I don't have a magic solution to fix rising health care costs that would benefit Americans from all income levels. I do, however, know that focusing in on fringe issues takes away from the original intention of the debate, which was to figure out a way to provide more comprehensive and better coverage for Americans. To my knowledge, there is no way to keep costs down and make insurance available to the average citizen without a government-run insurance option. The existence of a so-called public option will increase competition by providing an incentive for private companies to keep costs down. Pre-existing conditions cannot be a basis for rejecting individuals who seek health care. A comprehensive health plan needs to include these components.
Democrats and Republicans are both guilty of pandering and maneuvering without addressing the primary flaws in our health care system. The Democratic leadership has let us down in failing to fully back comprehensive reform, and, given recent developments, it seems that America will be disappointed by whatever form of health care reform eventually passes. All we can do is wait and see what happens, and hope that we don't have to wait another hundred years before the debate resurfaces.
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Andrea Lowe is a senior majoring in International Relations and Economics. She is the president of Tufts Democrats
