Racing to the finish line

Passage of health care reform is too close to call

By Frank Bradley
Sentinel writer

On Saturday night, the U. S. House of Representatives passed a 2,000 page piece of health care legislation (H.R. 3962) by a narrow margin (220 to 215). All Republican representatives, except one, voted against passage, as did 39 Democratic representatives. Among those voting against the bill was our U.S. Congressman, Heath Shuler, a Democrat of North Carolina’s 11th  District.
Action now passes to the U.S. Senate, where majority leader, Senator Harry Reed (Democrat of Nevada)  is working to craft a senate version of the bill. Once the senate passes legislation, if indeed it does, leaders of both the House and Senate would in conference work to iron out the differences, which would then require passage in both the House and Senate before it could be signed by President Barack Obama into law.
If you are someone who has good, affordable health insurance, you might wonder why passage of this legislation is so important. Consider this, of the 20 or so major industrialized countries in the world, the U. S. is the only country among them that does not have universal coverage. That means an estimated 47 million of our citizens do not have health insurance. They do not have it because they can’t afford it or because they have a pre-existing condition that is considered too risky for an insurance company to take. Hence, they have been turned down. Insurance companies are no dummies. The way they make a profit is by taking in as much money as they can in premiums and paying out as little as they have to in patient benefits. So, why would they insure someone who has been diagnosed with cancer, which would most likely involve costly treatment, when they can deny that coverage and save themselves and their stock holders bundles of money.
Also, consider this, the fact that you have health insurance coverage, does not mean that you will always have it. If a part or all of it is paid by your employer, there may come a time when you will have to pick up a bigger portion of the costs, or if you happen to get laid off, you could lose it altogether.
Another thing. Is our current health system set up so that if you have no insurance, you will never get treated? Well, no. If you find yourself sick as a dog, and you have no insurance, you can go to the emergency room of a hospital and they have to take you in. Especially, if it is life threatening. That doesn’t mean you are off the hook in not having to pay for the treatment. In fact, if you have tangible assets, hospitals and physicians have the legal right to go after those assets. That is why we find that so many personal bankruptcies occur as a result of high medical expenses. If you do not have sufficient assets, then the hospital has to write the bill off as “charity care.” That means costs for those patients or their insurance companies who are paying will have to pay more, which like a revolving door drives up insurance premiums.
Another reason costs keep going up is because as an insured patient, you are not actually paying the bill. You can order expensive, perhaps unnecessary tests and get Cadillac treatment without having to pay for it. The insurance company or the government (medicare and medicaid) is going to pick up the bill.
Much is talked about having so much government waste and fraud in the medical industry. Well, hey, sure there’s bound to be a lot of that when one-sixth of our Gross National  Product is spent on health care. In the U.S., we are paying about twice the amount other countries are, who are providing health care for everyone.
Probably, the biggest abuse of our health care system is caused by patients themselves, and by their families. Demanding to see specialists when it doesn’t appear to be warranted. Running unnecessary tests. And taking extreme steps to keep patients alive, rather than allowing the natural dying process take its course.
We live in a time of miracle medicine. So much has been done to relieve pain and improve the quality of life, especially with older patients. More and more of our medical dollars are being spent on our seniors, and certainly, we want to take care of them. Still, without significant reform to our health care insurance and delivery system, we are doing a disservice to our younger population: young families, middle class, workers and those at the bottom rung of our social system.
During the past year, Congressman Shuler has delved into the complex aspects of our health care system. He has made a concerted effort to talk with the many stakeholders involved, and from what we can tell he has an understanding of where we are and where we need to go as a nation. He certainly has a better understanding of the issues than we do. It is also our sense that he is earnest in trying to do what is right for our district and nation.
His reservation with H.R. 3962 seems to be how to control costs and the need for incentives to get people to live a healthier life style: diet, exercise, cessation of smoking, reduction of risky behavior.
On those issues, we couldn’t agree more.
Still, as this legislation heads near the finish line, it seems to us, vital that it get done. The window of opportunity is rapidly closing. Our country needs health legislation passed this year. There will be time later to tweek it. To go after waste, fraud. To add incentives so that we become a healthier nation.
We urge Congressman Shuler to do as much as he can to influence the final bill for the better, but when the team is on the goal line, we urge him to join in with fellow Democrats to push it in for a score.