Health Care Reform 101

I will admit to having been following “Health Care Reform” without doing much homework on the issue.  From my peripheral vision, I’ve equated the topic to a battle in Congress over whether there should be a public alternative to private insurers, and I’ve worried about how Obama’s plan would affect the federal budget.  Beyond that, I’ve been content to hope the President’s vision is successful, not really understanding the details.

That complacency changed yesterday when my wife and I attended an Organizing for America forum in Dorchester, Mass.  In a Service Employees International Union hall we joined approximately 200 volunteers recycled from the Obama grassroots campaign organization.  You could tell it was the Obama team at work, because we were invited to fill out contact information on arrival, and it was difficult to leave without turning in a form with more contact information and details of the tasks we were willing to undertake.  From 10 a.m. till 1 p.m. on a muggy July Saturday, we willingly descended into the weeds of this vast topic, hearing from a procession of speakers actually involved in the proposed health care legislation. Two stood out for me.

John E. McDonough is senior advisor to Sen. Ted Kennedy on national health reform.  Because of Senator Kennedy’s key role on the issue, even as he has to sit out the current debate because of brain cancer, it’s clear that McDonough is close to the action in Congress.  He struck me as a calm, pragmatic, engaging fellow.  He said that everyone could agree in general terms that something has to be done about escalating health care costs in this country, but now that there are actual bills filed in Congress, “we’re using real bullets.”  Too much conflict and arguing?  “That’s what we do down there,” he said. “It’s called democracy.”

I take comfort knowing that people like John McD0nough are crafting health care reform, as opposed to Maureen Dowd, Keith Olbermann, Rush Limbaugh, or Glenn Beck.  If you put those four and all their pundit kin in a room with the task of creating anything that would benefit the nation–well, good luck with that.  But if you put McDonough and his counterpart staffers from conservative members of Congress together, along with the members themselves, and you provide a strong push from a new president to get something done on this issue that has been kicked down the road for generations, well, maybe something really might change in the way health care is provided in America.

I believe it was McDonough who explained what will be necessary for Congress to pass meaningful health care reform.  “Do the members feel they have to do it?”  That’s the question which he said must be answered affirmatively – thus the need for grassroots work.  Another speaker stated that the insurance industry is spending $1.4 million a day to make sure no reform passes.  Without political pressure on behalf of reform, you’d have to say the odds favor the status quo, as usual.  And that status quo is costing us dearly – $2.5 trillion a year or 17 percent of Gross Domestic Product, more than any of our international competitors.

We were told that the next few weeks, before Congress leaves for its August recess, will be critical in determining the success of reform.  On the screens appeared a list of the members of the Senate Finance Committee and we were each urged to ask 10 friends in the members’ states to email support for reform.

The other speaker who impressed me was Rahul Rajkumar, a senior advisor to Doctors for America, a grassroots organization of more than 13,000 physicians in all 50 states seeking to engage doctors in healthcare reform. He calmly addressed the key question: how are we going to pay for this?  I recorded his talk, and you can listen to it here.  He pointed out that the issue of cost really has three components – how will families pay for medical costs, how will the nation pay for medical costs, and what will the impact be on the federal budget?  The third aspect is “what’s sucking up all the oxygen in Washington,” Rajkumar said, but the first two are crucial in understanding the entire issue.

I was surprised to learn from Rajkumar’s pie charts that 25 percent of us already receive health insurance from the federal government, through Medicare, Medicaid, and the Veterans Administration.  The pie chart won’t change much in the proposals before Congress, he said, except that most of the uninsured would obtain insurance, and those with private plans would have other options.  He also noted that more than half of all bankruptcies in the United States are due to medical costs which people are unable to pay. Of those health-care related bankruptcies, 68 percent involved people who had health insurance that was clearly inadequate.

As a new student in Health Care Reform 101 I won’t presume to write a definitive thesis on the topic this morning.  But my interest was piqued, and I’m ready to do some work on behalf of sensible reform that can bend the escalating curve of medical costs away from the unsustainable track they are on now, as well as provide coverage for the millions of Americans who have none.

The speakers at the forum recommended these sources of continuing information about the health care reform initiative: Ezra Klein of The Washington Post, Jonathan Cohn of The New Republic, and Talking Points Memo, as well as general coverage in The New York Times.  For balance, you might want to add the Heritage Foundation and the Cato Institute, as was pointed out to me by Mike Neumann, a Twitter follower who offered pithy rebuttals to my Tweets from the forum.

On my own after the forum, I came across this excellent overview of the issue in The New York Review of Books.

Let the learning begin!

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