By Mary Margaret Bollinger

Those of us who experienced the 1993 health care debate should remember the “Harry and Louise fear of change” ads that were used to incite public opposition and defeat health care reform efforts.

Most of the changes the ads warned would come with the Clinton proposal, happened anyway: HMOs and insurance plans limited which doctors patients could see, what hospitals they could go to, and what treatments they could receive. Costs went up, more people lost coverage, Medicare costs continued to increase at an unsustainable rate, and everybody with coverage is paying more for it.

The same “fear” strategy is being used this time as our troubled economy, skyrocketing costs, and the sinking quality of American health care drive the current health care reform effort.

We worry that if everybody has access to health care -- universal coverage -- our own access to health care will somehow be lessened and we will pay more even though we know that everyone who currently has health insurance has seen those costs escalate faster than inflation for more than a decade. We worry that we will not have access to the newest tests and the latest procedures. We worry that we will not have access to the physicians we want to see -- even though that access is limited now as Mississippi has the lowest doctor-to-person ratio in the country.

The best argument for universal coverage is that, by providing more preventive care, it will help drive health care costs down by keeping people healthier in the long run. The man with undiagnosed and untreated high blood pressure dramatically increases his chances of a crippling stroke. The child with asthma whose parents cannot afford the medication or regular doctor visits is more likely to miss school and to end up with an expensive hospitalization. The woman who puts off a mammogram because her insurance does not cover it or she has no health insurance dramatically increases the chances that breast cancer will kill her because treating the disease when it can first be detected is cheapest and has the best odds for success.

The reform we should all be pushing for should include regulation so that insurance companies play fair and cover people with existing conditions. There should be mandates so that most employers continue to offer coverage to their employees, and tax credits and subsidies so that working families who really cannot afford health coverage can get it. And there should be competition -- the public option -- so that we really can get more for our money. The public option should make available for buy-in the government programs that work now: Medicare, the Veterans Affairs system, and the health insurance that members of Congress have.

A recent Wall Street Journal poll found that, when they learned what is in the health care bill in Congress, clear majorities supported the basic components: universal coverage, a public option, paying for the changes with increased taxes on high income Americans and employer contributions.

Some for-profit health insurance companies, who have been making record profits since the last health care reform effort, are trying to convince Americans once again that change will make things worse, not better. This time Harry and Louise are on to them; they are pushing for change along with a long list of large and small business associations, and health care advocates including the American Medical Association. About 14,000 Americans are losing health coverage every day. Continuing down this unsustainable path without serious health care reform is what we really have to fear.
Bollinger is a former tax attorney in Jackson.
Copyright (C) 2009 by the Mississippi Forum 9/09