What could derail healthcare reform


While I am anything but happy with the Senate’s healthcare reform bill (The Patient Protection and Affordable Care Act), it certainly is better than the status quo. It would end the insurance practice of rescission, which retroactively cancels your insurance when you get sick. It would curb such abuses as denying coverage for preexisting conditions, charging women more than men for the same policy, and imposing annual and lifetime caps on benefits. It would close the prescription drug coverage gap for seniors and give them free annual checkups and preventive services for the first time. It would cover 31 million uninsured Americans, helping to eliminate the “hidden taxes” that insured persons now pay to help cover the costs of caring for the uninsured. It would prohibit insurance companies from using huge portions of your premium dollars for advertising, corporate retreats, executive salaries, and unheard-of profits. And it would give small businesses an immediate tax credit to help them afford health benefits for their workers.

Moreover, according to a report from Richard S. Foster of the Centers for Medicare and Medicaid Services, it would increase overall national healthcare spending by just slightly more than 1% over the next decade, even though we would be delivering care to 31 million more people. Moreover, out-of-pocket spending would decline more than $200 billion by 2019, with the government picking up much of that. The additional funds would come from a 5% surtax on the rich (individuals earning more than $500,000 annually or families earning more than $1 million), a 40% tax on so-called “Cadillac” health plans, and most likely an increase in the Medicare payroll tax. For sure, reimbursements for healthcare service delivery would decrease. However, if we continue as we are, healthcare spending could double over the same period and Medicare will become bankrupt. So what choice do we have?

This is why many of the differences between the House and Senate versions of the healthcare reform bills are well on their way toward resolution. However, the debate over abortion has yet to begin in earnest. Cloaked in moral rhetoric, certain politicians will “stand on their principles” (while collecting billions from lobbyists) and refuse to support any legislation that might remotely cover abortion services. The House bill effectively bans any coverage for abortions. Senate provisions would allow states to choose whether to cover abortions (as long as those who want abortions pay for them). The debate over abortion alone could derail all efforts to reform health care. And make no mistake: Principles have nothing to do with it.

Also, there’s considerable concern about who will win Ted Kennedy’s Senate seat. That race has become close, and the Republican running for the seat is basing his campaign on the defeat of healthcare reform. As appalling as it may seem, one man could deny health care to millions.

Of these two greatest threats to healthcare reform, the abortion debacle is more likely to derail healthcare reform—in the name of morality, no less!

The views and opinions expressed by Perspectives contributors are those of the author and do not necessarily reflect the opinions or recommendations of the American Nurses Association, the Editorial Advisory Board members, or the Publisher, Editors and staff of American Nurse Journal. These are opinion pieces and are not peer reviewed.

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