HealthCareForAmericaNow

At the Democratic National Convention last week, Senator and former presidential candidate Hillary Clinton made an eloquent case for quality, affordable health care for all:

And she's right. Everyone who believes in health care for all needs to be on the same page for the coming legislative battle. Unity is strength. But more needs to be done. Earlier at a different event, Richard Kirsch, our National Campaign Director, laid out the obstacles to health care reform:

To win health care reform in 2009, we're going to need to win over a broad swath of Americans, liberal and conservative alike.

This weekend, I was in Chicago visiting friends. I had a few long conversations with a good friend of mine who's views are significantly more conservative than my own. Surprisingly, one of his foremost concerns was the prospect of health care for all, which he was against.

Over the course of these discussions, I realized that there are a few key facts that once agreed on open the door to convincing the more conservative among us to support health care reform, or at least not be as afraid of it.

1. Preventative medicine and visiting a doctor is cheaper than the emergency room.

Almost nobody disagrees with this fact. It is more expensive to go to deny yourself needed health care and go to the emergency room to treat conditions that blossom into real emergencies than to visit your doctor regularly and get preventative care. In fact, by many estimates, emergency care is 3-4 times more expensive than regular care.

2. The uninsured or underinsured force everyone to pay more.

When someone who can't afford adequate health insurance (or any insurance at all) finally has to go to the emergency room, not only is that care more expensive, but that care is paid for by society as a whole - either hospitals foot the bill as a loss, causing increasing prices for others, or the state pays for it in some way, again raising costs.

3. Rising health care costs are the main driver behind our national debt.

The fact that rising health care costs for programs like Medicare and Medicaid are the main drivers behind our national debt is something almost everyone can agree on too, especially when they take a look at the numbers.

Once those facts are agreed upon - and they generally are agreed upon by most - the case for health care reform becomes clear.

If preventative medicine and regular checkups are cheaper, obviously folks should be able to see their doctors when they have a need to help control costs. And if the bill for the uninsured or underinsured, besides costing more, is shouldered by society, it clear more people need to be covered with adequate health insurance.

Of course, many conservatives might argue that even if we covered more people and cut emergency costs, we'd still be spending a ton of money financing health care for all, something they simply can't support. And they'd be right. Any solution to the health care crisis that doesn't control costs simply will not work.

That's where the third fact comes into play. Given that health care costs are driving our national debt, something that pretty much everyone agrees is a bad thing, what can we do to lower costs? There's really only one good answer: Risk sharing.

Here's the argument for fair risk sharing:

The private insurance industry in America can charge customers different premiums based on their age and health history - the amount they can afford to pay doesn't factor into the decision. When old, sick, and/or poor customers can no longer afford their premiums, or have to change jobs, get married, or do anything else that would change their insurance status, private insurers do everything they can to drop them as customers, because these people very quickly go from being profitable accounts in their ledgers to big expenses. These old, sick, and/or poor end up on public health care plans like Medicare or without insurance altogether - which means they show up at emergency rooms to get treated for free, by far the most expensive way to get health care. Therefore, our current health care system allows private insurers to collect premiums from healthy and/or wealthy customers and drop the sick, old, or poor on the public's rolls. This is not sharing risk fairly.

To reduce health care costs, risk must be spread out - even if it is at the expense of profits. Premiums should be calculated based on a person's ability to pay, not on their health history or age. Standard levels of care need to be established, both for preventative medicine and for treatment of the sick. A public health care plan must be created that is open to all to fairly share risk. Most importantly, insurers - both private and public - must not be allowed to drop customers or raise rates when health circumstances change. To do less is not fair, and as it is currently practiced, unfair sharing of risk is the main driver of health care costs in this country and one of the main reasons we spend so much more on health care than other countries.

To put it slightly differently, our current insurance market allows private insurance to collect money from those who pay into the system - the young, healthy, and/or wealthy - and dump those who take money out of the system on the state - the old, sick, and/or poor. That's why Medicare and Medicaid costs are spiraling. The people in these programs by definition take out more money than they pay in. Now, if the risk were shared fairly, young, health, and/or wealthy people would pay into the same system as the old, sick, and/or poor. There would be far more money to going into the system and the cost the government or anyone else has to shoulder would be far less.

From the three facts above, you are left with only one solution: Heavily regulate the insurance industry to enforce fair risk sharing, and create a public insurance plan that everyone can buy into, with rates decided on a sliding scale based on what each person or family can afford. This way, more people are covered (lowering costs) and risks are shared fairly (again, lowering costs). This is simply the only way to really lower health care costs.

Presenting these arguments to my friend this weekend, I can't say I convinced him, but there is no doubt we both saw some common ground. Health care is a moral issue for me, yes, but it is also an economic one. In this country, we spend more and get less, and that's just not alright, no matter your political views.

Nobody likes to waste money and America shouldn't be wasting money on our inneficient, broken health care system. It must be changed.