Health Care Reform

Let’s Get Back To Basics On Reform Of U.S. Health Insurance System


By John A. Ostenburg

Lots of people are trying to make the Washington debate on health care much more complicated than it should be.

Actually it’s really about only two issues: (1) making sure that the millions of Americans who presently have no health insurance are able to get the coverage they need, and (2) protecting those who presently do have health insurance from the kind of skyrocketing increases in their premiums that have been occurring in recent years.

At a time when the nation’s economy is in the basement and unemployment is at dangerously high levels, the first of the items is doubly important. Since so much health insurance in the U.S. is offered through employers, persons who lose their jobs also lose their coverage. What that means is that the rolls of uninsured citizens is likely to increase over the months ahead. Unless the folks who are losing their jobs are able to find work where they can regain their insurance coverage, they’re out of luck.

The second item also is important to workers. Increasing insurance rates have led many employers to insist that the employee pick up a larger portion of the costs. At the same time, many firms are not giving their workers salary increases because they claim profits are going more and more to cover health insurance costs. Increases in premium costs, therefore, reach directly into the pockets of members of the public.

Americans who have insurance constantly are telling their political leaders and media representatives that they like what they have. The question, however, that needs to be asked is this: “Like it or not, will you be able to afford it unless some kind of reform occurs?” No matter how much you may like your doctor, if you don’t have health insurance — whether due to losing a job or simply because you are not able to afford keeping up with premium costs — it’s highly unlikely you’ll be able to keep seeing him or her without some kind of assistance from someone, be it family member, friend or neighbor, or the government.

While lots of Americans may not recognize what the true issues of the current debate are, you can be sure that the bigwig insurance lobbyists and the legislators they support see things with eagle eyes. They know they’ve had a great ride over the last few years, doubling insurance rates regardless of what their actual costs may have been. They’ve been in control, with the power to deny coverage at will even for persons who have paid thousands of dollars in premiums for years before unfortunately being struck with some major illness. They’ve been free to say “no” to persons seeking insurance coverage because of the potential that some pre-existing condition may force a payout down the road. This latter matter is a major reason why we have so many uninsured residents in the U.S. today.

Because the real reason behind their opposition to health reform is so blatantly self-serving, the insurance moguls and their political serfs have had to find a way to stop the process without exposing their true hand. So, they’ve planted fears among the public: death panels, socialized medicine, rationed care, reductions in Medicare. Anything to get segments of the population that already distrust government to be even more distrustful of government’s efforts to reform health care.

Too many legislators lack the fortitude to stand up to the kind of opposition the insurance industry is pushing, so they’ve caved in and have proposed bills that cut back here or cut back there, and ultimately offer no true reform at all. So while there are so-called reform bills in the hopper, the content of those bills is of limited value because they either are impossible to pass in both the House and Senate or because they are so watered down as to be totally ineffective.

So what can be done.

It seems to me that there’s really only one solution available at this point: true presidential leadership. What President Barack Obama needs to do is show the kind of courage he did on a cold February morning in 2007 on the steps of the Old State Capitol in Springfield, Illinois, when he took on members of his own political party and those of the opposing party in declaring his candidacy for the presidency. What he was embarking on at that moment was a challenge much more severe than the current health insurance dilemma, but he was successful because he was courageous and took control of his own destiny. He needs to do that again.

President Obama needs to send his own bill to Congress, rather than rely on the half-measures that weak-kneeded legislators have put forth. He needs to be courageous in stating clearly that (1) we need health insurance coverage for every American, and (2) we need to set limits on how high premium costs can go. End of story.

Then the President needs to tell Congress, both the members of his own political party and those of the opposition party, in as forthright a manner as possible: “Give the American public what it wants, needs, and deserves, or be prepared to go back home at election time and suffer its wrath.”

And he needs to add, “Oh, did I forget to tell you? I’ll be on their side!”

John A. Ostenburg is mayor of Park Forest, Illinois, and formerly served in the Illinois House of Representatives. He is the chief of staff for the Chicago Teachers Union. E-mail him at [email protected]. This article is from his blog The Outpost Observer, Copyright © 2009 John Ostenburg, used with permission.