Bush health care plan: Youre on your own

Health care advocates slammed President Bush’s latest health care proposals as free-market fantasy that would dismantle employer-provided health coverage, enrich insurance companies and worsen the nation’s health care crisis.

Bush’s proposals are seen as part of a wider move to shift debate on health care away from the growing demand for universal, affordable health coverage, diverting it to corporate-friendly measures with higher cost and less coverage. While Bush’s plan is more extreme, California Gov. Arnold Schwarzenegger’s health care plan, the new Massachusetts health insurance law and Sen. Ron Wyden’s “Healthy Americans Act” all put the main burden on individuals to purchase private health insurance.

Responding to Bush’s proposals, Anthony Wright, executive director of Health Access California, a statewide health care consumer advocacy coalition, wrote in a Jan. 29 blog, “Rather than expanding public programs (which are far cheaper per person than private coverage) or expanding group health coverage (which enjoy a group discount), he is encouraging people to get coverage in the most expensive way possible.” Bush’s plan amounts to “Message: You’re on your own,” said Wright.

Bush’s measures, outlined in his Jan. 22 State of the Union speech, would tax workers for what he contemptuously called “gold-plated” employer-provided health coverage, and would offer a tax deduction for people who buy health insurance on their own.

Steelworkers President Leo Gerard said in a statement, “Congress should reject this plan out of hand. It not only erodes employer coverage, where two out of three Americans now receive their health benefits, it’s a backdoor attempt to saddle union workers with a tax for the health care benefits they negotiate through collective bargaining.”

Elise Gould of the Economic Policy Institute commented, “More than anything, the health policies introduced by the Bush administration … are about shifting risk onto the individual.” She noted, “The individual market puts the onus on the individual to find and purchase health insurance, and there is no guarantee that the insurance they buy today will be available to them next year. Those unlucky enough to be unhealthy today or to get sick tomorrow will find it very difficult to find affordable insurance in the private market.”

Hanh Kim Quach, Health Access California health care policy coordinator, said Bush’s reference to “gold-plated” health plans “is actually referring to comprehensive health coverage that could actually provide patients protection from crushing medical bills should they ever get sick.”

What Bush and others are promoting as “affordable” coverage is high-deductible individual plans, but even these are expensive, and they leave individuals paying huge amounts for medical care out of their own pockets. The net effect, health advocates say, is that people will avoid getting needed health care, leading to worse health status and bigger health costs down the road.

At a Jan. 24 Washington press conference, health care advocates condemned Bush’s plan and others that rely on private insurers.

Dr. Oliver Fein, Cornell University professor of medicine and director of Physicians for a National Health Program, said such plans “would leave millions without coverage and continue to squander $300 billion annually on private insurance marketing, bill collectors and other useless bureaucratic activities.” Moreover, Fein said, “none of these plans would upgrade coverage for the tens of millions who are currently under-insured. Three-quarters of Americans bankrupted by medical bills last year had health insurance. Only national health insurance can cover all the 47 million uninsured and improve coverage for all other Americans at an affordable cost.”

Fein and other speakers called for enactment of HR 676, “The National Health Insurance Act: Medicare for All,” which Reps. John Conyers and Dennis Kucinich are reintroducing. The “single-payer” bill had 78 co-sponsors in the last Congress. More than 225 unions have endorsed it, including 17 state AFL-CIOs.

Other industrialized countries “all have national health care systems that cover everyone and are more efficient than our broken, fragmented system,” Kay Tillow of the Kentucky Nurses Professional Organization noted. “Single-payer is the only plan that will cover everyone and effectively control costs.”

Congressional Democrats are expected to focus on expanding health coverage for children as one starting point that can draw wide support. The federal-state Children’s Health Insurance Program (CHIP), which covers children in families with income too high for Medicaid, is up for renewal this year. Wright, of Health Access California, said, “This federal fight is crucial not just in the effort to cover all children, but for health reform in general.”

suewebb @ pww.org