Cribsheets

Quality Affordable Health Care for All

With a new budget that allocates funding for health care reform, the next step will be for Congress to pass a health care reform bill.

Posted Thursday, May 14, 2009 in Cribsheets by Natasha Bowens

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  • Quality Affordable Health Care for All

“Health care reform cannot wait, it must not wait, and it will not wait another year.”– President Barack Obama

Summary

The United States currently spends $2.3 trillion dollars on health care, yet we are one of the unhealthiest developed nations in the world. Our health care system is inefficient, our families are drowning in health care costs, and health insurance companies are profiting while denying care to those that need it most. The key challenges facing our health care system are the cost of care, the need for better-quality care, and lack of access to care. Each of these challenges has a direct effect on family budgets, on U.S. businesses, on government spending, and on the country’s ability to compete globally.

In order to build a sustainable economy in the long-term and compete with nations providing health coverage to all citizens, Congress must pass legislation, outlined by the recently passed budget for fiscal year 2010, that invests in reforming our nation’s health care system and carves out a path to reduce wasteful spending and alleviate the financial burden of rising health care costs. We must make bold investments in health care reform now and ensure quality, affordable coverage for all.



Problem

  • We spend billions more than other nations on health care, yet we are not healthier and still have 46 million uninsured – that is nearly 1 out of 6 Americans. Millions more are underinsured, with just bare-bones coverage that leaves them exposed to significant financial hardship if they get sick.
  • Young adults, age 19-29, have the highest uninsured rate of any age group (30% of uninsured). Coverage received through a parent’s private plan or through a public program typically terminates when an individual turns 19 years old. Many of these young adults have entry-level, low-wage, and temporary jobs that often do not offer health coverage and public coverage options for low-income young adults are very limited. Efforts to decrease the overall number of uninsured must address this population, if we don’t act now, we fall even farther behind.
  • The cost of health care has crippled the American manufacturing industry, stalling our strongest job-creation engine. Auto makers are spending more on health care coverage for employees than they spend on steel for manufacturing vehicles.
  • Our economy and our families are drowning in health care costs that are skyrocketing, while insurance companies profit. The average cost of an employer-sponsored family health insurance policy exceeded $12,000 in 2008, more than twice what it cost fifteen years ago. Insurance premiums have grown faster than wages, resulting in less take-home pay for workers, while the top seven insurance companies CEOs profit some $14.2 million a year.
  • While only one-third of the U.S. population is made up of racial and ethnic minorities, they represent over half of the uninsured — over 30 percent of racial and ethnic minorities are without health care coverage. Disparities in health status involve increased rates of mortality and level of chronic disease burden.
  • Our current system is based on quantity of care, not quality. Therefore doctors are being paid for how many procedures they provide, instead of the health of their patients. Our reactive, rather than preventive, health care system not only adds to the poor health of our nation, but adds to the high costs of treating sick patients that quality care could have prevented.



Progressive Health Care Reform Priorities

I. Provide a Public Health Insurance Plan
It is the responsibility of our government to guarantee quality, affordable health care for everyone in America and it must play a central role in regulating, financing, and providing health coverage by establishing a choice of a private or a public insurance plan, without a private insurer middleman, which would allow you to keep the insurance you have if you like it or buy into the public option.

Creating such a large pool not only spreads the risk but spreads the cost of coverage and ensures no one is left out. Coverage will be a shared responsibility between government, families and business, therefore large employers not providing coverage would contribute to the cost of health coverage based on employee wages.

Families will pay on a sliding scale based on income, ensuring affordable coverage based on ability to pay. Assistance to middle-class and low-income families must be provided by the government, as well as tax subsidies for small business to afford coverage for employees, to ensure accessibility for all.

Utilizing effective cost controls that promote quality and lower administrative costs, like through improved IT, will provide long term financial sustainability. It is vital that the government plays a watchdog role on all plans, to assure that insurers do not deny care based on pre-existing conditions and that risk is fairly spread among all health care payers. Obama has outlined savings from reducing waste in programs such as Medicare/Medicaid to help pay for health care reform.

