Hospital sale just tip of iceberg

by Clint Talbott

Last week, Colorado Attorney General John Suthers concluded that the sale of two hospitals to a Catholic organization did not threaten to effect a "material change" in the charitable purposes of the hospitals.

For those whose health-care plans are not chained to the Exempla hospitals that are to be sold, that's a facile conclusion. For those whose fully covered hospital visits may be denuded of certain reproductive-health services, Suthers' conclusion is harder to justify.

The Exempla sale is still being challenged in court by people concerned about diminished health-care options, so Suthers' is not the last word. Questions about such deals are obvious. For instance: Why should a religious group parcel out only those health-care services with which it feels comfortable?

The guiding principle would be what's best for the patient, based on the best medical science. Health care should not be circumscribed by matters as wobbly as the pontiff's matters of faith.

The Exempla story is a relatively small story among many of emerging importance in 2007. It signifies the increasing and systemic failure of the health-care system to concentrate on its prime objective: the health of patients.

Next year, Colorado legislators and presidential hopefuls will grapple with the health-care crisis. The most sweeping and promising proposals (some variation on a single-payer model) will be summarily rejected because they will be tagged as "socialized medicine." With such a moniker, most reasonable debate on single-payer will be derailed.

That is a genuine shame, because the 47 million non-elderly Americans who lack insurance compose a larger percentage of the U.S. population than at any time since 1987, according to data from the U.S. Census Bureau. But the uninsured represent only part of the problem.

The "under-insured" includes tens of millions more people who went without insurance for some period last year, or whose coverage is so spare as to mock the term "health-care coverage."

Most of these people are not (as some suggest) unemployed. Eight of 10 uninsured people are in working families, according to the group Cover the Insured. But can't the uninsured just go to the emergency room for care? With all the sensitivity of the legendary Marie Antoinette, that was President Bush's suggestion.

The answer is, "no," ER visits are no substitute for actual health insurance. They are more expensive. And less effective. About 18,000 Americans die unnecessarily each year because they lack adequate health insurance, according to the nonpartisan Institute of Medicine.

It's all very easy to argue that things aren't that bad, or that the free market can solve the problem. The fact is, things are bad. And the goals of free-market barons differ considerably (and obviously) from those of physicians.

Expect the health-care issue to stay in the headlines this year. But given the powerful and wealthy forces arrayed against meaningful change, don't bet the farm on reform.

--Clint Talbott
© 2007 Daily Camera and Boulder Publishing, LLC.