National NOW Foundation Times >> Spring 2009  >> Article

Health Care Reform -- Will the System Still Be Sick?

By Jan Erickson, Director of Programs, NOW Foundation

At last, the move is on to do something about our national health care crisis -- though what the final plan will look like is still a huge question mark. President Barack Obama convened a health care summit in early March at which members of Congress, unions, health care industry officials and policy experts discussed reform options. But given the extensive participation of insurance companies, hospital associations, the pharmaceutical industry and other medical professional groups, it is doubtful that a reformed system will be truly universal and affordable.

The Urban Institute estimates that 22,000 adults died in 2006 because they lacked health insurance. FamiliesUSA estimates that nearly 90 million people -- more than one in three non-elderly persons -- went without health coverage for part or all of 2006-2007, with four out of five of those individuals members of working families.

According to the National Coalition on Health Care, total health expenditures in 2007 were $2.4 trillion ($7,900 per person). This is increasing at the rate of 6.9 percent per year -- twice the rate of inflation. The annual premium for an employer group health plan covering a family of four averaged nearly $12,700. These costs are beyond excessive and rising fast, clearly not hindered by "competition" in our private insurance system. Conservatives and business interests assert that competition will lower health care costs, but that has not been our experience. On the other hand, a single-payer approach like the Canadian system could cut out 30 percent of those costs or more.

A tragic fact of political life is that private insurance companies and other for-profit health entities maintain extraordinary influence over government decision-making. The tens of millions of dollars they provide for election campaigns corrupt the process, potentially preventing Congress from making the best decision on health care reform.

Some observers speculate that the long-awaited health care reform bill being crafted by Sen. Edward Kennedy's (D-Mass.) Health, Education, Labor and Pensions Committee will be a health insurance mandate like the one recently adopted in Massachusetts. By law, every adult in Massachusetts must purchase health insurance -- an insurer's dream -- and with everyone insured the costs were predicted to decrease.

The problem is that during the two years the plan has been in effect, total costs for health care have increased by more than $2 billion. To pay for that additional cost, Massachusetts is draining budgets for community health centers, HIV/AIDS care and other programs for low-income people. Only half of the previously uninsured in that state are now covered, and many very ill people are worse off. Meanwhile, insurance companies spent millions to narrowly defeat a 2008 ballot initiative in Massachusetts that would have authorized a single-payer system.

NOW supports the single-payer approach, as detailed in the Expanded and Improved Medicare for All Act (H.R. 676) which would require that the government pay private health care providers directly to care for those who need medical attention. Treatment for any medically-necessary condition could not be denied. Private insurers would be prohibited from offering policies for basic health care, although they could offer supplemental policies for services that are not medically necessary, such as cosmetic surgery. Patients would be free to choose any doctor they wanted.

NOW has backed single-payer since 1993, when members adopted a resolution at our annual conference declaring that health care is a right and not a privilege, while correctly noting that women are charged disproportionately higher rates. The resolution identified a variety of health needs especially important to women, such as reproductive health care covering the full spectrum and without limitation; care for diseases that predominantly affect women, such as endometriosis and chronic fatigue syndrome; and adequate home nursing care and long-term care, among many others.

Women's groups are gearing up for the national debate, determined to promote these "bottom-line" aspects of caring for women's health. For years, NOW activists have been speaking out at public events about the need for a single-payer health care system, and NOW will continue to push the envelope by demanding that the final initiative -- if it aims at reforming the private insurance system -- also include a public-funded, single-payer plan. Already, insurance company lobbyists are attacking the idea of a public plan, fully aware that this is the most cost-efficient way to provide universal coverage.

Women's rights supporters should speak soon with their members of Congress about the need for a Medicare-style plan that will cover everyone, reduce costs, and ensure that women receive the full range of reproductive health care. A health-care reform bill is expected to be ready for floor votes by August or September of this year. Check NOW's web site for updates on this critical issue.