The health care crisis we face is real, and Rhode Islanders deserve an authentic solution.
Employers are being priced out of the system and dropping coverage for employees; workers and their families have no guaranteed continuity of coverage within the employer-based system; young people are losing coverage as they age out of their family plans; and local hospitals are struggling to provide care to greater numbers of uninsured patients.
In this crisis, there is a central moral choice we as a state, and as a nation, need to make. Do we have the courage to rethink our notion of how to pay for health care? Or are we going to continue with Band-Aid reforms that only postpone the collapse of our irrational non-system of for-profit health care?
It is time for our lawmakers and our entire community to commit to rebuilding a health care system that ensures quality care for everyone and that is economically sustainable over the long term.
At the national level, reforms supported by for-profit insurance companies and the pharmaceutical industry have focused on the idea that we as patients are the problem, and that the "fix" is in the personal choices individuals make.
Reform proposals include high-deductible health plans that neglect to control the real cost drivers in our system. And by raising out-of-pocket costs for patients, many prevent them from getting the health care they need. While everyone must take responsibility for their own health, wellness is only one small piece of the larger reforms that must take place. Patients are not to blame for out-of-control health cost inflation, and simply shifting costs onto our shoulders is not a solution.
Lacking leadership in Washington, states across the nation have tried to tackle the complex problem of health care in a variety of ways. But in too many cases, these noble efforts fall short of challenging the pattern of for-profit, private health insurance. Plans like the one passed last year in Massachusetts do not deal directly with cost controls, fail to move coverage out of employer-based systems, and continue to support for-profit insurers.
These reform efforts may increase insurance coverage in the short term. But years from now, states like Massachusetts will be back where they started: Workers and employers will be unable to pay, people will lose coverage, and public programs will become more expensive.
So what do we do to achieve a sustainable universal health care system for Rhode Island?
First, we must hold the line. We must protect Rhode Island's incredibly efficient and successful public health care programs, including RIte Care.
Last year, lawmakers enacted changes that bar hundreds of children from enrolling and take away health care from 1,800 parents. This year, we must restore coverage to all children and parents who fall within the income eligibility levels. More uninsured Rhode Islanders mean more emergency care that we all pay for. RIte Care prevents future, costly health care emergencies.
Second, lawmakers should pass legislation this year to control costs through statewide coordinated health planning and institute "community rating," a common-sense model that creates a single insurance pool for the entire community. Our system must recognize that we are all in this together.
Third, let's take the profit out of health insurance. The market may work for selling dishwashers or tennis rackets, but it doesn't when it comes to ensuring a basic right like access to health care.
Nonprofit insurers use the money they collect in premiums to pay for better health care. For-profits use that same money to pay higher dividends to investors and soaring salaries to executives.
We cannot afford the higher overhead costs associated with for-profit insurance. Overhead costs for public programs like RIte Care are just a few pennies on the dollar, while for-profit overhead is often 20-25 cents or more.
By taking the profit out of health insurance, we can make real systemic change based on specific principles and goals that put patients and community well being at the center of our system.
Now is the time for Rhode Island to tackle the real problems in our health care system in order to provide quality, guaranteed, affordable care for all. Each of us must contribute to reform – so that every one of us gains.
Craig O'Connor is associate director of Ocean State Action, a coalition of community organizations, professional associations and labor unions.
