American health care system is already in crisis

Posted Aug. 27, 2009, at 6:04 p.m.

Maine and the nation need health care reform now. We don’t need to wait for a so called “trigger” — where the government will step in only after the insurance industry fails to live up to its promises to cut costs. With double-digit premium hikes occurring annually, costs skyrocketing and the quality of our coverage eroding, we all are aware that the health care and coverage system has already failed. Waiting for a trigger would be like waiting for the house to completely burn down before calling 911.

We need fundamental change and we need it now. We need change that will guarantee that every Mainer and every American has access to quality, affordable health care. Anything short of that is unacceptable.

There are certain components that must be part of any reform of our nation’s health care system. They should be non-negotiable. Indeed, every country in the industrialized world has them. Any plan worth supporting has to be available for everyone with the guarantee of quality, affordable coverage. No one should ever be denied coverage because of their health status or a pre-existing health condition.

The coverage has to be comprehensive with a benefit structure that emphasizes primary and preventive care while addressing the needs of people with a catastrophic illness such as cancer or diabetes. Appropriate screenings can catch illnesses early, which can save lives and help to keep skyrocketing costs down. No family should ever have to lose their home or business due to medical debt. Ever.

The coverage has to be portable, meaning when you change employers or choose to work for yourself you can keep the same insurance. Any reform proposal should include absolute transparency from insurers and providers so that the public, as the ultimate payer of all medical bills, knows what it is paying for and getting with its hard earned dollars.

We also need to be sure that we are getting the quality outcomes we expect for the medical care we pay for. We don’t need more care; we need more appropriate care. Understanding what we are paying for and how we are paying for it has to be part of any national reform proposal. The health of our nation and the health of our nation’s economy depend on it.

Any health plan given serious consideration must also include broad-based financing. Everyone needs to pay into the system based on their ability to pay, so that it is equitable and an accepted societal obligation. Currently, most people who are uninsured are from working families that cannot afford coverage. They should not be failed by the country they pay taxes to just because they are not fortunate enough to work in a job that pays for their insurance.

Any reform package should also seek to protect families from high deductibles, high co-payments, and high out-of-pocket expenses. Consider the Maine family who has a household income of $46,000 and pays $1,000 per month in premiums for a $10,000 deductible plan. Any one of a number of catastrophic illnesses or an unforeseen accident could easily set that family back $22,000 or more in one year. That is nearly half of that family’s income! We all deserve a better option.

A meaningful public option that incorporates all of the above components is long overdue for our nation’s families and small-business owners. It is the meaningful change we deserve and have been waiting for. For those who believe this type of reform is too expensive, I remind them that it is still less than the $1.8 trillion cost of the Bush tax cuts. If we could afford those, we can certainly afford to provide quality, affordable health care to our people. The nation’s voters are ready for this kind of fundamental health care reform. Let’s convince our elected officials that they should be ready as well.

Pat Berger of Sidney is a self-care instructor and therapist.

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