II. Guarantee a standard for comprehensive, quality, and preventive health benefits
Our current system is a reactive, not preventive, system with limited benefits for health risk assessment, physical exam, immunizations, and cancer screenings; also there are no community resources for long term health benefits like smoking cessation or nutrition counseling.

Health care benefits provided in the public plan or employer/private coverage options should cover all necessary care such as doctor, hospital, mental health, prescription drug, some vision and dental, and chiropractic care, including preventive services and treatment needed by those with serious and chronic diseases and conditions. Too many sick patients are either being denied care or are paying out-of-pocket for expensive treatments or operations, due to lack of comprehensive benefits and because our system is based on quantity rather than quality.

Preventive care is essential in reforming our health care system and improving the health of our nation. There should be low out-of-pocket costs, such as co-pays and deductibles, and plans should allow a wide choice of doctors and health care providers to ensure quality care. Grants should be given to state and local governments to promote innovative, wellness and prevention programs, such as nutrition counseling. Government should also invest in research on preventive and wellness programs

III. Ensure equity in health care access, treatment, research and resources
Disparity in health care is characterized by differences in the quality of medical care that is provided and its availability to diverse populations. In order to provide quality coverage for all, with a truly affordable benefit package, services must be accessible in communities of color and among marginalized populations.

Service delivery and quality improvement programs need to be targeted to underserved communities and program models must recognize the needs, language, culture, infrastructure and practices of the local population and build local capacity to address the health care deficiencies in the community. There needs to be a larger, more diverse and culturally-competent health care workforce that is better distributed in low-income and minority communities. Incentives, as well as reimbursement reform, must be aimed at training, attracting, supporting and retaining a diverse, culturally competent workforce.

Our reformed health care system should provide resources and standards for language access to ensure effective communication between consumers and providers and prevent medical errors. We must also invest in an adequately funded, standardized data collection and reporting system to identify and remedy disparities. This includes capturing data on race, ethnicity and ethnic sub-population, socioeconomic position, primary language, age, gender and gender identity, income, and sexual orientation.




Status

The House and Senate have voted on a conference agreement approving the final budget resolution for fiscal year 2010. The passed budget preserves the major priorities in President Obama’s budget proposal, specifically with strategic investments in health care reform. The budget conference agreement follows up on the health investments made in the economic recovery package, and includes, as requested by the President, a reserve fund to allow for a major health reform initiative.

The conference agreement also includes reconciliation instructions for health care reform as an important backup measure that will improve the chances that a health reform bill makes it to the President’s desk this year. Reconciliation will require a vote on a health reform bill by October 15 and will protect health care reform from being blocked by a minority of Senators.

With a new budget that allocates funding for health care reform, the next step will be for Congress to pass a health care reform bill. Congressional committees and leadership, including Senate Finance Committee Chairman, Max Baucus (D-MT) and Senate Health, Education, Labor and Pensions Committee Chairman, Edward Kennedy (D-Mass.), have already begun the process of drafting this legislation with hopes of introducing the bill into Congress by the summer and having a final vote by the fall. There is strong support for health care reform in Congress and across America, however there is also some opposition and false reform proposals:

Support

  • Senate Majority Leader, Harry Reid called for bi-partisan support for health care reform in the Senate
  • Senators Baucus (D-MT) and Grassley (R-Iowa) have released the first of health care proposals, while Senator Edward Kennedy (D-Mass.) has already held a hearing on state health care policy lessons
  • Sixteen Senators have sent a letter to the two committee chairmen that are in charge of health reform, calling for a public insurance option.

Opposition

  • National Insurance Agents urged Congress not to include reconciliation for health reform

You can stay up to date on the next steps for economic opportunity at Funding Our Future, Campus Progress’s blog on the budget and economic issues affecting young people. You can learn more about the health care reform process using Health Care for America NOW’s useful “Steps to Win” tool.

Take Action:

1. Click here to thank Congress for passing the budget.
2. Share your Health Care Story.

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