Something is better than nothing

Posted in CULTURE by Joel Gillespie on Tuesday, March 16, 2010 at 10:00 am

Champaign County Health Care Consumers has been working for underprivileged consumers of health care in this community for over thirty years. It is no exaggeration to say that they have single-handedly helped to improve access to health care for thousands of local community members.

With the current final push to get health care legislation passed in the U.S. Congress, the CCHCC has been working hard on a local level to convince local citizens to support the bill. Later today, they will be passing out copies of their "Quick Guide to Health Reform" on the corner of First St. and Kirby Ave. (Florida) in Champaign and they have more actions planned as the week goes on. We recently had a chance to discuss the bill and the CCHCC's views with Executive Director Claudia Lennhoff.

Smile Politely: Your organization seems to be making a big push to support the current bill in Congress. However, it would seem like this bill doesn't really go as far as you would like compared to your original vision of health reform last year. Why have you decided to support it? 

Claudia Lennhoff: Champaign County Health Care Consumers (CCHCC) is supporting the Senate health reform bill because it will make concrete improvements in people's lives. We know people who will be helped within the first year of the bill's passage.

The Senate health reform bill will:

• Require insurance companies to cover people with pre-existing conditions and making it illegal to drop coverage for people who get sick
• Provide tax credits to small businesses to help them provide healthcare coverage to their employees (CCHCC, as a small non-profit, will benefit from this provision this year!);
• Extend dependent coverage to age 26 without requiring that dependents be students (effective this year!)
• Cut waste, fraud and abuse in Medicare and Medicaid and help assure that Medicare funds go to improving care instead of insurance company profits
• Increase oversight of the insurance industry to crack down on rate increases and abusive practices
• Reduce prescription drug costs for seniors by closing the current donut hole gap in Medicare drug coverage
• Expand Medicaid eligibility and get rid of the assets test in Medicaid, meaning that childless adults will be able to get covered
• Require that members of Congress get their health insurance through the same Health Exchange as other Americans.

The Senate bill, is of course, not perfect. But CCHCC can't walk away from the opportunity to make improvements in people's lives. For too long, the uninsured have suffered and died prematurely — this includes some of our clients. Too many of our insured clients have been ruined financially and lost their access to health care because their health insurance failed them. We know what happens if we do nothing — and it's more of the same — more devastation. What is happening now is totally inexcusable and intolerable.

Anyone who believes that this bill is worse than doing nothing is not in touch with the everyday people whose lives are harmed by the failures of our health care system. We take what we can when we can, and we keep pushing and working for more. This bill isn't the be-all and end-all of health reform. Social Security wasn't created and made perfect in one legislative session when it was introduced. Neither was Medicare. Neither was the State Children's Health Insurance Program. Advocates, activists and organizers dedicated to these struggles know that these are struggles that continue for years, not just one legislative session or year. So just because the bill isn't how we would have designed it doesn't mean that it is worthless or harmful or that you walk away from it.

Smile Politely: What do you say to people like Rep. Dennis Kucinich (right) who will not support the bill because it does not go as far as he would like?

Claudia Lennhoff: Well, I'd say he's fortunate to have health insurance, probably provided by a private company, paid for at the taxpayers' expense.

Why is he denying the American people the opportunity to have health insurance? I have read that Rep. Kucinich objects to the individual mandate and requiring people to purchase health insurance from private insurance companies. That seems rather ideological. I would understand that position more IF health insurance companies were NOT being regulated heavily. The fact of the matter is that insurance works better and is more affordable when the pools are bigger, and when you regulate the industry — this is what this bill will do. Also, I think it's a position of privilege or luxury to have the mindset that this bill is worse than nothing. Ask most uninsured or uninsurable people if they would like to have the opportunity to get health insurance, and they will say yes. Most people just want to be covered so they can go to the doctor when they need to.

