HEALTH CARE: Only the Public Option can Resuscitate Reform
Published: October 30, 2009
The public health insurance option has been declared dead many times over the past few months. Monday, it was revived once again. Harry Reid's inclusion of a public health insurance option in the Senate legislation is a great step toward real health care reform. Now the real work begins in the Senate to bring the legislation to the floor and get the 60 votes necessary to pass the bill. Sens. Mark Warner and Jim Webb will have a critical vote on health care reform in the coming months and I urge them to support a strong public health insurance option.
If the past few months are any indication, there will continue to be a contentious debate on health care reform as we near the end of the year. Our senators will continue to be subjected to the sound and the fury thrown forward by the opponents of health insurance reform. Misrepresentations and outright untruths will continue to be trumpeted by those attempting to block reform. It is essential that our members of Congress be impervious to insurance industry lobbying and move forward quickly, as our current health insurance system is terribly broken.
As a family physician practicing in medically underserved communities in Richmond, I experience the failures of our broken system every day. I have chosen to work with patients who lack access to medical care, and I have seen my patient lists swell with the rising cost of health insurance and the rising unemployment rate. In the Richmond area alone, 62,000 residents lack health care insurance -- and nationally nearly 10,000 people per day lose their health insurance.
These staggering numbers affect the care I am able to give to my patients on a daily basis. I have had to work with patients to determine which of their prescriptions were most important, as they could afford to fill only one of them. I have had patients ask me to do only the barest of essential tests and procedures and to wait until Medicare kicked in before doing preventive and health maintenance care. Patients delay valuable and necessary care because of cost and lack of insurance coverage.
Meanwhile, for-profit insurance companies make enormous profits while working to deny care to patients. WellPoint -- parent company of Anthem, Virginia's largest insurer -- made $61 billion in profit last year. WellPoint has made a practice of rationing health care services by rewarding its own employees for rescissions and compiling an absurd list of pre-existing conditions that includes pregnancy. Studies have shown that patients who actively look to purchase health insurance are unable to do so 75 percent of the time due to cost or pre-existing conditions.
The current private health insurance system has had decades to address the health care challenges we face -- and has failed miserably. Our health care system ranks first in the world in terms of how much money we spend, but only 37th in overall performance, according to the World Health Organization. Health care currently makes up 16 percent of our nation's GDP, and is expected to rise to 25 percent of GDP by 2025. Even with this expenditure, one out of every seven Americans has no health insurance.
Over 50 percent of personal bankruptcies in the United States are the result of health care costs, and most of these patients had insurance when they first got sick. Public plans like Medicare and Medicaid are burdened with covering those patients with the greatest needs, such as seniors and the dis-abled, while private insurance plans cover a disproportionately large proportion of young, healthy patients who need less health care. Small businesses are unable to invest in growth because they are hamstrung by the ever-increasing costs of health care insurance for their employees. The ramifications of our flawed and failing system will continue unless we enact reform soon.
The only true path to health care reform is a strong public health insurance plan option. The inclusion of a public health insurance option in the Senate bill will set a standard for costs, coverage, and access that would force for-profit plans to be competitive and ease the cost burdens on small businesses.
As a country, this is our chance to have substantial health care reform. As a doctor, this is my chance to care for underprivileged and marginalized patients.
The public health insurance option is supported by a breadth of health care professional organizations and numerous other stakeholders. The next few months could dictate health care in this country for the next 30 years. If we fix our broken health care system now, the nation will benefit. If we don't, more and more people will be lost to the system.
I urge Warner and Webb to vote to begin debate on the floor and support a strong public health insurance option as part of Senate health care reform legislation.
Mark Ryan is a family physician working in Southside Richmond at the Hayes E. Willis Health Center, part of VCU Health Systems. Contact him at
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Reader Reactions
To anyone who might be tempted to, don’t delude yourself by thinking you’re your “brother’s keeper” and holier than thou by supporting “the public option”. Like a typical collectivist, you’re just saying - “hey- you with some savings over there - take some of your dough and give it to that guy over there who has a “need” I’ve determined to be more important than your right to keep your property”. That’s all your doing and it ain’t charity. It’s just self-righteous posturing to make yourself feel good. True charity doesn’t require third-parties.
I’m assuming that with that last statement civicminded is advocating for the abolition of the evil collectivist third party insurance companies, right?
The insurers do have a minor function; the simple task of money-changing; taking premiums and paying out in claims 20-30% less than what they take. They deserve no more than a small fee for such, as appears to be the case for the paperwork insurers do for plans within the Federal Employee Health Benefits program covering 9 million active & retired civilian workers at premiums much lower than the private sector, where average family coverage for one employee this year is $13,400 increasing somewhere in the 10-12% range for 2010.
Course the me-only crowd don’t care and would not support lower insurance costs for others, even when tens of millions of others and small employers would gladly see that $1,115 per month premium cost for one employee with family reduced to $587, $629, $682, $790, $839, as options of five Virginia plans (full premium).
Imagine what an employer and employee could do, if access to the $682 per month UnitedHealth plan (no taxpayer $; thus no skin off the “me-only” crowd)? Extra $433 per month, $5,000+ a year, for extra pay increases or enough saved among ten employees to keep from eliminating one existing job, perhaps hire one more.
