Public Option Versus a Senate Mandate

I am skeptical over the possibility of merging house and senate health care reform bills through a conference committee.

A conference committee process includes selected members of the house and senate. The committee will bring an integrated measure that will be presented to the chambers for a final vote without amendment. It is simply a yea or nay.

If a merger is to be successful, I am most concerned with the house call for a public option, and the senate's more Draconian idea of a mandate forcing everyone to buy health insurance.

The Senate's Patient Protection and Affordable Care Act would compel everyone to buy health insurance or face a fine. The supposedly "affordable" aspect would contain tax credits of up to 400 percent of the federal poverty level, which is $88,000 a year for a family of four[i].

So while a family of four, as described above, would be eligible for tax credits, they don't know how much the tax credit would cover.

That makes me sick to my stomach because it leaves too much wiggle room for the health insurance industry.

Further, the "affordable" part of the senate bill would be defined by the politicians, who are very well off to outright rich and many do not personally know any working class or unemployed persons.

Meanwhile, the house bill's call for a public option is more in line with the rest of the industrialized nations in the world.

There are 28 industrialized countries with single payer universal health care systems. Germany has universal health care but it is a multi-payer system much like that which was proposed by President Clinton.[ii] Even developing countries have universal health care.

If the rest of the world can do it, why can't the United States do it?

The answer is supplanted somewhere in the convoluted logic of greed.

The United States spent $2.2 trillion dollars on health care in 2007[iii], which amounts to over $7 thousand per person, easily making it the most expensive health care system in the world.

In 2000, the World Health Organization released a report of the health care systems of the world. The United States ranked 37^th in overall "goodness" of their health care system.[iv]

Various estimates place the uninsured in the US at somewhere around 45 million people. That is the entire populations of California, Virginia and Vermont combined. People without health insurance tend to "live sicker and die younger" than people with health insurance.[v]

In his 2008 Frontline Documentary, "Sick Around the World," correspondent T.R. Reid compared the health care systems of the US to the United Kingdom, Switzerland, Germany, Japan and the Philippines.

All of the physicians and health care administrators polled about their systems admitted they weren't perfect but all believed the lack of access to health care and the concept of medical-related bankruptcies were "unconscionable."

If the US is to succeed with real health care reform, it is to do so with a vigorous public option. It works around the world, and while it is not perfect, it helps millions of people. It puts health insurers in their place, and it enables working people to get and maintain health care that is a basic human right around the world.

A mandate forcing people to buy health insurance at rates the government deems affordable will only further health insurers ability to make obscene profits through a corrupt and broken system.

If anything comes out of a merged congressional health care bill it still has a very long way to go.

We continue to cross our fingers and hope for the best.

[i]Huffington Post. House, Senate Bills Comparison, December 24, 2009.

[ii]John R. Batista, M.D. and Justine McCabe, M.D. The Case for Single Payer, Universal Health Care for the United States, from an outline of a talk on June 4, 1999. http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm.

[iii]The Henry J. Kaiser Foundation. Health Care Costs: A Primer, March 2009-http://www.kff.org/insurance/upload/7670_02.pdf.

[iv] World Health Organization. World Health Report 2000-Health Systems-Improving Performance (Geneva: WHO 2000).

[v] American College of Physicians-American Society of Internal Medicine. "Statement for the Record of the Ways and Means Health Subcommittee on the Nation's Uninsured," April 4, 2001.