Will Congress step up to health-care reform? This week, an obscure conference committee meeting between a handful of members of the House and Senate may well decide the fate of President Obama's health-care reform. It's a decision that directly involves more than $1,000 in costs billed to you if you have insurance.
The conference committee will decide--through a technicality called "reconciliation"--whether health-care reform can be passed by a majority vote in both houses of Congress, or whether it will require a super-majority of 60 to pass it in the Senate. Against the power of the Big Pharma, the drug-company lobby and the health insurance lobby, it will take a pitched battle to get significant reform with 50 votes. If it requires 60, it isn't likely to happen.
More than 45 million Americans have no health insurance--and the number is rising rapidly. About 785,000 people go without insurance in Cook County, and about 1.7 million in Illinois.
Those without insurance don't go completely without health care. They tend to put off preventive care, regular checkups and early treatment, but when they get truly sick, they end up in emergency care--the most expensive care possible. They pay some of their costs, but not all. The patients pay an average of $583 themselves, while, on average, $1,686 is paid annually by other sources for each of America's uninsured, according to the Kaiser Family Foundation.
The rest of the tab gets picked up by hospitals, nonprofits and government. And much of the cost gets added onto the bill of those who have insurance. That cost is inflated because people without insurance are often treated only when their condition is truly serious.
Obama has demanded that Congress move on health-care reform this year. He wants a plan that will cover everyone, giving employers the right to decide between a private plan and a public plan. Employees with insurance can keep what they have. Or they can choose from a range of alternatives, including a public plan on the order of Medicare.
The insurance companies are all for universal insurance--as long as it's private. They oppose a public plan as a competitor and will lobby hard to weaken regulation that prohibits them from discriminating against those with pre-existing conditions. They will spend hundreds of millions to oppose real reform.
Poverty rates are rising rapidly in the city and the suburbs. A rise in the number and costs of the uninsured follows inevitably.
That is the too-often-ignored reality of the congressional debate. We hear a lot about long-term deficits. Much is said about the cost of entitlements like Social Security and Medicare. But the reality is different. America doesn't have an entitlements problem; it has a health-care cost problem. The president put it bluntly: "If we don't address [health-care] costs...we'll run out of money. The federal government will be bankrupt."
And so will state governments, businesses and families. We have no choice but to reform health care--and making insurance universal with a public plan to compete with the private insurers is a good place to begin.
The health insurance and drug industries have a multibillion-dollar stake in limiting reform. But you and I have a direct personal interest in comprehensive reform that helps get costs under control.
The insurance company lobbies are laying siege to the Senate now. The question is whether the senators will hear from the rest of us.