Insurance alone won’t solve our health care crisis

By Malinda Markowitz
Newberg Graphic
April 9, 2008

With Oregonians about to get a close up look at the presidential race, expect to hear some talk about health care, one of the hottest issues this year with more Americans falling through the safety net every day.

As the candidates debate solutions, they might want to pay a visit to Bruce Freeman, a disabled veteran from Newberg.

Here's what Bruce recently wrote in The Newberg Graphic:

"I have told Congress persons, and everyone else with whom I come in contact, that if we are seeking a model for how well universal health care can work in this country, we need look no further than the Veterans Affairs Health System.

"In 2005 the VA was called the best health care system in the United States by Time magazine. I agree totally. I am someone who has had to access VA health care via several VA facilities where I have had surgeries and numerous other treatments over the past three decades, and where I get all my prescriptions, and I am telling you that the VA system, facilities, and personnel within that system are the very best.

"Prescriptions and refills are handled with skill, accuracy and speed and I receive refills in the mail. Superb service, despite dramatic cuts in funding by the Bush administration, do not diminish the excellent work the VA provides under dramatic constraints."

Yes, we've all heard about the horrors at Walter Reed Army Medical Center, but Bruce says that aberration is far different from how the VA system typically runs.

"I have also worked in and around numerous health care facilities and providers my entire adult life in the military, for university health care systems in California and Texas, and within private-sector health care providers. The VA health system is by far and away the best model for health care we have in this country, and in my opinion, in the world.

"If the U.S. would follow the VA model, universal health care could become a reality for all Americans in short order and sooner than trying to create a new model from the ground up. The perfect model already exists, so there is no need to reinvent the wheel."

Bruce makes you think the VA system deserves a closer look. The main difference between the VA facilities and our private system is what the VA is missing - insurance companies sticking their hands in your pockets and deciding if you deserve to get care.

It makes you wonder why the presidential candidates continue to promote more reliance on the private insurers.

Sens. Hillary Clinton and Barack Obama have presented comprehensive health care proposals; their main difference is on who should be required to buy private health insurance. However, mandatory insurance is not universal health care, especially when the insurers can continue to charge as much as they want and continue to restrict care.

Sen. John McCain offers far less change from the dismal status quo. His prescription of increased corporate competition to supposedly limit rising costs and tax credits to encourage the uninsured to buy insurance tax credits would have little impact on the current crisis. Insurance companies don't compete by delivering more care or lowering prices. They compete by rounding up more customers and cutting costs by denying claims for care.

If more market-based solutions worked, they'd be working now. Under the stewardship of a market friendly administration this decade, premiums have jumped 87 percent, far outpacing inflation and wage increases.

And once-a-year tax credits are of little help to those already facing financial distress in an imploding economy. Those who most need coverage will still be unable to afford premiums that now average more than $12,000 per family, not including skyrocketing deductibles, co-pays, drug and hospital charges and other fees.

Contrast that with the VA, which guarantees quality health care coverage for everyone and gets the insurance companies out of the way.

It's a system, with some nuances, in place in every other Western country, and it works. A January study by the London School of Hygiene and Tropical Medicine, for example, found the U.S. ranked worst among 19 industrial nations in preventable deaths.

Surely that's the real reform all Americans deserve.

Nurse Malinda Markowitz is a member of the council of presidents of the California Nurses Association