May 27, 2018
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Abandoning health care reform not an option

By Benjamin Schaefer, Special to the BDN

While only a minority of the members of Congress are health care providers, one might envy them these days. They experience first hand what it is like to treat a lethal disease affecting one in seven Americans (lack of health insurance, resulting in 45,000 deaths a year) and to be on the brink of its cure against all odds. It is a gratifying experience, one that health care providers do not have often. More often, we lose the fight. But the wins and the losses both stay with us.

What appeared almost certain a week or two ago suddenly seems like a long shot. But while the Massachusetts vote threatens to paralyze the Senate on health care reform, it did not change a single thing for patients. More and more Americans are uninsured, or will soon join those ranks. Those with pre-existing conditions still go uncovered, and many face delays and denial of care. Physicians and other health care providers see this every day. It comes as no surprise that half a million doctors support health care reform and that many major medical professional organizations have signed on.

A number of prescriptions have been offered in the past few days to advance and complete the reform effort. Abandonment has certainly crossed everyone’s mind. Other solutions include passage of parts that form the smallest denominator, compromising with Republicans; House approval of the existing Senate bill, for which the support has been almost entirely Democratic; and “starting over,” which some have called for. The latter comes close to pronouncing reform dead.

Passing only the most popular parts of the bill is a drop in the ocean. It will not help anyone, and it may do harm. As an example, if insurance companies are required to cover pre-existing conditions, and this is not compensated for by increasing the risk pool by an insurance mandate, things would only get worse. It is like car insurers selling their policies at the scene of an accident. Insurance premiums would skyrocket, while deductibles would rise even further, and coverage would deteriorate.

In the past few weeks, we have witnessed a somewhat sad display of political discourse that resembled a hostage situation more than democratic process. Quite a few things have disappeared from the health care bill, most notably a so-called public option that many feel is the only effective way to introduce competition into the world of health insurance; a world where we have to remember antitrust laws do not apply. Reps. Chellie Pingree of Maine and Jared Polis of Colorado are mounting an effort to bring the public option back to the table as part of a reconciliation process, and they have to be congratulated for their courage.

Speaking to both sides of the aisle, President Barack Obama in his State of the Union address has called once again for our legislators to come together to create meaningful health care reform. Unless some Republicans are (wo)man enough to stand up to their party and do right by the people, and Democrats stay united, it seems the only sensible way forward is to pass the Senate bill in the House and leave the discrepancies to budget reconciliation.

Let 2010 not be the year we look back upon and say, “We were close.” Let it be the year we recall as making history and setting us back on a humane and compassionate path, taking care of the people, not just business. The U.S. has almost caught up to the other developed nations in what many consider a human right: universal coverage. Abandoning it must not be an option.

Benjamin Schaefer is a cardiologist in Bangor and a board member of the National Physicians Alliance, which advocates for universal health care.

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