Wednesday, March 10, 2010

The American Battle for Health Care

Barbara O'Brien -- who blogs at Mahablog, and who occasionally writes for Crooks and Liars and Alternet -- reflects the frustration many Americans feel as they watch President Obama attempt to steer a health care bill through Congress. 

We tend to forget that Tommy Douglas faced many of the same frustrations and distortions in his battle to bring public health care to Saskatchewan. It was his drive and his courage which made Medicare a reality for all Canadians. Like Senator Kennedy, Douglas left a legacy which has long outlived him.

The benefits of public health care are myriad. In this guest post, Ms. O'Brien touches on just a few:

Would Health Care Reform Help You?

Many obstacles and stumbling blocks remain in the way of health care reform. The House and Senate bills will have to be merged, and then the House and Senate both will vote on the final bill. We don’t yet know what will be in the final bill, or if the final bill will be passed into law. Passage will be especially difficult in the Senate, where it will need 60 votes to pass. It is still possible that after all this angst, just one grandstanding senator could kill the whole thing.

But just for fun, let’s look at what conventional wisdom says will be in the final bill and see if there is anything in it that will be an immediate benefit to people with mesothelioma and other asbestos-related disease.

It is likely that the final bill will provide additional funding for state high-risk insurance pools. Currently more than 30 states run such pools, which are nonprofit, state-sponsored health insurance plans for people who can’t buy insurance because of pre-existing conditions. The biggest problem with such pools is that, often, the insurance they offer is too expensive for many who might need it. Both the Senate and House bills provide $5 billion in subsidies for state high-risk pools to make the insurance more affordable.

Under the Senate bill, beginning in 2014, private companies would no longer be able to deny coverage to adults with pre-existing conditions, nor could they charge higher premiums for people with pre-existing conditions. Until then, the state high-risk pools could provide some help.

Closing the Medicare Part D coverage gap — also called the “doughnut hole” — is another potential provision that could help some patients with asbestos-related disease. The “doughnut hole” is the gap between the coverage for yearly out-of-pocket expenses provided by Medicare Part D and Medicare’s “catastrophic coverage” threshold.

For example, in 2009 Medicare Part D paid at least 75 percent of what patients paid for prescription drugs up to $2,700. After that, patients must pay for all of their prescription medications until what they have paid exceeds $6,154. At that point, the catastrophic coverage takes over, and Medicare pays for all but 5 percent of the patient’s drug bills. The final health care reform bill probably will provide for paying at least 50 percent of out-of-pocket costs in the doughnut hole.

You may have heard the bills include budget cuts to the Medicare program, and this has been a big concern to many people. Proponents of the bill insist that savings can be found to pay for the cuts, and that people who depend on Medicare won’t face reduced services. But this is a complex issue that I want to address in a later post.

The long-term provisions probably will include many other provisions that would benefit patients with asbestos-related disease, including increased funding for medical research. Although there are many complaints about the bill coming from all parts of the political spectrum, on the whole it would be a huge benefit to many people.
— Barbara O’Brien
March 9, 2010


Flower Child said...

Because my wife and I have a son who has lived with his family in the US for the past 14 years, we have been following the evolution of possible changes to American health care with considerable interest.

That at this point in the debate you are so concerned about such marginal changes to your system - perhaps the most expensive health care system in the world, one which affords so few benefits to so many Americans - is saddening.

It appears that any compromise which Congress might reach will be based on the profit principle, a notion which is, with the possible exception of a greedy few (who might wish to profit from the misfortunes of the sick and the dying), utterly repulsive. Sarah Palin's exhortations to Canadians during a recent visit to this country to "put the profit back in health care" might as well have come from Mars. Canadians were deaf to them.

We are aware that American opponents of universal, publicly-funded health care point to our system as proof that publicly funded health care doesn't work.

When asked about that argument during a CBC interview last year, Ralph Nader turned it on its head.
"How many Americans died this year because they couldn't afford health care?" he asked the interviewer.
Answering his own question, Nader replied: "About 40,000."
"How many Canadians?" he asked. Again he answered himself: "None."
"How many Canadians went bankrupt attempting to pay their medical bills? - None."
"How many Canadians were afraid to change jobs, or to move from one province to another because they might lose their health benefits? - None."
And so the interview went, each of Nader's answers a condemnation of "health care for profit" and indirectly of the people who are its proponents.

Over the past year, as my wife and I watched the media coverage of President Obama's basic plan to make American health care what it should be - a model of humanitarianism for the rest of the world to emulate, and eventually saw it so undermined by all the Republicans, some Democrats, (and much of the American mass media) as to be barely recognizable, we wondered whose interests your media and the members of your Congress really represent. It certainly isn't the average American's, including our son's and his young family of four.

We wish you every success in attempting to salvage something from the wreckage of what originally had been a promising health care plan, a plan proven to work, a plan suited to a country like yours, one of the leading countries of the First World.

Owen Gray said...

My hunch is that many Canadians would agree with Flower Child -- not out of a sense of moral superiority -- but out of a sense of frustration.

For generations we have looked to the south; and many of us have immigrated there, sensing that America was a land of opportunity.

We have felt that, when push comes to shove, Americans will do the right thing. We can only hope that, once again, they will.

ChrisJ said...

I remember part of an article by Diane Francis, an American ex-pat who wrote (writes?) for the National Post - she said that America is the greatest country on earth unless one is poor or sick (apologies if I have this not exactly right).

Having just had the first of two total hip replacements, I am deeply grateful to live in Canada. In the US, I believe ONE such surgery costs about 60,000 - so 120,000 for both).

I am fortunate enough that I could make some very serious sacrifices and actually pay for one and just possibly both surgeries, but so many are not.

There are currently ads on television for Habitat for Humanities, showing the dilemma some face between having food or having shelter, for example.

No one should have to face this kind of sacrifice, for any reason. And no one should have to do so to serve the profit motive!

Owen Gray said...

Our second son was born with a cleft lip and palate. He required seven surgeries. All were covered under Medicare.

He also required extensive orthodontic work. Seventy-five percent of the cost was covered by the government of Ontario.

As Chris says, we consider ourselves blessed to be citizens of this country.

Flower Child said...

I'd like to correct an error I made when I claimed Sarah Palin, on a recent visit to Canada, had urged us to put "the profit" back into health care. In fact, during that visit, she swallowed her foot even more deeply, volunteering that her family had sometimes taken advantage of our health care system, crossing the international border into Whitehorse in order to receive it.

She made the "health care for profit" comment to an undercover film crew posing as a Canadian right wing political group when it attended one of her book signings in the USA.

The incident was honoured with a prominent spot on a weekly public affairs spoof, a goofy sort of nationally televised programme, the perfect place for her comment.

My apologies.

Owen Gray said...

It strikes me that your comment is more of an addendum than an apology.

As I understand it, the congressmen and women who promise -- after the next election -- to repeal health care reform have public insurance.

Are they and Ms. Palin hypocrites? You betcha!