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  • Of health insurance, tea parties, babies and bathwater

    By Diana DiNitto
    Diana DiNitto
    Published: Oct. 4, 2010
    Of

    Diana DiNitto is Cullen Trust Centennial Professor in Alcohol Studies and Education and a University Distinguished Teaching Professor in the School of Social Work. She is the author of “Social Welfare: Politics and Public Policy” and the co-author of “Chemical Dependency: A Systems Approach,” among other publications. She specializes in chemical dependency (alcohol and drug abuse), social welfare, politics and public policy.

    Americans are sharply divided over the Patient Protection and Affordable Care Act of 2010 and related legislation, which are being used as a wedge in this fall’s elections.

    The legislation is the major “policy punctuation” or change in health insurance legislation since 1965 when Medicare and Medicaid were enacted. The legislation is also notable for other reasons, including the votes it garnered. Sizeable majorities of House and Senate Republicans voted for the Social Security Act of 1935 (the cornerstone of the nation’s social welfare policy), and 50 percent of Republicans in the House and 40 percent in the Senate voted for Medicare in 1965, but not one Republican voted for the Patient Protection and Affordable Care Act, despite the benefits it will provide.

    The 2010 legislation will close insurance gaps the private sector has failed to fill.

    Conservatives have not provided proposals that would reduce the number of uninsured to any comparable extent. For many Republicans, tea partiers and other Americans, the 2010 legislation is too much government intervention even though doctors and other private sector health care providers will continue to operate in the free market system. In fact, given that more Americans will have access to health care, demand for health care services will increase. Many progressives or liberals wanted the legislation to go further than it did by adopting a single-payer system. Such a system would use standard claim forms and centralized government payment processing for all insured to save time and money that could go to provide health insurance, including insurance for mental and substance use disorders and dental care.

    The nation’s health care bill is a major concern. Health care comprises more than 16 percent of the nation’s gross domestic product. Medicare, Medicaid and the State Health Insurance Program consume more than 20 percent of the federal budget. Medicaid is more than a quarter of the Texas state budget. Despite outcries about costs, the nonpartisan Congressional Budget Office estimates that the law’s funding mechanisms will reduce the federal deficit by $143 billion between now and 2019.

    As we go to the polls, this fall, let’s remember a few critical health care facts. Compared to all or many other developed countries, the United States:

    Spends more on health care per capita and

    • has poorer health outcomes (for example, infant mortality and life expectancy)
    • has higher uninsured rates and
    • is the only country other than South Africa without national health insurance.

    Among other things, the Patient Protection and Affordable Care Act and related legislation will

    • increase the number of insured by 32 million
    • prevent insurers from denying coverage for pre-existing conditions
    • help lower-income individuals and small businesses purchase health insurance and
    • attempt to improve health care quality and outcomes.

    Texas has much to gain from the health care legislation because it has the highest percent of uninsured residents in the nation.

    Had the United States adopted some form of national health insurance earlier in its history, Americans might have come to view health care as a right. Instead, for many Americans, health care has been a matter of luck — working for an employer who offers health insurance, living long enough to qualify for Medicare or having sufficient income to pay health care expenses out-of-pocket. Even those segments of the low-income population that have Medicaid might be considered lucky because they have health insurance.

    Most of us will never be as witty as Molly Ivins or as provocative as Karl Rove when it comes to discussing politics, but neither we nor the candidates we elect should be so shrill that only dogs can hear us. Instead of throwing the baby (health care legislation) out with the bathwater (or the tea water), we should elect candidates who can work together to see that all Americans have health insurance and that health care costs are brought into proportion. The physical and fiscal health of Americans depends on it.

    Visit the mid-term elections blog series home page for a complete lineup of faculty experts’ analyses.

