Healthcare reform: Mission Impossible

Since 1994, when the Clinton administration’s attempt to fix the healthcare system was rejected, well over 1,000 bills relating to healthcare reform have been introduced in Congress.

There have been more calls for action to improve our tangled, ineffective system than there are members of Congress. Despite the enormous number of proposals, very little change has been accomplished. While there’s no shortage of interest in improving the system, there’s a debilitating shortage of the requisite political will and courage to do what needs to be done in the right way to actually make a difference.

Every presidential candidate is talking now about the urgency to reform healthcare, and each has a different idea for how to do it and pay for it. Understandably, their ideas remain relatively sketchy at this stage in the campaign. But the fact that candidates are talking about it and public opinion polls list healthcare reform as a top domestic priority leaves me hopeful that this country will get serious about transforming the critically ill healthcare system.

With nearly 50 million Americans uninsured, including nine million children, and many millions more underinsured, action is long overdue. No longer should anyone have to make the terrible choice among food, shelter and medicine.

Reforming the healthcare system is a daunting—but not an impossible—task. There are numerous ideas for how to accomplish it, how to finance it, and how to deal with the many interests that want to reap significant profits.

In the end, the bottom line is that the restructured system must provide quality, affordable healthcare for all Americans, and those who work in the system have to be treated and compensated fairly. Accessible, affordable healthcare should no longer be considered a privilege for some; it should be a right for all.

Three major reform options are getting the most attention. A “single-payer” plan would be a government-run, taxpayer-supported program that basically would expand Medicare. A “pay-or-play” program would require employers to provide a benefit plan equal to or better than the government’s plan, or pay a tax so that their employees can be covered under the government’s plan. And finally, President Bush’s plan involving additional tax incentives would encourage people to provide their own health insurance and encourage employers to drop coverage—a plan that the AFT vigorously opposes. Of course, the devil is in the details of any plan, and that’s where political will and courage come in.

In a resolution passed by the 2006 AFT convention delegates, the AFT reaffirmed its support for national healthcare reform that would provide universal coverage and access to quality healthcare at a reasonable cost. We believe a single-payer system could work to prevent cost shifting and to reduce administrative expenses. We also have pledged to support other proposals—such as employer mandates or extending eligibility of Medicare and Medicaid—that would move toward achieving the goal of quality, affordable universal coverage.

The United States currently spends $2 trillion annually on healthcare, and that cost continues to climb. This money needs to be better spent and, frankly, even more must be allocated to get quality, accessible healthcare where we want it to be. There are tens of millions of children and adults who have no access to healthcare because they are uninsured, millions of others who are underinsured, and others who have such high co-payments and other costs that decent health coverage is often out of reach. As healthcare costs continue to rise, more and more AFT members are paying more just to maintain their benefit and often are asked to make an untenable choice between a salary increase and better health coverage. In addition, retirees are threatened with the loss of benefits.

The AFT will continue its work with members of both houses of Congress and with its many partners in the effort to reform the healthcare system. Comprehensive, intelligent reform of the healthcare system is a top priority for the AFT, especially in light of the current political season. Healthcare reform might seem like a Herculean task, but it is possible. We can wait no longer.