Let’s get back to what health care reform should be about

By Rose Ann DeMoro for the Cleveland Plain Dealer –

From the fabricated “death panels” scares to the traumatized seniors urging legislators to keep the government’s hands “off my Medicare,” it’s apparent that the health care debate has lurched off the rails.

We’ve lost sight of families like Nathan Wilkes’ who, introducing President Barack Obama at a Colorado town hall meeting last week, described their frantic search for new health coverage after losing protection for their 6-year-old son, Thomas, who has hemophilia.

Or Janet Stephens, an emergency room nurse from Anaheim, Calif., with bladder disease who is facing the loss of her home because of monthly out-of-pocket costs of over $1,100 from her insurer.

Or the tens of thousands of other Americans callously and routinely refused needed medical care because their insurer doesn’t want to pay for it — a nightmare scenario Mike Madden of Salon wrote last week are the “death panels [that are] already here.”

Or the half of Americans who are already skipping needed medical care because of the cost. A Commonwealth Fund report Aug. 20 predicts that without reform, insurance premiums will increase another 94 percent by 2010.

How did such a critical reform, and our debate over it, go so badly astray?

In an MSNBC interview last week, Democratic Party consultant Lawrence O’Donnell said the White House erred from the start by paying too much heed to convention wisdom and compromising with themselves.

“They didn’t go for the best bill,” he said, which would have been a single-payer system, essentially expanding Medicare to cover everyone.

The system which even the fiercest critics of Obama’s plan strongly defend, when they demand protection for Medicare.

There’s a reason Americans love Medicare — and probably would love its universal expansion. A Commonwealth Fund study in May found that Medicare enrollees have greater access to care, fewer problems with medical bills and greater satisfaction with their health plans and the quality of care they receive than do customers of private plans.

Further, “elderly Medicare beneficiaries were also significantly more likely to report being very confident that they could get high quality and safe medical care when needed, and very confident that they would be able to afford the care they need.”

Even after all the attacks by Fox News, right-wing policy groups and the insurance industry, a Kaiser Foundation poll released Aug. 19 shows that by a margin of 75 percent to 22 percent, Americans favor expanding Medicare to cover people from age 55 to 64 who do not have health coverage.

Similar national systems, of course, exist in every other industrialized country, the reason the United States lags so far behind most of them in every crucial health care barometer from life span to health disparities to access, to even the much-debated issue of waiting times for care.

O’Donnell, who worked on President Bill Clinton’s failed health plan in 1994, said that his party failed to learn a crucial lesson from the 1994 debacle, that they should have spent the past 15 years preparing for this moment and pressing for the best plan of all — Medicare for all.

Instead, the administration and their allies in Congress chose to negotiate downward from the start, and ended up making concession after concession to conservative opponents likely to oppose any reform plan.

What they ended up with is a muddled message. That’s no surprise for a plan whose central element is a requirement that everyone buy private insurance products, with some subsidies offered to help low income people. This amounts to pass-throughs to the big insurers, and begins to look like another massive corporate bailout to another highly unpopular, wasteful industry.

With last November’s mandate, and sizable majorities in the House and Senate, there’s still time for the administration and Congress to salvage badly needed reform that will be genuinely universal, bring rising costs under control and improve quality.

The House has already committed to a floor vote in September on the option of expanding Medicare to cover everyone. That’s the public option that a majority of the nation’s registered nurses and doctors, those with the most daily experience with our fractured health care system, have long supported as the best way to achieve the promise of reform that started this debate.

Rose Ann DeMoro is executive director of the 86,000-member California Nurses Association/National Nurses Organizing Committee, the largest U.S. union of nurses, and a vice president of the AFL-CIO.