When Barack Obama talks about America’s deplorable health insurance problems, he speaks with undeniable passion. So what is he proposing?
For starters, he wants a national dialogue. Shades of Hillary Clinton, the Obama administration plans to encourage Americans to have house parties focused on health care, the most expensive in the world but far from adequate. Then Obama wants a national conclave in Washington. At least the meetings will be open and public, unlike Clinton’s task force.
Obama has nominated Tom Daschle, the former Senate majority leader from South Dakota, to head the Department of Health and Human Services and also develop policy to improve health care. Daschle is a smart choice because he knows how to write legislation that can get through the Senate. Obama called Daschle the original no-drama guy known for speaking softly but leading boldly.
But Obama is still not able to answer the most important question about improving health care in America: how to pay for it. By some estimates, his ideas to expand health insurance would cost $65 billion. He had planned ending the Bush administration’s tax cuts for wealthy Americans to finance it, but raising taxes in a bad recession is now not likely.
At least Obama understands the problem. While President Bush never focused on health care, Obama spent months hearing heart-breaking stories about voters’ health care catastrophes. The leading cause of family bankruptcy is medical bills.
It’s hard to overstate the urgency of this work, he said at a press conference announcing his pick of Daschle to spearhead health care reform.
Over the past eight years, premiums have nearly doubled and more families are facing more medical debt than ever before, he said. Forty-five million citizens have no health insurance at all. And day after day, we witness the disgrace of parents unable to take a sick child to the doctor, seniors unable to afford their medicines, people who wind up in emergency rooms because they have nowhere else to turn.
A group representing 27,000 emergency room doctors announced two days before Obama nominated Daschle that emergency rooms are already stretched beyond capacity, that long waits for help are going to get longer, that the state of emergency care is serious. The 2009 National Report Card on the State of Emergency Medicine concludes the overall grade for the nation is a C-minus, with 90 percent of the states earning mediocre or near-failing grades.
Millions of Americans have no alternative when they need care but to head for the nearest emergency room. Emergency rooms legally must not turn anyone away who seeks their help. But partly because of the bad economy, there are 120 million emergency room visits a year compared with 90 million 10 years ago, and hospitals are bracing for many more even as they complain they can’t handle the influx. Every year they turn millions of dollars more in unpaid bills over to collection agencies.
Obama recognizes the challenge: Year after year, our leaders offer up detailed health care plans with great fanfare and promise, only to see them fail, derailed by Washington politics and influence peddling.
Forcing employers to pick up more of the health insurance burden is not an option. It is often a leading factor in the failure of small businesses. Some large firms are unable to compete with global companies that don’t have to pay employee health benefits. Solving the economic crisis means solving the health care crisis.
Obama proposes investing in preventive health care and pushing computerized health records to cut costs. He wants doctors, nurses, patient advocates, business and labor to discuss how to cut costs and improve access, innovation and affordability. He wants to change the Medicare Advantage program he says spends billions of dollars subsidizing insurance companies without improving the health of seniors.
On top of his other challenges, Obama must do something concrete in 2009 about health care besides talk about it. Choosing Daschle was a start, but the clock is ticking.
(Scripps Howard columnist Ann McFeatters has covered the White House and national politics since 1986. E-mail amcfeatters(at)hotmail.com.)