Whose
Health Care Agenda?
by
Steven Rosenfeld
Dissident Voice
March 15, 2003
March
10 marked the start of "Cover the Uninsured Week," a major campaign
by a who’s who of foundations, business and labor groups, and health advocates
to address the problem of 75 million Americans who lack health insurance.
This latest number, derived
from census data, is up from the prior oft-cited estimate of 41 million
Americans without health insurance. It includes growing numbers of middle-class
Americans, who can’t afford it or don’t want to pay for it.
"The findings in the
report should represent a sea change in the way we think about the
uninsured," said Ron Pollack, executive director of Families U.S.A., an
organizer in the campaign. "We are moving toward a political tipping point
that will require real and meaningful action to expand health coverage."
While there is no doubt the
problem of caring for the uninsured is one of the biggest problems in public
health and adds to health insurance's ever-increasing cost, there indeed is a
sea change going on in Congress about how to cut health-care costs -- but it’s
not the change called for in the campaign’s media blitz.
In fact, in the very week
the "Covered the Uninsured" campaigners want the media to talk about
the uninsured, the House is poised to pass H.R. 5, a bill that will cut
insurance-related costs for physicians and their insurance companies -- by
limiting jury awards for pain and suffering in medical malpractice cases.
And here’s where the ironies
pile up faster than the health-care bills.
The House bill isn’t only
about cutting the cost of doing business for doctors and insurers. It’s also
about discouraging injured people from suing to collect pain and suffering
awards.
Indeed, many "Cover the
Uninsured Week" sponsors from the private sector, such as the U.S. Chamber
of Commerce, the American Medical Association and Health Insurance Association
of America, put H.R. 5 at the top of their congressional agenda -- far ahead of
covering the uninsured. Of course, there’s nothing in the tort reform bill
tying its savings for doctors and insurers to expanded access to health
insurance, drugs or cutting health care costs.
But perhaps the biggest
irony of all is that at the very time many "Cover the Uninsured"
sponsors will be happy to talk about the need to do something about the issue, some
key tort reform supporters are the ones making the link between using projected
savings from H.R. 5 to address the nation’s biggest health problems, such as
covering the uninsured.
"One current estimate
of the cost of malpractice insurance and claims is about $10 billion a
year," said William R. Brody, president of Johns Hopkins University, in a
recent speech given at the Manhattan Institute entitled, "Is the Legal
System Killing Health Care?"
Brody is also associated
with Common Good, Philip Howard’s anti-trial lawyer group dedicated to
"reforming America’s lawsuit culture."
The $10 billion figure was
one of several Brody cited in his pro-tort reform speech on February 25. He
went on to say, "It’s [the malpractice insurance crisis] a problem we dare
not ignore, because it’s a problem we simply cannot afford. Current estimates
of the added costs of defensive medicine range anywhere from $50 to $100
billion per year. That’s how much additional cost we’re adding just trying to
prevent lawsuits.
"Forty-one million
uninsured Americans? There’s money to cover them right there, with funds left
over to address truly pressing medical problems, like the need to develop a new
generation of antibiotics and slow the frightening increases in chronic
diseases."
These kinds of numbers --
projecting billions in savings from proposed legislation -- are always suspect,
especially when they come in a nasty political fight, such as tort reform. But
suppose they were true, or accurate within a certain range? And what if some of
the anticipated savings in litigation and malpractice premiums were applied to
other needs, such as covering the uninsured, as William Brody suggests?
That certainly would throw a
wrench into the House's tort reform debate. But, of course, what’s on the
House’s agenda this week is a bill to buoy the bottom lines of two white-collar
professions, not legislation to lower what the public pays for health
insurance.
Let’s just hope the
"Cover the Uninsured" campaigners don’t forget to mention what is --
and isn’t -- happening in Congress when the television cameras are turned on.
Steven Rosenfeld is a commentary editor and audio
producer for TomPaine.com., where this article first appeared (www.tompaine.com).