Let's Really Fix Health Care

From the President: Gerald W. McEntee

Like Rip Van Winkle rousing himself from a 20-year nap, President Bush has finally awakened to the fact that our health care system is — to put it mildly — in trouble. First of all, I'd like to welcome him back from his slumber. Many people have long recognized that America's health care system is broken and in need of urgent repair.

But now that the President has joined the rest of us, he should go back to the drawing board. His signature proposal is the Health Savings Account (HSA), a tax-sheltered savings account similar to an IRA but earmarked for out-of-pocket medical expenses. If that's all he's got, then the question is not if our system will collapse, but when.

We all know the problems we face. The cost of health care is rising at an alarming rate, and governments and businesses are struggling mightily to keep up. They're shifting more of the expense to employees, whose costs rose by 126 percent between 2000 and 2004. Increasingly, we're no longer bargaining over wages — our biggest bargaining battles are to keep our members from paying more for their health insurance, from increasing premiums to higher co-pays.

And sadly, 46 million Americans — about one in every seven — are without health insurance altogether. Many of them are child care workers and home care workers, attending to children as well as our most vulnerable citizens. Yet they are without health care themselves.

HEALTH CARE: A COMMODITY?

The trends are made worse by the erosion of employment-based coverage, thanks in large part to the "Wal-Mart effect": the explosion of service jobs with low wages and nonexistent benefits or benefits that are inadequate or unaffordable, for workers.

Bush believes that part of the answer to our health care crisis is expanding HSAs and giving more tax deductions for medical expenses. But these policies just shift the financial burden and risk from the larger group to the individual.

Tax cuts and HSAs only help the "healthy and wealthy." They do nothing to provide coverage for those most in need. These proposals treat health care as a commodity — like a flat-screen TV or a car — that you can buy if you can afford to. But health care isn't a TV. Everyone needs it and at some point must have it, regardless of income or ability to pay.

WIDENING GULF

HSAs and tax cuts won't increase coverage, and they won't lower the cost of health care. All they do is widen the gulf between the haves and the have-nots. This go-it-alone approach ignores the fact that society benefits, and ultimately spends less, when everyone has equal access to good health care.

When the uninsured can't get routine care, the medical treatment they receive often comes too late to be of much help to them. And it's given in hospitals, the most expensive settings for care. What starts out as a simple problem becomes serious and costly, and we're all left to foot the huge bill for care that insurance doesn't cover.

Only major changes will end this cycle. That's why AFSCME is making health care reform a top priority in 2006 and beyond. And in 2008, any Presidential candidate who gets our support must favor comprehensive reform that guarantees coverage and controls costs.

We've joined with more than 100 businesses, labor unions and health-advocacy organizations to form the National Coalition on Health Care. We've all agreed on several principles that must be at the heart of any reform: Everyone must be covered; costs must be contained and shared fairly by all; the quality and safety of health care must be improved; and administration of the health care system must be simplified. This is no time for "trickle-down health care." President Bush has an obligation to come up with a real plan for reform now.