Improving Access to Health Care

By Bill Cahir

It is time to turn elect a new class of problem-solving lawmakers dedicated to serving the public instead of ignoring major economic problems. Getting affordable health care for working Americans must be a top priority for Congress.

Fully 47 million people did not have health insurance in 2006, and the ranks of the uninsured expanded by 2.2 million people in a single year, according to a report released last year by the U.S. Census Bureau.

The tally of the uninsured included 1.23 million people in Pennsylvania, or 10 percent of the population statewide.

"Over the past decade, personal health care spending, health insurance premiums, the uninsured population, and the number of hospitals in financial distress have all increased," Mark Volavka, executive director of the Pennsylvania Health Care Cost Containment Council (PHC4), said in a press statement in October 2007.

The council found that employer-based health insurance premiums for family coverage increased from $6,721 per employee in 2000 to $11,801 in 2006. That's an increase of $5,080, more than 75 percent, over six years. Not surprisingly, PHC4 also reported that number of Pennsylvanians receiving health insurance through their jobs decreased by an estimated 450,000 people from 2000 (8,569,000) to 2005 (8,119,000).

The American economy finances the best health care research and treatment facilities in the world. When foreign leaders come down with major illnesses, they often come to the United States - to the University of Pittsburgh Medical Center, for example- for life-saving care. But excellence in basic care, in pharmaceutical research and last-minute surgical intervention does not address the more fundamental economic problems that afflict the American health care system.

A series of financial cancers are metastasizing and causing more severe health care problems for small business owners, farmers, self-employed people, contractors and sub-contractors, employees working in service sector and wage-and-hour jobs, and even relatively well-paid people who have health insurance.

Deductibles, co-payments and premiums are going up, while coverage is becoming more riddled with loopholes.

People who don't have health coverage don't engage in sufficient preventative care, and their wait to report to emergency rooms requires the most expensive interventions possible. Even people getting health care through their jobs are using their credit cards to pay rising expenses. Families USA, a non-profit group that focuses on consumers' health care needs, reports that even Pennsylvanians with health insurance are paying more cash out of pocket:

• In 2000, 1,869,000 non-elderly Pennsylvanians were in families that spent more than 10 percent of their pre-tax income on health care costs.

• Between 2000 and 2008, the number of people in families spending more than 10 percent of their pre-tax income on health care costs will have increased by 371,000. This increase is greater than the population of Centre, Clearfield and Clinton counties combined.

• Nearly 9 out of 10 people, or 87.1 percent, in families spending more than 10 percent of their pre-tax income on health care costs have health insurance.

• 1,952,000 non-elderly Pennsylvanians with insurance are in families that will spend more than 10 percent of their pre-tax income on health care costs in 2008.

Costs continue to rise. An aging population of 303 million people, when matched up with a health care research system producing high-cost innovations and treatments, warps health care costs according to a series of inexorable laws:

An older, sicker population requires more care. A well-informed, technology-savvy population wants the latest drug, the latest therapy, and the latest health care innovation, no matter the cost. Hospitals and doctors face extraordinary financial stresses due to the need to provide more free care to the rising number of uninsured people walking in the door.

President Bush responded to the Census Bureau's analysis by twice vetoing a bill to expand the State Children's Health Insurance Program, or SCHIP, by $35 billion. President Bush's budget for next year would reduce Medicare payments to hospitals by $5.5 billion over five years, according to the Hospital & Health System Association of Pennsylvania (HAP).

"Reducing payments on this scale will reduce the funds hospitals need to improve quality and patient safety-through investment in vital state-of-the-art facilities and equipment; workforce training, recruitment, and retention; essential health information technology; and bioterrorism, flu, and disaster preparedness. All of these impact a hospitals' ability to take care of patients in a safe, high-quality way," HAP President and Chief Executive Officer Carolyn F. Scanlan said in a statement.

The next lawmaker from Pennsylvania's Fifth Congressional District must work with doctors and state and local financial leaders to:

• Create a voluntary purchasing pool that would let farmers, self-employed people and business owners with 50 or fewer employees join a broad risk pool and help them buy affordable private health care coverage;

• Ban discrimination against people with pre-existing health conditions, such as diabetes and high blood pressure, to ensure that all who apply have a chance to buy reliable health coverage;

• Reduce the required age of eligibility for Medicare from 65 to 60 to ensure that early retirees and workers from collapsed businesses get the care they need;

• Increase Medicare funding for rural hospitals and health care clinics;

• Strengthen the Medicare prescription drug benefit so that it is easier to understand and less riddled with loopholes;

• Provide federal funds to states like Pennsylvania that are launching their own health care coverage plans;

• Finance health care initiatives by allowing President Bush's tax cuts for the wealthiest Americans to expire. That would mean allowing the Clinton era tax rates to take effect one more time for individuals earning $200,000 per year, for single head of households earning $300,000 per year and for married couples earning $400,000 or more per year.

Instead, lawmakers more concerned about their own salaries and their own health benefits came to power. They ignored rising health care costs and the welfare of the people they were paid to represent.

It is time to turn the tide and elect a new class of problem-solving lawmakers dedicated to serving the public instead of ignoring major economic problems.