What is lacks in reasoning is why the me-only folk seem to desire physical and financial suffering of others? Politics or plum eat up with hatred for others among our society? Oh well. There is always a few rotten apples somewhere near the bottom of the barrel.
It’s time to eliminate the insurance company middleman.
To anyone who might be tempted to, don’t delude yourself by thinking you’re your “brother’s keeper” and holier than thou by supporting “the public option”. Like a typical collectivist, you’re just saying - “hey- you with some savings over there - take some of your dough and give it to that guy over there who has a “need” I’ve determined to be more important than your right to keep your property”. That’s all your doing and it ain’t charity. It’s just self-righteous posturing to make yourself feel good. True charity doesn’t require third-parties.
one more time since I now see more of where you are coming from.
“I am not my brother’s keeper.“ I can not affect the bad decisions, life choices, etc. of others. That does not mean I would not help them in need as the current health system does. It may not be perfect but I have personal experience of the late life care given someone who could pay nothing. The me-only reference was how you unknowingly would likely place me, not how I am. But you can continue your attack of me or anyone else who disagrees. I wasn’t trying to change your opinion.
“I am not my brother’s keeper.“ ….No doubt, the lone wolf who strongly feels such, is not his brother’s keeper, although some who are not his brother, feel otherwise toward the me-only wolf.
On this very rainy day I drove to the Marine Corp Museum off I-95 exit 150 near Quantico, taking a 20-yr old Marine with me who is on a 72 visiting my wife and me. During dinner tonight we discussed loyalty; especially, loyalty as it relates to all our brothers and sisters during our short years of life, even those not blood related. The young man who may soon deploy to Afghanistan said if he saw any of his Marine brothers lying wounded in a street with bullets flying about, he would not hesitate in running to help save his brother, even if he knew not his name.
We have many brothers and sisters in need in our country and no, we are not expected to help them with normal wants of life; but when it comes to the basic need for life-saving health care; YES! WE DO! And damn any heathen who would care not.
“My final word on this post as I move on.”?….Good. Be gone from civilized people. As to final word, be prepared for your final word when God’s asks you, “Why?“
Health “care” reform has NOTHING to do with reducing the cost of health care (the $$ it costs to go to the dr) and is about regulating health care insurance. No other “insurance” industry is regulated by the govt. No one tells me that I HAVE to have life insurance, or dental insurance or HOW MUCH homeowners or car insuanrce to have. Insurance is about “risk assumption”.....controlling the cost medical CARE should be the focus not managing the country’s threshold for risk assumption…...
No, it’s because they don’t exist. But we are at opposite ends of argument anyway, so we both just try to get our points across.
“I am not my brother’s keeper.“
And if I don’t look out for myself, who will? And at my current life position I might even do better with the proposed plans, since my income would probably qualify for the lower costs or subsidized plan. I just don’t agree my kids, their kids and others should pay for me.
My final word on this post as I move on.
“maybe you can send me pictures of the US citizens dying in the streets”?
Why? Sight of such would not impact the emotions of one who is “me only”. After all, for the me-only’s of the world, life is never meant to be “fair”. For others who embrace a civilized society, as those in all other advanced nations who have universal health care at much lower costs than we, and for majority of Americans, the “all-only” civilized portion, the thought of fairness vs unfairness is never in doubt. The goal is to strive to make a society as fair as possible, not to accept the unfairness of humans most basic need; affordable health care; thus life itself.
Would hope some me-only wolves would consider cost-savings of universal health care delivery, but the negative desire to see others suffer outweighs our nation reducing overall delivery costs.
“the marketplace will take care of those issues”?...No, it will not. It will only take care of expanding profits until the nation collapses. Just as we see the Family of Five major financial institutions back to same practices that created the crisis of today, the Family of Five major insurers will continue to squeeze us dry.
I think the marketplace will take care of those issues. People will leave companies who drop insurance and those who dropped coverage will come back to it if its still a valuable benefit. Or maybe the employees would rather have the extra pay than health coverage? Many already do as one RTD poster noted in his company where employees turn down child coverage at only a $100 additional costs. These are personal choices.
So yes, I now have coverage and my main concern, you can call it me-only if you wish, is to continue that coverage and benefit. I see the current plans proposed as only costing me more for less benefit, while many who have failed to make their health coverage a priority will be asking me to help pay for theirs. Hey, life is never meant to be “fair”. But maybe you can send me pictures of the US citizens dying in the streets. As to the economy, the rising taxes on businesses, including those “rich” people making over $250,000/yr, who also run many small businesses, are more of a threat to jobs than lack of health insurance coverages to employees.
Those who oppose the proposed plans do not object to health care reform, just the proposed plans which change only some issues, most costly to premiums, and do little or nothing to improve health care or lower premiums. Plus we get to pay for it for 3 years before it takes affect. For those who refer to Repubs as party of “no” I call them the party of “KNOW”.
But thanks for responding.
Funny thing happened with my daughter’s employer coverage. They decided to have her pay more of the monthly premium but would increase her pay to cover. Guess they did not realize that costs them additional 7.5% in FICA costs and maybe other employer taxes. She would rather they pay the coverage and give her the 7.5%!
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