Healthcare Bill Limps Along

The top priority of the Obama Administration when it took office last year was to pass healthcare reform, but that effort has been stymied by opposition from both Republicans and some Democrats. Now the Administration appears to be modifying its message and talking about Health Insurance Reform as the goal. House Majority Leader Nancy Pelosi has talked about breaking the bill down into smaller pieces and trying to pass some reforms if not the entire bill. This is a tremendous disappointment to many Americans, including League members, who have fought to have this important reform passed. Health insurance is a right for all Americans and healthcare costs must be kept down so the country can afford to pay the bill for providing it. Both the Senate and House Bills that were passed before the Christmas break contain important elements of reform. If you care about healthcare, contact your representatives and tell them they need to pass a meaningful reform bill this Spring.

Is healthcare a right of the states?

One of the strangest movements in the healthcare debate is coming from some state capitols where legislators are trying to ban a mandate for everyone to have health insurance. Although health economists agree that universal coverage would not be possible without requiring everyone to share the costs of insurance, these legislators, according to a report in the N.Y. Times, are trying to enact amendments to the state constitutions forbidding the mandate to buy or otherwise acquire health insurance in their state. Arizona's plan is slated to come before the voters in 2010. What exactly are these people trying to do? It seems clear that their goal is to preserve the current haphazard system of health insurance in America and leave the uninsured to suffer. Fortunately it seems likely their efforts will be deemed unconstitutional, but perhaps they just want to delay the process of reform.

Do we want healthy children?

Cynthia Tucker, writing in today's S.F. Chronicle, asks the provocative question "Are We Shortchanging Our Children?" The answer is clearly, "Yes, we are." Although Americans have succeeded in providing universal healthcare to people over 65, we have failed miserably in insuring coverage for young people. As many commentators have mentioned, if 10-year-olds could vote they might have more clout, but instead it is often those who benefit most from government-supplied healthcare who insist on denying it to their grandchildren. This is not only cruel, it is dangerous for the country. Healthy children will grow up to provide care, both financial and physical, to all of us as we grow older. They should be the major concern of our healthcare policies. As old age stretches out longer and longer, with more people living for 30 years or more after retirement, we should think about cutting back on some of generous benefits given to seniors regardless of their wealth, and start thinking about the needs of younger generations. The future for all of us depends on young people--let's make their lives healthy and reasonably secure.

A sad day for healthcare

The loss of Senator Ted Kennedy is another blow for healthcare reform in the U.S. For many years he was the force behind the effort to insure universal healthcare for all Americans. Now that it seems we may finally be drawing closer to getting a bill passed, it is sad that Ted Kennedy will not be able to share the joy of achievement. However, there are still forces working against healthcare reform, and Senator Kennedy's death will not turn back those forces, as reported in the N.Y. Times. Those of us who believe in universal healthcare must work harder than ever to make sure that Ted Kennedy's dream does not get frittered away in partisan bickering that does no good for anyone.

Still wonder if we need reform?

The overwhelming need for better healthcare systems in this country has been demonstrated again in Ingleside, California, where a medical charity has offered free testing, check-ups, and dental care to thousands of people. Lining up for hours and sometimes staying overnight was less onerous for some potential patients than going more months or years without care. How can a country and a state as prosperous as ours offer so little to so many people. The dental needs alone are overwhelming, but we haven't begun to address those. Let's hope Americans can at least agree on how to provide adequate medical care for all the people who need it.

One sign of hope, also noted in the N.Y. Times, is the attention that is now being paid to areas in the U.S. which do manage to provide reasonably-priced care. One issue with healthcare is that it has to be local. If good care doesn't exist close to where you live, you are out of luck--you can't order many medical services online. By looking at the communities that have overcome some of the price barriers, other cities can learn how to do it. One key seems to be the provision of electronic records that can be shared by providers. Moving more of our medical record keeping online would not only improve jobs but also offer new jobs for the young people coming out of schools and colleges. This is certainly a step worth taking.

Is this the way to handle healthcare?

Isn't summer supposed to be a relaxing season? This year it seems to be a time for yelling and shouting at some Bay Area community meetings. Members of Congress have returned to their districts to meet constituents and hear what they have to say about issues and some of them are getting an earful. Healthcare seems to be the flash point for many citizens. The SF Chronicle has reported that some Bay Area meetings have been interrupted by Conservative critics determined to fight against the healthcare legislation currently being considered in Congress. The aim seems to be to break up the meetings rather than to offer suggestions about how healthcare should be provided. Surely this should be the time for calmer voices to be heard. The League of Women Voters of San Francisco is one established civic organization that's been sponsoring a series of meetings on healthcare proposals at which experts can speak and citizens can ask questions. Let's support a rational, democratic process in healthcare reform, not the ranting of extremists.

Figuring out the costs

One of the most popular topics of conversation these days among Americans trying hard to understand the debate over healthcare is the issue of whether higher cost bring better care. A number of articles have discussed the Dartmouth studies on regional differences in the cost of healthcare to patients covered by Medicare. Today's N.Y. Times provides an overview of those studies by one of the researchers involved. Although there are some questions raised by critics, such as questions about whether people in some parts of the country are just sicker than others, the evidence seems overwhelming that much of the difference comes from the attitudes and practices of the doctors and hospitals involved. Let's hope the educators developing curriculum for medical schools are taking a serious look at the results of these studies and designing courses that train doctors to consider the implications of their decisions on the nation's healthcare. Our hopes for true and lasting reform in healthcare depend as much on our young doctors as on lawmaker's decisions. And while we're at it, let's reconsider covering more of the costs of medical education so young doctors don't face the burden of overwhelming debt that conflicts with their desire to give service where it is needed most.

What's changed in healthcare?

The League's Healthcare Forum on May 27 got a lot of members talking about how healthcare has changed over the past fifteen years or so. Looking back to the early 1990s when President Clinton introduced healthcare legislation only to have it turned down, most of us can recognize that costs have gone up and care doesn't seem to have improved much. But now we can turn to some documentation produced by the National LWV to get some hard facts on what the changes have been. Not only do far fewer people have healthcare insurance through an employer, but the many HMOs and other forms of insurance plans that have been developed in recent years do not seem to met the vision of the early 1990s. It's not easy to see how we can move ahead on healthcare in the midst of the severe economic slump we are in, but it's obvious that something has to be done. San Francisco has started an innovative program to provide healthcare for everyone, and the California legislature is considering a bill to provide single-payer health insurance. As citizen we have to keep our eyes on what is being done and persuade our representatives at all levels to make the changes needed to strengthen healthcare for all.

Healthcare struggle ahead

President Obama has promised to bring forward a healthcare plan that will enable Americans to get the kind of healthcare they deserve, but it won't be easy. The struggle to unite insurance companies, the government, the medical profession and the general public promises to be a long one. Already supporters of single-payer healthcare are turning to demonstrations and civil disobedience to protest the lack of a public option in the bill currently proposed. Some Californians, despairing of action on the national level, prefer to support Sen. Mark Leno's proposal for single-payer insurance in California. The state legislature has supported this approach before, but Governor Schwarzenegger has vetoed each bill passed. This is a crucial area for most Californians and the League of Women Voters, plans to provide informative forums and other programs to allow voters to learn more about the plans supported by various groups. The first forum was held on May 27, and another one is planned for early September. Keep tabs on what is happening by visiting www.sfvotes.org frequently for the latest updates.