Sickness & struggle: The urgency of reform

PART 1

By David Hoskins

Aug 6, 2009

The push for meaningful health care reform is in peril. Congressional Democrats have advanced flawed legislation that fails to live up to their campaign pledge of universal health care reform. Republicans allied with right-wing “Blue Dog” Democrats have worked overtime to derail any attempt at reform.

Congress adjourned for the August recess without a floor vote on health reform, leaving many observers to speculate that the plan is doomed to repeat past failed health-reform attempts.

The need for quality universal health reform is more urgent than ever. More than 50 million people living in the U.S. lack basic health insurance. Another 25 million are underinsured.

Families USA, a nonprofit advocacy group for health reform, issued a July report detailing how rising insurance premiums and growing unemployment contribute to an average of 44,230 people losing health coverage each week.

These figures, while important, tell only part of the story. The real-life instances of tragedy resulting from a lack of health insurance tell the other part.

One such story emerged in February 2007 when 12-year-old Deamonte Driver died in Maryland after infection from an abscessed tooth spread to his brain. His mother, Alyce Driver, had spent a considerable amount of time prior to his death trying to find dental care for her children. Deamonte died after weeks of emergency hospitalization failed to save his young life.

Although Alyce Driver was a working mother, none of her jobs in a bakery, construction or home health care provided insurance for her family. Her son’s story adds to the picture of a health care system in crisis and reveals the backdrop to the biggest struggle for health care reform in 16 years.

Not since the 1993 Clinton health reform fiasco has there been such widespread popular support for a radical overhaul of the health care system. Labor unions, progressive health care professionals and consumer advocacy groups all agree that the current system is untenable.

Many among these sections of the organized left have also concluded that the current Democratic reform plan is woefully inadequate and prone to failure.

President Barack Obama’s former doctor recently came out against the Democratic health plan, according to a July 29 article on the Huffington Post. Dr. David Scheiner, a single-payer advocate who treated President Obama for 20 years, says: “I look at his program and I can’t see how it’s going to work. There would be no effective cost control in his program. The [Congressional Budget Office] said it’s going to be incredibly expensive ... and the thing that I really am worried about is, if it is the failure that I think it would be, then health reform will be set back a long, long time.”

This certainly would not mark the first time health reform has suffered a severe setback. An examination of the struggle for reform throughout U.S. history reveals an uphill battle with many major defeats for the movement and some modest concessions from the state.

Medicare, Medicaid and the Children’s Health Insurance Program rank among the most significant health care gains won by workers and oppressed people. But despite a century of struggle, workers in the United States have yet to win a system of quality, universal health care for all. Access to adequate care is now considered a basic right in every other industrialized capitalist country.

As the current push for reform teeters on the brink of collapse, the movement must grapple with a new set of questions.

Why have past attempts at systemic reform failed? How did the modest reforms in health care, such as Medicare and Medicaid, come about? What is the impact of the scientific-technological revolution on health care delivery and patient access? And last but certainly not least—how can quality universal health care coverage be won?

President Obama often referred to “the fierce urgency of now”—a phrase first popularized by Dr. Martin Luther King Jr.—to appeal to voters during the presidential election. A fierce urgency of now exists when it comes to the radical changes needed in the health care system.

The U.S. spends far more on health insurance than other countries, according to a 2009 Organization for Economic Co-operation and Development report on comparative health data. U.S. health care expenditures account for 16 percent of gross domestic product. France came in second on this measure with health spending equal to 11 percent of GDP.

The OECD average was just under 9 percent. U.S. per capita spending of $7,290 was almost two-and-a-half times greater than the OECD average of $2,964. The OECD has 30 member countries, including all of Western Europe, Canada, the U.S., Japan, south Korea, Australia and four countries from Eastern Europe.

This same report found that, despite exorbitant costs, the U.S. has fewer physicians and hospital beds per capita, a higher infant mortality rate, and a lower life expectancy than most other OECD countries.

A 2008 study published in Health Affairs Journal found that the U.S. had the highest rate of preventable deaths before the age of 75 out of the 19 countries it examined. The study concluded that as many as 101,000 deaths a year could be prevented by ensuring that all patients receive quality care in a timely manner.

In this time of severe economic crisis capitalism might be sick, but it is the workers who are dying.