    • Quote 2
      nimupedia said on Aug. 25, 2011 at 2:09 a.m.
      you right, I'm one of those who are against this health care thing.
    • Quote 2
      Lauren said on July 6, 2011 at 3:54 p.m.
      Health care should be treated as a right not something for the lucky. It should be treated as a government service. I can't tell you how many times someone comes into our office after being laid off and then does not qualify because of a pre-existing condition. These are people in there 50's who are to young for medicare but to old to qualify for regular health insurance. This only causes disruption in our society and undue burden on ordinary working Americans. This gap must be solved or we will end up with millions of uninsured citizens and the burden will grow worse.
    • Quote 2
      Brian Greenberg said on June 30, 2011 at 2:39 a.m.
      I really hope that "medicare for all" is the next slogan for the next medical care debate. It was so disappointing how the last few major debates turned out with "universal healthcare", and the "public option" as the catch phrases. The country needs this to survive... literally and economically.
    • Quote 2
      Raquel Galson said on May 16, 2011 at 5:02 a.m.
      You go right, I go the other way. You talk about it correctly but still opposing outlooks are common!
    • Quote 2
      Johnny Taylor said on May 1, 2011 at 1:26 p.m.
      I'm one of those who are against this health care thing. The way I see it is the government has no business providing Americans with health care at all, nor are they constitutionally allowed to force people to buy something from a private company for just merely being alive. If the government could back off of so much regulation they could let the free market take over and that would help them save money on so much regulation and to get this country out of debt!
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      Wholesale Insurance said on Jan. 19, 2011 at 6:38 p.m.
      I heard that the American Cancer association was started by none other than John D. Rockefeller. That just screams from the very beginning that the ACA is a money laundering scheme. I'm saying this only because it just leads us to the fact that healthcare wouldn't even necessary if the AMA and ADA etc weren't in the hands of people like him.
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      Sarah said on Nov. 1, 2010 at 11:20 p.m.
      I am skeptical that we are the only country in the world without national health insurance excepting South Africa... did the author intend to say developed country? Certainly there are other, although always poorer, countries without national health insurance. If someone could clarify that for me I'd appreciate it. I am curious how Susan Reeves (above post) lost a physician, dentist and optometrist after the legislation passed and what the legislation had to do with losing individual doctors. Clarification is appreciated. And the reason kids in the prime of life should buy health insurance instead of partying is because kids (frequently, perhaps, directly because of partying) will still end up in the emergency room if an accident or unexpected illness occurs, and the government WILL end up footing the bill. Insurance reform will actually save money, and would probably save more if it were more comprehensive. And in response to your question about where the number 32 billion came from, it is the latest number from the Congressional Budget Office which is nonpartisan. 24 million people will purchase coverage through the new insurance exchange and 16 million people will enroll in Medicaid or CHIP. However, 5 million people outside of insurance exchanges will stop purchasing insurance and 3 million will stop receiving insurance through their employers. One third of the remaining uninsured will be unauthorized immigrants. Does that answer your question?
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      Susan Reeves said on Oct. 15, 2010 at 11:56 a.m.
      Do you have any original ideas? What improved health care are you talking about? I lost a physician, dentist and optometrist shortly after the legislation passed. Thanks. Why should kids in the prime of life have to buy insurance if they would rather spend it on partying? Better, why should they help me with my bills? Where did you get the figure 32 million? Out of the same hat as 47 million?
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      tim said on Oct. 14, 2010 at 10:23 a.m.
      we are the only country in the world without national health insurance except for South Africa. if that's true, then out of all these countries, surely there are one or two that would serve as a model for us to try and replicate. Just as Finland has an excellent school system that we could learn from, what countries do you know of that you would say have good and effective national health care programs? and Mexico has national health for it's citizens? and Peru?
    • Quote 2
      David Young said on Oct. 5, 2010 at 7:06 p.m.
      Standard leftist defense of the Obama health care initiative. In 2011, we'll see legislation that actually DOES achieve most of these goals -- without having the government in charge. And with individual consumers free to make their own choices.
    • Quote 2
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