By Cindy Gomez-Schempp
Que Paso columnist
(Originally published in the High Plains Reader October 5, 2009 by Cindy Shawcross*)
I was recently in DC representing People Escaping Poverty Project (PEPP), at a conference co-hosted by Reps. Peter DeFazio (OR) and Tom Perriello (D-Va.) with speakers including Steve Kagen, M.D. (D-Wisc.), House Majority Whip James Clyburn (D-S.C.) and attended by at least 36 congressional staffers. The Democratic members came to support a report released by the Center for Community Change and the Center (CCC) for Rural Affairs on rural communities’ attitudes toward health care reform. Moderating the event was Washington Post writer Ezra Klein who talked about the “true cost” of health care reporting that:
The average health-care coverage for the average family now costs $13,375, according to Kaiser [Family Foundation’s 2009 Employer Benefits Survey]. Over the past decade, premiums have increased by 138 percent. And if the trend continues, by 2019 the average family plan will cost $30,083. Washington Post, Ezra Klein, staff writer (Sept. 20, 2009) from “You Have No Idea What Health Costs, If You Did, You Might Just Want Real Reform.”
The report issued by CCC highlighted stories from people across many rural states (see http://www.statefairstories.org ). According to the report titled, “Sweet The Bitter Drought: Why America Needs Health Care Reform,” 82 percent of rural counties are classified as medically underserved areas. Medicaid and Medicare accounted for 60 percent of revenues in rural hospitals. Furthermore, during 2006, twenty-five percent of family farmers with insurance reported debt from medical expenses. There is a seventy percent chance that if you are a rural American you are underinsured or uninsured than if you are from urban America.
Those who spoke at the conference, like myself, talked in detail about how people in rural communities are facing the same problems the rest of Americans in the country face with access, affordability and quality of coverage; that we in rural America also suffer the same level of damage to our local economies due to the crushing burden put on small businesses, entrepreneurs, small companies, farmers and the self-employed. A poll of rural communities showed overwhelming support from all rural states for a public option. But being from ND, I already knew all of that and had already heard time and again from its people; how health care costs had broken them; how they lost a loved one because they couldn’t continue coverage; how many of them don’t even have health care. After listening to the speakers and the members express their support, I walked out of the conference with a feeling of hope.
Unfortunately, when I visited my own member’s office (Sen. Conrad) and listened to many of the members of the Senate finance committee that evening on C-Span, I was left with quite a different impression of our health care future. Sen. Conrad’s staff did explain that he would not support Sen. Rockefeller’s amendment which had a pubic option because it tied costs to Medicare reimbursement rates, and this would hurt North Dakota. However, Conrad did not vote for Sen. Schumer’s amendment either which also contained a public option and did not tie rates to Medicare.
Although the Senator’s Aids (both in Fargo and D.C.) repeated that the senator was “focused” on health care reform and acknowledged the problems with the current system, I could not get a response from anyone as to why the senator could not support a public option. I was told by one aid in D.C. that there are not 60 votes for a public option, but Conrad’s “co-op” has nowhere near 60 votes either, so this left me quite confused about what the senator will do to help people desperate for health care coverage in North Dakota.
I decided to look for answers elsewhere. As I listened to others on Capitol Hill while in D.C., and later on C-Span and on talk radio and TV, I realized that despite all the pleas, the common sense, and the overwhelming support for a public option in health care reform, there were some very frightening arguments in opposition.
Here is what I learned: Apparently, there are dozens and dozens of reasons why we should not pass a health care bill with a public option. To be fair, I cannot do justice to all the arguments I have heard, but here are some of them:
More Fraud and Abuse
If you thought that only the insurance companies can gouge you (and commit fraud against federal government programs like Medicare and Medicaid) – but you would be wrong! If a “government run” option becomes available to people, that system could also possibly be abused by people who may lie about who they are. Of course this is conjecture, but the opposition supposes it could happen. Essentially, the message is that fraud and abuse of the “system” will still be there – but insurance companies won’t be the only ones perpetrating it if a public option passes.
When Joe Wilson felt compelled to scream “You Lie” at the president during his joint address to the houses of congress on health care, he wasn’t the only one who was thinking it. Most republicans and a small number of democrats also agree that Obama’s promises were false, especially when it comes to the cost aspect. Obama did promise that not a penny would be added to the deficit to fund health care reform. But, as I listened to the opposition, I found that insurance companies will be required to offer – – across the board – – a minimum of services and benefits (even for the cheapest of plans). This, many argue, will inevitably raise the cost of premiums for all. But wait, there’s more! Employers who are now not giving you raises because of exorbitant health care premiums will not be the only ones suffering. That is if you have a job or insurance to begin with, I’m assuming.
Unwanted Government Intrusion
Employers who otherwise did not offer insurance will now have to buy insurance. That’s going to cost them money they could have used to pay you more money! Instead of money, you will only have your health.