I think it's a luxury to have the mindset that Rep. Kucinich has. He thinks he's standing up for people, but really he is denying people the opportunity to get health care coverage like he has. Most people who I know who have this mindset are healthy people who have health insurance. I actually get really angry about this. This isn't theoretical or ideological. We live in a country where, in order to get health care, you have to have health insurance. That's the fact. We don't yet have single payer (and no, this bill is not standing in the way of single payer — there is not yet enough support for single-payer, though we're working on it!), so therefore we're going to have to provide people with coverage through both public and private health insurance companies. Many of the clients with whom I'm working right now will qualify for Medicaid under the expansion in this bill. They can't wait to get health insurance! Others will be able to get coverage through private plans. They can't wait to get coverage!

The way I think of this imperfect legislation is this: If one is hungry, one does not walk away from half a loaf of bread just because it is not a full loaf of bread, or the type of bread we really wanted. You take the half and come back the next time for the other half or for another loaf. You don't walk away from the opportunity to help real people. Our nation is desperate. I think Rep. Kucinich must not feel the desperation and must not have had to witness the destruction of people's lives because of our current health care situation. I would invite him to walk one day in my shoes, working with local clients. Or better yet, walk one day in the life of one of my clients. Being sick and not knowing how, or if you're going to get better is a very terrible way to live.

Smile Politely: Isn't reconciliation a Democratic way of sneaking the bill through?

Claudia Lennhoff: Yes, Fox News would have you believe that reconciliation is a Democratic trick. It's not.

Reconciliation is a process set forth in the Congressional Budget Act that allows for expedited consideration of legislation affecting mandatory spending programs or taxes.

Reconciliation has been used many times to make major policy shifts, including the following:

• 1996 Welfare Reform
• 2001 Tax cuts for the wealthy
• 2003 Tax cuts for the wealthy

Congress has also used reconciliation in the past to establish new health coverage programs, or to expand existing programs, such as:

• 1985 COBRA, which continued employer-sponsored health coverage (ever wonder about what COBRA stands for? It's Consolidated Omnibus Budget Reconciliation Act)
• 1997 Children's Health Insurance Program
• 1997 Medicare Advantage, which established the Medicare+Choice program

A few important facts about Budget Reconciliation:

• Can only be used for items that impact the federal budget deficit
• After the Republican-led tax cuts of 2001 and 2003, which INCREASED the budget deficit, Congress in 2007 adopted new rules preventing Congress from using reconciliation to increase deficits and debt
• In other words, any health reform changes made through reconciliation will necessarily be changes that do NOT increase the budget deficit
• Since rising health care costs are the single largest reason for projected long-run deficits, it is appropriate that health reform be considered through the reconciliation process
• Reconciliation rules specify that reconciliation CANNOT be filibustered, and there is a time limit allowed for debate in the Senate.
• There is a myth that provisions in a reconciliation bill must expire after five or ten years. This is a myth! Provisions must sunset ONLY if they would increase deficits in subsequent years.

It's important for people to understand that budget reconciliation is NOT the vehicle for health reform — the Senate bill is. Budget reconciliation would make some changes to the Senate bill, but is not at all the major vehicle for changing our nation's health policy.

Smile Politely: Why not just start over?

Claudia Lennhoff: Why should we start over? The people calling for Congress to start over are the opponents of health reform, not the people who want health reform.

Scrapping the bill is simply a delaying tactic. Opponents have no intention of reforming the health system. The opponents do not want any health reform to pass — they care more about health insurers than American families. After more than a year of debate, Congress should listen to everyday Americans, not the insurance lobbyists who are spending millions to block health care reform and protect their profits. We can't afford to continue with the status quo of denied care and rising premiums from insurance companies.

Smile Politely: How does the current bill address some of the insurance industry's more problematic practices, like recision and pre-existing conditions?

Claudia Lennhoff: The Senate's bill has excellent hard-fought and hard-won regulations on the insurance industry that will prohibit the worst, most harmful, and profitable practices of the insurance industry.

