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RAD:May 8/21/08 9:24 PM Page 9 Rose Ann DeMoro Executive Director, CNA/NNOC Shooting Yourself in the Foot Why is Health Care for America Now giving up on real reform? with the meltdown of our healthcare system, a first order of business under a new administration next January will likely be healthcare reform. If John McCain takes the oath of office, there will probably be little change from the present dismal course. But if Barack Obama is the next president, action is expected quickly. In May, Obama told reporters that healthcare reform is a key part of his agenda for his first 100 days. "We need a bill...by March or April to get going before the political season sets in." In other words, before opponents can mount a "Harry and Louise"-style counterattack. That timeline is a major reason for the shuffling now underway over the character of that reform. Various proponents of incremental reform are battling for which proposal will get the most media ink and line up the most supporters. That's the context for the Campaign for an American Solution drive by America's Health Insurance Plans (AHIP) to build an "activist army" of 100,000 people who are satisfied with their private insurance (presumably because they've never been sick) and to hold press events across the country heading off genuine reform. It's also a major factor in the recent formation of Health Care for America Now, a coalition of labor, progressive, and liberal groups who have proposed various partial reforms that will also only perpetuate, not end the healthcare crisis. Unlike AHIP, whose views parallel McCain's, the groups behind HCAN are working in concert with the Obama campaign and Democratic Congressional leaders to build "consensus" around the plan they hope is the one that emerges in Congress. But, in search of a supposedly politically viable plan, the advocates of this approach have surrendered in advance on the only overhaul that will actually cure the disease: a singlepayer, expanded, and improved Medicare-forall reform. Their good intentions will leave the same failed system in place, and will not even blunt political opposition from AHIP, other J U LY | A U G U S T 2 0 0 8 corporate interests, and their allies in Congress who will continue to challenge anything that looks like even modest change. They create a false hope of systemic change, squandering the opportunity to achieve the fundamental reform so desperately needed with so many lives in the balance. They've also missed one of the most important lessons of the failure of the Clinton plan of 1993-94 which collapsed in part due to the absence of a broad, grassroots, activist movement needed to counter the insurance industry. Only single-payer engenders such a movement, the very reason the single-payer bill now in Congress, HR 676, has more cosponsors than any other reform bill with tens of thousands around the country already working to enact it. Health Care for America Now has identified the main culprit and obstacle to genuine reform. As its inaugural ad proclaims, "Will health insurance companies ever put your health ahead of their profits? We can't trust insurance companies to fix the healthcare mess." There's just one problem—the coalition's proposal does nothing to end the actual practice of insurance companies putting their profits ahead of your health. Nor does it fix the two central components of the healthcare morass—insurance company denials of care and the financial squeeze facing American families (exacerbated by the escalating credit crisis) due to ever-skyrocketing healthcare costs. Rather than a real crackdown on the insurance pirates, HCAN proposes a "watchdog role" on the plans "to assure that risk is fairly spread" and that "insurers do not turn people away, raise rates, or drop coverage based on a person's health history or wrongly delay or deny care." You can watch someone rob your bank, but unless you stop them, the vaults are still going to be stripped bare. If you're looking for the hammer or any enforcement mechanism in the HCAN proposal, don't bother. It's not there. The insurers don't care if we know they are thieves, they will continue to deny and delay care because it's in their DNA. It's how they are set up to operate, it's how they make money for their shareholders, it's how they generate plush pay packages for their execuW W W. C A L N U R S E S . O R G tives, and it's how they compete with the other insurance giants. Nor does the HCAN proposal contain any effective cost controls on the insurers. Their commitment to basing pricing on "ability to pay" is a recipe for merely getting the healthcare you can afford, not what you need. It also fails to assure real choice of providers. HCAN supporters want single-payer advocates to believe their plan is the first step toward establishing a single-payer system because they would set up a public plan alternative to private insurance. The public plan, they contend, will be so much more attractive that the private plans will just wither away. Don't count on it. The wealthy insurers will always be able to undercut the public plan through massive marketing that public plans won't have the funds to match, and cherry pick the healthiest people. The sickest patients are dumped into the public plan, shredding the very purpose of a broad risk pool, depleting its resources, and probably bankrupting it. A July report by a House committee should be a sober reminder of our failed reliance on a commercially driven healthcare system. It found that the Medicare prescription drug benefit plan costs the government—all of us—about 30 percent more than the government would have paid for the same medications under Medicaid. That amounts to $3.7 billion, a nice handout to the pharmaceutical giants who aren't exactly struggling with the economic and credit crisis faced by regular Americans. The 25 biggest drug companies made over $100 billion in profits last year. How did this happen? The Bush administration successfully required Medicare recipients to go through private insurers for the benefit and blocked Medicare from using its bulk purchasing power to reduce costs and limit price gouging. Tinkering with the system is not going to work. Stopgap measures, partial solutions, and incremental reforms will not end our national healthcare disgrace. I Rose Ann DeMoro is executive director of CNA/NNOC. REGISTERED NURSE 9