National Nurses United

RAD_October 11/24/09 6:00 PM Page 9 Rose Ann DeMoro Executive Director, CNA/NNOC A Closer Look Revealing the good, the bad, and who benefits the most from the House healthcare bill of all the torrent of words that followed House passage of its v ersion of healthcare reform legislation in early N ovember, perhaps the most misleading were those comparing it to enactment of Social Security and Medicare. Sadly, no. Social Security and Medicare were federal programs guaranteeing, respectively, pensions and healthcar e for our nation's seniors, paid for and administered by the federal government with public oversight and public accountability. While the House bill and its Senate counterpart do have important reform components, neither comes close to the guar antees and the expansion of health and income security pr ovided b y Social Security or Medicare. By contrast, if the central premise of Social Security and Medicare was a federal guarantee of health and retirement security, the main provision of the bills in Congress is a mandate r equiring most Americans without health co verage to buy priv ate insurance. In other words, the principle beneficiary is not Americans' health, but the bottom line of the insurance industry which stands to harvest tens of billions of dollars in additional profits ordered by the federal government. Or as Rep. Eric Massa of New York said from the House floor, "At the highest level, this bill will enshrine in law the monopolistic powers of the private health insurance industry, period." Further, while Social Security and Medicare, two of the most important reforms in American history, were significant expansions of public protection, the House bill would actually reduce public protection for a substantial segment of the population, women, with its unconscionable rollback of reproductive rights in the anti-abortion amendment. Why then so much cheerleading by many OCTOBER 2009 progressive and liberal legislators, colum- with prior health problems, extending the nists, and activists? age that dependent children can be on their First, passage of the bill w as a clear parents' plan, and repeal of the anti-trust defeat for the opposition on the right by exemption for insurers. those who have so mischaracterized what Extend ing the same health benefit tax boils down to modest reform that looks like benefits available to married couples to a "robust" version of the Medicare prescrip- domestic partners. tion drug benefit or the state children's A pr ogressive tax to help pa y the bill health initiative. through a surcharge on wealthy earners and Second, proponents of the bill, starting in required contributions from large employers, the White House and running through the in sharp contrast with the Senate proposal to Democratic leadership in Congress, with the tax health benefits on misnamed "Cadillac" assistance and supplans, compr ehenport of many in labor, sive coverage won by liberal, and progresmany nurses and sive constituency other union memDon't be misled groups, have so lowbers, for example. by howling from the ered expectations on But the acclaim insurance industry health car re form e now flo wing fr om which has been that with eyes wide some quarters would spending some shut they can call have been better $1.4 million a day this a sweeping vicde served had these to steer the direction tory. laudable provisions of legislation. They To be sure there been enacted on their would have preferred are commendable own—not accompathe status quo, but provisions in the nied b y the man y will be more than happy House bill that bear shortcomings of the to count the increased note. Among the legislation. T o cite revenues coming most important are: the most significant: their way. Expansion of Medicaid to millions of low-income adults. Reduction of the "doughnut hole" in the Medicare drug coverage law, making drug costs more affordable for many seniors. Additional federal funding for public health, such as community-based prevention programs. Increased funding for nursing education and training, nurse-led health clinics, and home visits for nurses and social workers to low-income families. Ad d itional r egulation of the insur ance industry, mostly targeted to help people who are presently without coverage rather than those with e xisting health plans . Those include limits on insurers' ability to drop sick enrollees or refuse to sell policies to people W W W. C A L N U R S E S . O R G Healthcare will remain unaff ord able for man y. The bill does not do nearly enough to control skyrocketing insurance, drug, and hospital costs. With no effective limits on insurance industry price gouging, out-of-pocket costs for premiums, deductibles, and other fees will, by some estimates, eat up from 15 to 19 percent of family incomes. Little assistance for individuals and families in employer-sponsored health plans who face frequent erosion of their coverage and health security. No help for healthcare costshifting from employers to employees. No meaningful reform for denials of medical treatment insurance companies don't want to pay for. (continued on page 17) REGISTERED NURSE 9

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