The Senate bill will regulate private health insurance companies by:

• Preventing insurers from denying coverage to people with pre-existing conditions.
• Barring insurers from basing premiums on health conditions or gender, as they currently do. CCHCC is a victim of insurer's gender rating practice. See our website for more information on this.
• Restricting insurers from raising rates when people get sick.
• Prohibiting insurers from the practice of "rescission" -- dropping coverage when someone gets sick.
• Prohibiting lifetime and annual caps on insurance coverage.
• Limiting out-of-pocket expenses.
• Requiring insurers to devote at least 85% (for group plans; 80% for individual and small group plans) of premiums to medical benefits. If insurance companies do not meet this threshold, they must provide rebates to consumers.
• And much more!

Every day, we at CCHCC see clients who come to us because their insurance companies have failed them in some of the ways that the Senate bill proposes to regulate. We are very excited about these long overdue regulations because for too many people, private health insurance has become like an umbrella that melts in the rain, but worse than leaving people wet from the rain, people's health and their financial lives are destroyed. This situation plays out every single day in our community.

These regulations will provide insured individuals and families with security — the knowledge that their health insurance company can't just rip them off, deny or rescind coverage, and leave them holding the bag for unplanned and unexpected medical expenses.

Smile Politely: Most legislators have already decided how they'll vote — why would any action this week make a difference? Why would a person think they could make a difference at this point?

Claudia Lennhoff: Actually, there are about 70 undecided Representatives. There are a number of Illinois Representatives whom we all should be calling and telling them to vote yes for health reform because Illinois needs it! These Representatives include: Daniel Lipinski (right), Melissa Bean, Jerry Costello, and Bill Foster.

The reason that people CAN make a difference by taking an action like calling a Representative is because that individual is one of many, and it takes all of us to raise our collective voice as Americans, or Illinois residents. The lobbyists are descending on Capitol Hill like locusts; we can't remain silent. It takes less than five minutes to make a phone call, and isn't it worth doing if it might make a difference? And it is more likely to make a difference if you are one among many doing it.

It's very easy — right now, people can actually use the Families USA toll free number to call and connect with a legislator's office.

The number is: 1-800-828-0498

Smile Politely: If this is just the first step, what would the CCHCC like to see happen nationally or locally in the long term and why?

Claudia Lennhoff: The first step is getting health reform passed. We have to educate people about what's in the Senate bill that will help them. CCHCC has put together a Quick Guide that folks can check out.

The next step will be to fight against repeal. The Republicans have vowed to repeal this legislation.

Then, of course, we have to work hard to implement health reform. That has several components, including working with clients to enroll them in the various options as those become available, and working at the state level to implement the systems that are necessary for health reform.

In the end, all health care is local. We get health care (or don't) locally. But we need the state and national policies and funding sources to help make access to care a reality for everyone. CCHCC is dedicated to the struggle for health care for all, and we will keep working to expand access at the local level, and to influence the state and national policies that affect access locally.

We are also very excited about the prospect of single-payer health care at the state level. The Senate bill actually has a state waiver provision that will help make it more possible for states to enact single-payer bills. So, there is plenty of work ahead. It will be good to work on making improvements and moving things forward, rather than constantly fighting against going backwards and continually seeing people's lives destroyed by our miserable health care system.

Smile Politely: Your organization has played a very large role in the merger between
Carle Hospital and Carle Clinic. Can you talk about that? How will this
merger benefit the community?

Claudia Lennhoff: We are thrilled with the merger of Carle Clinic with Carle Hospital to form a vertically-integrated non-profit health care system. This is the single best thing that could happen in our community right now in terms of expanding access to health care for those who have been locked out.

This merger will benefit the community because Carle Clinic will no longer be for-profit, but will become non-profit. A non-profit organization can put people first, rather than profits. We are already working with Carle Clinic to come up with new ways of doing payment agreements, so that patients are not cut off from care when they incur debt, and Carle Clinic will be implementing a financial assistance program, very similar to the excellent program at Carle Hospital. The first of the changes will start to take place in April. This is very exciting!