People who otherwise didn’t have insurance as small business owners, or self-employed persons will now be required to have health insurance. Subsidies will help people afford the insurance but there will still be costs that these people were not making before. So, if you wanted to spend your life without ever once having to see the inside of a doctor’s office, even if your life depended on it – – there go your rights!
And companies who purchased “Cadillac” plans for their executives would be taxed on any fancy “extras”. Won’t that discourage the wealthy to be healthy? What is even worse is that there will be a “cap” on how much insurance executives can earn! You may live longer due to having better health care coverage Americans, but you won’t be able to enjoy it on the mediocre wages you will earn (especially if you were an insurance executive)!
Your Current Coverage Won’t Exist Anymore
If a government-run option is available, opponents argue that no insurance company in the public sector will be able to compete with the low prices of the government-run plan. Therefore, in order to keep insuring their employees, employers will switch to the government-run plan. The plan you had, which you were probably happy with, won’t exist anymore. Essentially, the government will become the “Walmart” of insurance, offering discounted prices that no “mom and pop” insurance company will be able to beat. Pretty soon, all the small town insurance store fronts will be closed and the big government giant “public option” plan will be the only player in town.
In essence, the fear is this: a public option could affect capitalism, could raise your premiums, could decrease your coverage, and might lower your wages. For those of us without a job or health insurance, these fears are moot. But for the many Americans who still hold on to their jobs, and have insurance through their employers, these fears could just sway them to oppose a public option.
Your Health Care Will Be Rationed
Opponents of health care reform realize that with all Americans (or at least most) being able to finally access care – there will be a run on hospitals and clinics. There will be so many people, and so few doctors to treat all these new people that healthcare will have to be rationed. Again, this is an assumption, but a scary one. I was already aware of rationed care by health insurance companies – who currently decide what treatment is covered, who is covered, for how much, and for how long. So, I’m not sure who to be more afraid of, the insurance companies who are rationing my care or the “possible” rationing of care that is supposedly going to take place if a public option is passed.
According to the U.S. Census Bureau, about 20 percent of Americans did not have health insurance in 2008, and Americans are losing their jobs at an estimated rate of between 14,000 and 23,000 per day! So, if most people get their health care through employment, being unemployed puts thousands into the category of the non-insured daily. For those of us without adequate coverage or without insurance of any kind, there is no rationing. There is nothing. We just die. How many? Well, one study (by the Urban Institute) estimates 137,000 Americans died between 2000 and 2006 because of a lack of health insurance. The same study projects that between 2008 and 2010 another 7 million will lose their insurance. If job losses reach 10%, then it is estimated that another 6 million will lose their insurance. All tallied that would be 50- 60 million uninsured and un-cared for Americans.
What Do We Have to Lose?
After seeing arguments and fears of opponents of a public option, I have to say – I’ve seen scarier “B” list horror flicks. Nothing really scares the heebee-jeebees out of you more than being uninsured and sick, or dying. That is the type of fear that faces nearly a quarter of Americans daily (for those who are uninsured) and nearly all Americans who are under-insured or stripped of a stable financial future by exorbitant health care costs. So, even though the opposition’s fears are scary, they pale in comparison to the lump in your breast you cannot have checked or the ultrasound you can’t afford that will tell you if cancer has spread to your lymph nodes; the fear of leaving your children orphaned or watching someone you love die because they’re too poor to afford insurance in our sick-care system. The fear of dying trumps all else. So, what can we lose by adopting the public option?
As a country, adopting the public option means we will “lose” uninsured people. The Congressional Budget Office (CBO) projects that when fully implemented (health care reform legislation proposed in H.R. 3200) the number of uninsured nationwide will fall from 51 million to 16 million. In North Dakota, the number of uninsured would drop from 74,000 to 16,000 (a 78 % decline!). So, except for covering uninsured people, the distribution of insurance coverage would essentially remain largely unchanged under H.R. 3200 for North Dakota. In other words, people happy with their health care plans would keep what they already have and be unaffected. All those new insured persons will generate new revenue for ailing North Dakota hospitals and decrease the losses for uncompensated care. The public option would, according to CBO, literally save North Dakota hospitals millions. Although Sen. Conrad has proposed a co-op plan he hoped would gain bi-partisan approval, CBO assessed that co-ops will not work saying that “[T]he proposed co-ops had very little effect on the estimates of total enrollment in the exchanges or federal costs because, as they are described in the specifications, they seem unlikely to establish a significant market presence in many areas of the country or to noticeably affect federal subsidy payments” (emphasis added).
I believe North Dakotans are smart enough to see through the thinly veiled arguments to scare us out of fighting for our own lives…..and I’m not flinching. We’ve already lost too much to stop now. Contact your members and let them know how you feel!
**Questions and comments: email@example.com
*Original publication in HPR under the author’s former last name Shawcross and email. Updates to HPR’s website have inaccurately changed the name of the post publisher and date. Original post date listed above.
**Current contact email updated.