AMY FRIED

Why health security matters

Posted Jan. 03, 2012, at 3:02 p.m.

My dad used to say, “Without health, you have nothing.” Maybe he exaggerated a bit, but it’s certain that poor health and lack of health care coverage undermine people’s opportunities and our economic vitality. Babies born to mothers with poor prenatal care start out behind. No matter how motivated one is to work and succeed, untreated illnesses sap strength and limit lives.

If we want people to have the opportunity to reach their potential and realize the American dream, we must start with a pragmatic understanding of what opportunity requires.

Proclaiming one believes in an America of opportunity is nice, but words accomplish little. Realities matter more.

Health security matters for people and the economy.

Opportunity is helped by health security. It’s much easier for people to take the leap to starting their own businesses if, as self-employed individuals, they can afford health insurance and insurance companies are unable to deny them coverage because of preexisting conditions.

As the distribution of wealth has become more skewed, people whose main income comes from stock deals now pay lower rates of taxation than mechanics and teachers. And, as programs serving the many are cut and nearly everyone’s income stagnates, economic mobility has declined.

Yet the increasingly skewed distribution of health care coverage has been defended by ideologues who operate in a world of theory, not reality. Turning the real world upside down, these ideologues claim that people are more free if health care is not secure. But as Franklin Roosevelt said in 1936, “Necessitous men are not free men.”

These ideologues also scoff at the idea that having no health coverage means more sickness and death, but that’s exactly what happens. In the real world, health security matters. Forty-five thousand people a year die in the United States from a lack of care due to no insurance.

Consider a man who doesn’t know he has colon cancer until a large mass is discovered and the cancer has spread, or a woman whose high blood pressure is not treated until she has had a massive stroke. Yes, both can be seen at the emergency room, but not for screening or ongoing treatment. Untreated conditions damage the body, cause death and cut short individuals’ work lives.

Candidate LePage was right that programs that stopped covering people when they worked or earned a little more create perverse incentives. Rather than expanding coverage, he now seeks to cut many thousands.

Even while cutting taxes on income estates over $1 million, Gov. LePage proposes another tax cut, on pensions, while contending the state can’t meet health care commitments that were affordable in June. Claiming the June tax cuts go mostly to working people belies the reality that income tax reductions could be “left in place for the bottom 60 percent” while the state treasury would “still recoup the vast majority [84.6 percent]” of the funds.

These policies injure individuals and Maine’s economic health.

Last week, the CEO of Northern Maine General Hospital, Reynold Raymond, noted that the hospital would lose $1.4 million “from the hospital’s budget for wages and benefits, leaving 40 to 50 people who provide the ‘actual care’ without a job. The local economy would lose the difference, $1.1 million, in terms of money spent in the area on things like fuel, food, etc. and would therefore also affect jobs in other fields.”

While the previous administration owed hospitals money, under Gov. LePage, the hospitals will be left with an influx of cases for which the state won’t issue either payments or IOUs.

As the directors of three Bangor community health organizations wrote, “There is no free lunch in health care — we all need it and it all needs to be paid for. Our choice is: Do we pay less by keeping people healthier or do we let people get sicker and obtain care in very expensive emergency departments or in hospital beds?”

Such costs — to patients, their families, members of their community and people who eventually will pick up the financial costs — are terribly high. And while we bear those burdens, so many opportunities for growth are dashed.

Amy Fried is a professor of political science at the University of Maine. You can follow her on Twitter at twitter.com/ASFried and on her blog, pollways.com.

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