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Over the next decade, Medicare and Medicaid may lose over $600 billion in funding with recipients, of course, making up the difference or foregoing care. About $317 billion is proposed for "efficiencies" with another $313 billion in cuts for hospitals that treat the poor and uninsured. Many of them are already severely strapped as unemployment soars, charitable donations are down, expenses rise, vital services and staffs have to be cut to stay afloat, and growing numbers won't make it as economic conditions worsen.
Instead of helping to fill budget gaps, Obama plans less aid to shut them down. It will leave some areas dependent on more distant ones for treatment, and let large chains consolidate for greater dominance. Accessible quality care will be less available and affordable so, of course, patients will lose out - mostly the elderly, chronically ill, those on society's lower rungs, and all working Americans because an uncaring administration and Congress threw them overboard for profit and "efficiencies."
If "Obamacare" passes, most working people, the disadvantaged, and those singled out as less important will experience large rollbacks in quality, readily accessible coverage. For them, future health problems will be more hazardous than ever because a callous nation doesn't care.
On July 17 as expected, two of three key House committees passed HR 3200. Largely along party lines, Ways and Means voted 23 - 18. Education and Labor approved 26 - 22 with a Kucinich amendment that may not survive a floor vote or make it to the Senate.
It leaves HR 3200 intact but lets states create single-payer plans. Eight are now considering them - California, Colorado, Illinois, Maine, Pennsylvania, Minnesota, Missouri, and Washington with perhaps more to follow.
On June 11 in Pennsylvania, HealthCare4ALLPA organized over 400 people for a state capital rally, and its Executive Director Chuck Pennachio predicts pending legislation passage later in the year because bipartisan support backs it. So do most Pennsylvanians, and Governor Ed Rendell said he'll sign what comes to his desk.
Kucinich hailed its importance in saying:
"There are many models of health care reform from which to choose around the world - the vast majority of which perform far better than ours. The one that has been the most tested here and abroad is single-payer. Under (it) everyone in the US would get a card that would allow access to any doctor at virtually any hospital. Doctors and hospitals would continue to be privately run, but the insurance payments would be in public hands. By getting rid of the for-profit insurance companies, we can save $400 billion per year and provide coverage for all medically necessary services for everyone in the US."
Tens of billions more annually could be saved if the government negotiated drug prices like it does for the Veterans Administration and Medicaid. The Congressional Budget Office estimated it would be $110 billion over 10 years for Medicare recipients alone, comprising about 15% of Americans. For the entire population, it would be much greater even though over-aged 65 people use more prescription drugs than any other age group.
A Fly in Obamacare's Ointment
One emerged on July 16 when Congressional Budget Office (CBO) Director Douglas Elmendorf told the Senate Budget Committee that health care bills under consideration will raise, not cut costs. "We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending. On the contrary, the legislation significantly expands the federal responsibility for health care costs" even though much of it is shifted to individuals.
Reversing its earlier opposition, the influential American Medical Association (AMA) endorsed the House bill after a new payments provision was added to halt scheduled 2010 cuts to doctors under Medicare.
AMA's president, Dr. James Rohack, said:
"We pledge to work with the House committees and leadership to build support for passage of health reform legislation to expand access to high quality affordable health care for all Americans." The AMA calls it "an important step, but one of many steps in the process," including income-increasing measures for their members and "individual responsibility for health insurance, including premium assistance for those who need it."
Opposing Obamacare are advocates for universal single-payer coverage like Physicians for a National Health Program (PNHP). On July 16, it said the House health reform bill is a "proven failure" and called for an amendment to overturn it and implement a Medicare-for-all system.
PNHP's Dr. Quentin Young said similar state efforts repeatedly foundered. Citing Massachusetts' experience, he explained that "The state is dumping 30,000 legal residents off insurance, and the largest safety-net hospital is suing the state for decimating the hospital's budget to shore up reform. Meanwhile 1 in 6 (state) residents (can't) pay their medical bills, and 18% (of them) with insurance skipped care last year because they couldn't afford it. The Massachusetts model is no solution." Neither are House and Senate bills that will make a broken system worse. It will backtrack from real reform and make it harder than ever to implement. The time to do it right is now.
