Where do we go from here with Health Care Reform?

I will have to admit that as certain as I think we need universal health care reform, it doesn’t look likely it will get done this time. The election of Republican U.S. Senator Brown from Massachusetts, who is opposed to universal health care reform, may be the “nail in the coffin.” This will make it even more difficult to overcome the cloture rule in the U.S. Senate which requires 60 votes rather than the simple majority which is what the U.S. Constitution intended for passage of bills.

The people I feel empathy for are those left uninsured because of pre-existing conditions, lose or change jobs, are dropped by their insurance companies, and/or denied medical procedures that their insurance company unilaterally decides to refuse. For those who are one serious illness away from being “buried” in medical bills they may never recover from financially and may even force them into medical-related bankruptcy. For small businesses and the self-employed who, having no bargaining power enjoyed by large government entities and large companies, cannot afford medical insurance costs with decent coverage. And for seniors, who might see life long savings and investments disappear in an attempt to pay medical bills. All of the above are likely to be forced to go without or run the risk of too limited coverage. Many will simply choose to forgo medical treatment well beyond the time when it is wise to seek it rather than go through the demeaning process of public assistance.

I would prefer to see the Democrats (since the Republicans have opted out of process) work their way through a compromise between the House and Senate bills doing away with all the “deal making” provisions that were offered as compromises to get the vote of a few Republicans and/or hesitant Democrats to get the bill passed. The Democrat leadership managed this bill poorly and this administration got caught up in the process resulting in bad bills. They need to take the good provisions of the bill (about 80 to90% of what’s there), and write a “clean and clear” one. It should contain at least a public option, universal coverage, and be deficit neutral or better. Then, take it to both the House and the Senate for a vote. If Republican and Independent Senators want to filibuster, call their bluff. Let them take responsibility for their actions with the American people. If in the end the bill fails, that’s fine.

Although risky, I don’t think doing this would be devastating to the Democratic Party. The American public knows why we need this legislation. If the bill fails, we should carefully track the medical costs, coverage, along with profits of insurance companies and others in the medical field who have spent millions to defeat this bill. If they continue to be unreasonable in their costs and coverage or get worse, make it clear to the American people that an honest effort to provide good, universal coverage at reasonable costs has been offered to correct this situation. Then, remind the electorate that if they will send to Washington both Democratic and Republican Congressmen who favor meaningful health care reform, the Administration and Congress will make another run at it.

I know that unemployment, stimulus bills, national security, the wars, financial regulation, rebuilding of infrastructure, restructuring of education, etc., are out there and need to be addressed. And, in dealing with these, we should adopt the attitude that the “big boys” have gotten their “gift horse”, and they can expect no more. In fact, they should pay back their loans and we should stop the prevalent practice of corporate welfare. Instead, the emphasis now should be dealing with the myriad of problems in a fiscally conservative fashion recognizing that it will still be expensive and will require increased tax revenues. But, we should never lose sight of the importance of medical care which represents 1/6th of our GNP. This is not a small issue we can ignore and it is one that potentially affects almost everyone. If the insurance companies and others in the medical field can’t get their house in order to give universal coverage at reasonable costs, it won’t take many election cycles before universal health care reform will be mandated. Maybe this time, we will be ready to insist on a true universal health care system somewhat similar to what every other advanced nation in the world provides their people.


It will take some political courage to approach it this way; but, in my opinion, the time has come for the electorate to step up to meet the challenge by holding their Congressmen’s “feet to the fire.” We can’t afford to continue business as usual allowing us to drift into a declining second class nation where we don’t even have the decency to provide our own people with adequate medical care when it could be structured to be a deficit neutral program or better.