Health Care Reform in critical condition

In a landmark vote on December 24, 2009, the U.S. Senate passed legislation that would reform the

nation’s health care system. The holiday week was filled with heated exchanges between Democrats and Republicans – interruptions, late-night sessions and high tensions proliferated, and in the end, the bill was passed without a single Republican vote.

The bill’s page count runs into the thousands, leaving many people skeptical of what else might be wrapped up in the health care reform package. The bill is similar to the House legislation that passed earlier in December but differs on many small details and costs. The Senate bill foregoes a government funded public option, expands Medicaid, instills greater hurdles for abortion coverage and estimates expanding health care coverage to 31 million people who are currently uninsured, leaving 23 million still without coverage.

Danbury Hospital Almost 8 million of the remaining uninsured would be undocumented immigrants, who, under the Senate bill, would be prevented from buying insurance from the state-created insurance exchanges, even if they could afford to buy a policy unaided. Others who would remain without health insurance are likely to be those who choose to be penalized instead of buying a policy and those who just can’t afford a policy.

According to Angelo Falcón, professor of International and Public Affairs at Colombia University, the vast majority of those who cannot afford health insurance are Latinos. In a recent Latino Policy eNewsletter, Falcón writes that 15 million Latinos were without health insurance in 2008 and had a median per capita income of $15,674. He also mentions that legal immigrants, along with all other permanent residents, would be required to wait five years to participate in Medicaid.

Those who can’t afford health care still need it, however, and at least for now, they are able to obtain services at hospital emergency rooms. According to Danbury Hospital Public & Government Relations Director Andrea Rynn, the hospital spent $4.75 million in charity care last year and extended over $25 million to supplement inadequate government programs.

These staggering figures cause skepticism when it comes to a public option.

“There are so many shortfalls between government programs,” Rynn said in a phone interview. “There’s likely to be more of that with a public option, and we can’t sustain the gap.”

Rynn explained that government health programs are grossly underfunded.

“Though the government offers these programs, it’s really the hospitals and physicians that pay for it,” she said. Rynn is also concerned about the proposed cuts to Medicare and the individual mandate for health insurance. “It’s interesting that the mandate carries a penalty for those who can’t afford health insurance,” she said. “For many people, it will come down to putting gas in the car or buying health coverage.”

While Rynn is still waiting for more details of the bill to emerge, she does see a potential positive change in our attitudes and actions concerning health and wellness.

“This could shift our focus towards prevention,” she said. “We could see expansions in community health and pilot programs. The Senate bill does indicate quite a bit of money for community health care.”

Connecticut Senator Chris Dodd applauds the bill’s provisions in funding community health centers, hospital construction, and easy transfer from state-provided health care to Medicaid.

According to Dodd, Connecticut residents currently enrolled in State Administered General Assistance Program, or SAGA, would be transferred to Medicaid without hassle and would receive half the amount of funds currently given to them by the state.

While this means more money for the state and possibly hundreds of millions more for health professionals and facilities, it means less monetary support for those currently relying on state health care.

The Manager’s Amendment in the Senate Bill would provide five billion dollars over the course of five years to community health centers nationwide, which is inclusive of the $1.5 billion allotted for construction and facility repair.

Dodd is also proud of the amendment’s $100 million grant for a university affiliated health and research facility.

“These provisions will bring millions of dollars to the state so that Connecticut’s residents can receive quality, affordable health care,” Dodd said. “Increased funding means that our community health centers will continue to grow and serve more families, our health care professionals will be adequately compensated, and more residents will be able to receive the care they need.”

Over the next few months, the House and the Senate will have to consolidate the numerous differences in their proposed bills. Meanwhile, Americans will be demanding a clearer picture of the new health care system. With zero bipartisan support, scores of specifications yet to be divulged and millions of people still without coverage under the new legislation, it’s safe to say that health care reform has a long way to go in winning endorsement, signatures and the approval of the American people.