Whose Health Care Agenda?†
by Steven Rosenfeld
March 15, 2003
March 10 marked the start of "Cover the Uninsured Week," a major campaign by a whoís who of foundations, business and labor groups, and health advocates to address the problem of 75 million Americans who lack health insurance.
This latest number, derived from census data, is up from the prior oft-cited estimate of 41 million Americans without health insurance. It includes growing numbers of middle-class Americans, who canít afford it or donít want to pay for it.
"The findings in the report should represent a sea change in the way we think about the uninsured," said Ron Pollack, executive director of Families U.S.A., an organizer in the campaign. "We are moving toward a political tipping point that will require real and meaningful action to expand health coverage."
While there is no doubt the problem of caring for the uninsured is one of the biggest problems in public health and adds to health insurance's ever-increasing cost, there indeed is a sea change going on in Congress about how to cut health-care costs -- but itís not the change called for in the campaignís media blitz.
In fact, in the very week the "Covered the Uninsured" campaigners want the media to talk about the uninsured, the House is poised to pass H.R. 5, a bill that will cut insurance-related costs for physicians and their insurance companies -- by limiting jury awards for pain and suffering in medical malpractice cases.
And hereís where the ironies pile up faster than the health-care bills.
The House bill isnít only about cutting the cost of doing business for doctors and insurers. Itís also about discouraging injured people from suing to collect pain and suffering awards.
Indeed, many "Cover the Uninsured Week" sponsors from the private sector, such as the U.S. Chamber of Commerce, the American Medical Association and Health Insurance Association of America, put H.R. 5 at the top of their congressional agenda -- far ahead of covering the uninsured. Of course, thereís nothing in the tort reform bill tying its savings for doctors and insurers to expanded access to health insurance, drugs or cutting health care costs.
But perhaps the biggest irony of all is that at the very time many "Cover the Uninsured" sponsors will be happy to talk about the need to do something about the issue, some key tort reform supporters are the ones making the link between using projected savings from H.R. 5 to address the nationís biggest health problems, such as covering the uninsured.
"One current estimate of the cost of malpractice insurance and claims is about $10 billion a year," said William R. Brody, president of Johns Hopkins University, in a recent speech given at the Manhattan Institute entitled, "Is the Legal System Killing Health Care?"
Brody is also associated with Common Good, Philip Howardís anti-trial lawyer group dedicated to "reforming Americaís lawsuit culture."
The $10 billion figure was one of several Brody cited in his pro-tort reform speech on February 25. He went on to say, "Itís [the malpractice insurance crisis] a problem we dare not ignore, because itís a problem we simply cannot afford. Current estimates of the added costs of defensive medicine range anywhere from $50 to $100 billion per year. Thatís how much additional cost weíre adding just trying to prevent lawsuits.
"Forty-one million uninsured Americans? Thereís money to cover them right there, with funds left over to address truly pressing medical problems, like the need to develop a new generation of antibiotics and slow the frightening increases in chronic diseases."
These kinds of numbers -- projecting billions in savings from proposed legislation -- are always suspect, especially when they come in a nasty political fight, such as tort reform. But suppose they were true, or accurate within a certain range? And what if some of the anticipated savings in litigation and malpractice premiums were applied to other needs, such as covering the uninsured, as William Brody suggests?
That certainly would throw a wrench into the House's tort reform debate. But, of course, whatís on the Houseís agenda this week is a bill to buoy the bottom lines of two white-collar professions, not legislation to lower what the public pays for health insurance.
Letís just hope the "Cover the Uninsured" campaigners donít forget to mention what is -- and isnít -- happening in Congress when the television cameras are turned on.
Steven Rosenfeld is a commentary editor and audio producer for TomPaine.com., where this article first appeared (www.tompaine.com).