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Self-interest underlies health care debate

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The Tampa Tribune

Published: October 18, 2009

Updated: 10/19/2009 12:33 pm

The passage of the Senate Finance Committee's health care plan last week, hailed as a breakthrough by the Democrats, did nothing to relieve the anxiety most Americans have about the overhaul of a health care industry that represents one-sixth of the economy.

And Congress will never come up with a plan acceptable to Americans unless it recognizes every citizen has both a financial and medical stake in how this plays out. Dismissing protestors as crackpots won't do. They have every right to want the details about legislation that would so dramatically affect their lives - and livelihoods. Protecting one's self-interest is not mere selfishness.

Obama and the Democratic leadership should worry less about gaining legislative momentum than fashioning a health care bill that Americans will understand and accept.

Yes, some reform is needed. The nation cannot sustain the rate of increase in health care costs. Still, no one can describe what the new system would look like. It is very possible the cure - the expansion of coverage at an uncertain cost to taxpayers and with unclear government controls - could be far worse than the disease.

The new bill, it must be admitted, has some encouraging features. It does not include the so-called public option, a government-run health care provider to compete with private companies that the liberal House wants.

Instead, it would create state-run, not-for-profit options for individuals who don't receive a health care benefit at work and can't afford private insurance. These options would include government dictates, but much our health care coverage already is provided by the government through Medicare and Medicaid, the latter the federal-state insurance plan for the poor and disabled.

We may wish for a market-driven system, but finance chairman Max Baucus' plan at least keeps the federal government at bay for now.

Any final bill also will include a provision preventing insurance companies from denying coverage to individuals with preexisting conditions. This will come as a relief to anybody who is sick or has a family member living with a chronic illness.

If the insurance companies are required to provide coverage for preexisting conditions, they will need more money to offer it. That is why the bill would require all citizens to buy insurance or pay a fine if they fail to do it.

But the suggested fine under the Baucus bill - $750 a person per household phased in over four years - is not enough to push a potential policyholder into making a purchase.

Last year the average cost of private insurance for an individual was nearly $5,000. No one would pay that price if there is a $750 option. Instead, people will choose to wait until they are sick to buy health insurance.

The major problem with the legislation remains the cost. Can we afford it?

The bill got a boost from a preliminary Congressional Budget Office report, which estimated it will cost $829 billion over 10 years starting in 1913. But other estimates focus on a $1 trillion-plus price, which is more likely as the cost of health care continues to rise.

In general, Americans covered by private insurance don't care about hospital costs or physicians' salaries. They're not worried about a drug maker's research and development needs or insurance companies' profits. They may desire to see those without insurance offered coverage, but not if it means a huge leap in cost to them personally.

Americans want affordable access to health care, and they must be persuaded that, even as millions of more Americans could enter the system, their medical coverage will not be diminished.

Obama and the congressional leadership have yet to detail how an overhaul of this magnitude can be accomplished without bankrupting the country or destroying medical care as we know it.

It's time they did.

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