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Published on Friday, July 25, 2008 by The Miami Herald

Guarantee Healthcare for All

by Malinda Markowitz

A sobering report from the Commonwealth Fund released July 17 says a lot about the shameful state of our healthcare system and the abysmal failure of our elected leaders to enact meaningful reform.

The United States spends more than twice as much per person on healthcare as most other industrialized countries -- but it has plunged to last among those nations in preventing deaths through timely and effective medical care.

How many families does this touch? A shocking 101,000 fewer Americans would die prematurely if we matched the benchmarks of 18 other industrialized nations, 25 times the number who have died in Iraq.

No long waits

Remember all those horror stories about the long waits for care in countries like Canada and Britain? Less than half of Americans with health problems were able to get a rapid appointment with a physician when sick and were the least likely, among seven nations that measured it, to get after-hours medical care without going to the emergency room.

Notably, the Commonwealth study appeared one day after an NPR/Kaiser Family Foundation/Harvard School of Public Health survey of two key election battleground states, Florida and Ohio.

That survey found that 28 percent of Floridians and one-fourth of Ohioans say they or a family member had problems paying medical bills the past year. Among that group, more than half self-ration care -- delaying or foregoing needed medical treatment or dental care, not filling prescriptions, cutting pills in half or skipping doses.

There's also a direct convergence of the healthcare and economic crisis. The same survey found 17 percent of Floridians and 14 percent of Ohioans have used up all or most of their savings in the past year to pay medical bills. One in 10 stopped paying other bills as a result.

Residents of both states ranked the economy as their No. 1 concern, and healthcare third (with the Iraq war in between).

But Sen. John McCain's health plan won't come close to solving the problem. Echoing the Bush administration, under whose watch the crisis has spun out of control, McCain favors tax credits of $2,500 per individual or $5,000 for families to encourage the uninsured to buy insurance. But that's less than half the cost of average premiums now, not counting all the co-pays, deductibles, and other ATM style fees.

Florida's 'high-risk pools'

For those with preexisting medical conditions whom the insurance companies won't touch, McCain proposes expanding federal support for state ''high-risk pools.'' But, in a devastating recent critique, The New York Times noted that the state plans are largely a failure. Almost all impose long waiting periods, up to a year, before allowing you to enroll, and all have very high costs for getting in. Florida closed its pool in 1991, and the current membership is just 313 people, rather a small percentage of the state's population. Moreover, McCain has no proposal to pay for a federal expansion of this train wreck.

Further, McCain wants more deregulation of the insurance industry with the dubious notion that would spur more competition to lower costs. But insurers compete by lowering their own costs, through denial of care, reducing services, or price gouging.

Sen. Barack Obama's plan would have more impact, with more subsidies for low and middle income families and tougher oversight of the insurers. He also says everyone should get the same coverage available to members of Congress. But Obama's plan, like McCain's, still gives the insurers too much control over our health.

Approve HR 676

There's a better way. All the industrial countries in the Commonwealth study -- except ours -- have a national or single payer healthcare system, one reason they can have better quality at half the cost. U.S. administrative costs, for example, are 30 percent to 70 percent higher -- all to feed the private insurers.

The public has figured it out. More than half of those questioned in Florida and Ohio in the NPR/Kaiser/Harvard survey say the government should guarantee health insurance for all Americans. HR 676 in Congress, which would strengthen and expand Medicare to everyone would do just that. That should be at the top of the agenda for the next president.

Malinda Markowitz is co-president of the National Nurses Organizing Committee/California Nurses Association.
Copyright 2008 Miami Herald Media Co.

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