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Cover Story: Single-Payer Healthcare: A BlackCommentator.com Series - Part 43 - Why the new health insurance law is so short-sighted By Ethel Long-Scott, Executive Director Women’s Economic Agenda Project, BlackCommentator.com Editorial Board

 
 
 

The trouble with the new health insurance law just signed by President Obama is that it’s amazingly short-sighted for a law that takes eight years to become fully operational.  By not dealing with four fundamental problems, the new law is equivalent to trying to ease a housing shortage by adding more floors to the tops of apartment buildings whose foundations were already crumbling.

Problem One is that even though it helps some people, it’s not really health care reform, it’s actually health insurance restructuring.  Some celebrate as a major accomplishment the delivery of 32 million more people into our broken market-driven insurance system, even though about 24 million others will remain uninsured, and more will be under-insured.  They say it’s wonderful to end denials of coverage due to pre-existing conditions, although the insurance companies’ appeal process is internal to the industry and lacks enforcement.  They celebrate the allocation of billions of dollars more to community clinics to provide minimum care to the new mandated market.  But because it doesn’t raise the Medicaid reimbursement rates sufficiently, the safety-net hospitals could be in worse shape if Medicaid rolls rise as expected.

Problem Two is the reason the Democrats decided to put some good measures on top of a fundamentally broken system.  This restructuring represents a transition from employer-based health care delivery to an individual mandate health system. In an era of the jobless recovery and growing  permanent structural unemployment, this seems a prudent thing to do – if the main goal is to prop up health industry profits.  You may lose your job, but you still have to buy health insurance. The health industry is nearly 17% of the nation’s Gross Domestic Product. Mandating 32 million individuals to pay the health insurance industry for care is a subsidy to these companies at the expense of workers and the poor who still need health care.  The new law contains NO restrictions to keep insurance companies from skyrocketing premiums. 

Problem Three is that gender inequities will continue under the new system. Insurance companies in most states may continue to charge young women more for health insurance than they charge young men.  Women tend to need more health care than men, partly because of pregnancies and family planning, and partly because women are poorer than men. The new health insurance restructuring will not help with women's reproductive rights -- a new executive order from the President enshrines oppression against women by expanding segregation of funds, which in practice will likely mean few insurers will cover abortion and perhaps other reproductive medical services.

It gets even worse when you consider that women are disproportionately  represented in the ranks of the poor, and it’s well established that in the United States, the poorer you are, the worse your health care is. A Commonwealth Fund study released last May found that about 52 percent of working-age women, compared to 39 percent of working-age men, reported in 2007 that they had to forgo filling a prescription, seeing a specialist, obtaining a recommended medical test or seeing a doctor at all as a result of medical costs.  Beyond that,  “more than one-half of all bankruptcies related to medical costs in the United States in 2007 were filed by female-headed households.” 

 

And that’s Problem Four – and it’s huge.  The new law lacks the vision to see that the economic realities of globalization mean poverty is likely to grow – not good when people are required to buy health insurance.  New methods of production are replacing workers with everything from automated supermarket checkout stands to computer-controlled factories.  Every industry is being automated, and that destroys the social contract that developed under industrial capitalism.  From the jobless recovery to the bailout of the Wall Street tycoons to the new health insurance restructuring, the old social contract and social safety net are under full attack.  Instead of a government that takes care of people least able to take care of themselves, the rush today is toward a survival-of-the-fittest program called privatization.  Congress does the bidding of the wealthy people and corporations who fund its members.   As long as capitalism relied on the industrial workers of the U.S., the state protected the social contract between companies and the U.S. worker—in production and in society.  But in the current era of global capitalism, many other countries are suffering job loss from a decline in manufacturing. In the past decade, U.S. manufacturing jobs declined by more than 11 percent. During the same period, Japan's manufacturing employment base dropped by 16 percent. Manufacturing jobs in Brazil declined 20 percent -- and one of the biggest losers in manufacturing jobs was China!

The failure to face these realities goes a long way toward explaining why we got health insurance restructuring instead of the health care reform we need.   At a time when automation is creating permanent job loss everywhere, our government is steadily abandoning any responsibility for the people.  Instead it’s handing the market-driven health care delivery system even more billions of dollars in subsidies to insurance and pharmaceutical companies.  Did you know that the new law gives drug manufacturers even stronger protection against competition from cheaper generic drugs, which would lower everybody’s costs?   This amounts to a drug industry bailout along the lines of the Wall Street bailout.

So now that health insurance is being restructured, what do we need to do to get real health care reform?  First we need a clear vision of what would be in everyone’s best interest in a rich nation like ours, facing the unpleasant economic reality that most of the good jobs we were used to are never coming back.  That vision starts with something the United Nations said more than 60 years ago, back in 1948.   Health care is an economic human right.  Health care as a human right is not simply the absence of disease: People have the right to reach their highest attainable state of complete physical, mental and social well being. Adequate medical care is only one of the things that people need to be as healthy as possible. A few of the others are healthy food, adequate housing, the right to water and a clean environment, having control over your own life, and being able to fully participate in decisions about your community.  That is why in going forward, we must link all these things together.  Replacing the just-passed individual mandate plan with an improved and expanded Medicare for All program is an essential step in this process.  Congress knows how to do this.  The details were worked out years ago in earlier single payer proposals such as Just Health Care and HR 676 that was ruled off the table early in the Obama presidency, even though analyses showed it would cover everybody and more than pay for itself by eliminating the price-gouging private insurance companies from the system.  We need to build a people’s movement to demand this human right to universal health care.

BlackCommentator.com Editorial Board member Ethel Long-Scott is Executive Director of the Women's Economic Agenda Project, (WEAP), dedicated to attaining economic human rights for all people.. WEAP serves as state host of the California Poor People’s Economic Human Rights Campaign. She is known nationally and internationally for devoting her life to the education and leadership of people at the losing end of society, especially women of color. She is dedicated to economic security and justice and believes that the US is engaged in a relentless war against workers and the poor. Click here to contact Ms. Long-Scott.

 
 

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April 8, 2010
Issue 370

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