Sunday morning health care and basketball

I’m like about 90% of the country (including the President) waking up to find out that Kansas really did lose.   I watched the game, but still hoped it would be different this morning.  Yesterday was a disaster for my bracket:  I lost both Kansas and BYU from my final four and the only reason I haven’t lost Duke and Kentucky is they haven’t had their games yet.  March Madness a few years ago was like this:  upset after upset.  Great games, but hell on one’s picks.  At this point, I’m just watching to see what happens next.

And we are also watching health care to see what happens next.  The Republican/Tea Party folks must know they are going to lose.  Yesterday they showed their true colors.  The story in the Washington Post by Paul Kane begins

Members of the Congressional Black Caucus said that racial epithets were hurled at them Saturday by angry protesters who had gathered at the Capitol to protest health-care legislation, and one congressman said he was spit upon. The most high-profile openly gay congressman, Rep. Barney Frank (D-Mass.), was heckled with anti-gay chants.

Republican members of Congress addressed the crowd both before and after the incident.  Where were they to control their followers?

Democratic leaders and their aides said they were outraged by the day’s behavior. “I have heard things today that I have not heard since March 15, 1960, when I was marching to get off the back of the bus,” said House Majority Whip James Clyburn (D-S.C.), the highest-ranking black official in Congress.

Between race (I believe that the opposition to anything proposed by President Obama and the wanting to see him fail is simply because the Republicans can’t stomach having a black man in the White House.) and abortion (The opposition to a woman’s right to choose stems, I think, from a deep seeded belief that women are incapable of having their own religious convictions or of making a rational decision), I worry what happens during the fall campaigns.

So I have to turn to Paul Krugman’s column earlier this week to remind myself what we are trying to do.

So this seems like a good time to revisit the reasons we need this reform, imperfect as it is.

As it happens, Reuters published an investigative report this week that powerfully illustrates the vileness of our current system. The report concerns the insurer Fortis, now part of Assurant Health, which turns out to have had a systematic policy of revoking its clients’ policies when they got sick. In particular, according to the Reuters report, it targeted every single policyholder who contracted H.I.V., looking for any excuse, no matter how flimsy, for cancellation. In the case that brought all this to light, Assurant Health used an obviously misdated handwritten note by a nurse, who wrote “2001” instead of “2002,” to claim that the infection was a pre-existing condition that the client had failed to declare, and revoked his policy.

This was illegal, and the company must have known it: the South Carolina Supreme Court, after upholding a decision granting large damages to the wronged policyholder, concluded that the company had been systematically concealing its actions when withdrawing coverage, not just in this case, but across the board.

But this is much more than a law enforcement issue. For one thing, it’s an example those who castigate President Obama for “demonizing” insurance companies should consider. The truth, widely documented, is that behavior like Assurant Health’s is widespread for a simple reason: it pays. A House committee estimated that Assurant made $150 million in profits between 2003 and 2007 by canceling coverage of people who thought they had insurance, a sum that dwarfs the fine the court imposed in this particular case. It’s not demonizing insurers to describe what they actually do.

Beyond that, this is a story that could happen only in America. In every other advanced nation, insurance coverage is available to everyone regardless of medical history. Our system is unique in its cruelty.

And one more thing: employment-based health insurance, which is already regulated in a way that mostly prevents this kind of abuse, is unraveling. Less than half of workers at small businesses were covered last year, down from 58 percent a decade ago. This means that in the absence of reform, an ever-growing number of Americans will be at the mercy of the likes of Assurant Health.

So what’s the answer? Americans overwhelmingly favor guaranteeing coverage to those with pre-existing conditions — but you can’t do that without pursuing broad-based reform. To make insurance affordable, you have to keep currently healthy people in the risk pool, which means requiring that everyone or almost everyone buy coverage. You can’t do that without financial aid to lower-income Americans so that they can pay the premiums. So you end up with a tripartite policy: elimination of medical discrimination, mandated coverage, and premium subsidies.

Or to put it another way, you end up with something like the health care plan Mitt Romney introduced in Massachusetts in 2006, and the very similar plan the House either will or won’t pass in the next few days. Comprehensive reform is the only way forward.

Krugman concludes

Can you imagine a better reform? Sure. If Harry Truman had managed to add health care to Social Security back in 1947, we’d have a better, cheaper system than the one whose fate now hangs in the balance. But an ideal plan isn’t on the table. And what is on the table, ready to go, is legislation that is fiscally responsible, takes major steps toward dealing with rising health care costs, and would make us a better, fairer, more decent nation.

All it will take to make this happen is for a handful of on-the-fence House members to do the right thing. Here’s hoping.

Are you rethinking your position Stephen Lynch?  And what about you, Rick Boucher in Virginia?  Do either of you really want to be the vote that kills Health Care Reform?

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