HMO regulations won't fix health care mess

HMO regulations won't fix health care mess
Mark Piotrowski
May/June 2000

"Did the Florida Legislature pass a good HMO bill or a bad HMO bill?" This is the question that Lloyd Dunkelberger poses in his May 14 Gainesville Sun column, "HMO Reform a Question of Timing". The bill in question was the legislature's attempt to reform health maintenance organizations (HMOs). And the answer is hardly encouraging. Senator Richard Mitchell (D-Jasper) said "This bill does nothing." Senate Majority Leader Jack Latvala countered with this stunning endorsement, "This [bill] is better than nothing."

Great. So our choice is a bill that "does nothing" or one that is 'better than nothing." Sounds like a whole lot of nothing to me. Is this what the people of Florida really want when it comes to our health insurance?

The real question is "why is the legislature wasting its time and our money arguing over 'HMO reform' rather than overhauling the health care system to get rid of insurance companies altogether?". That is the question that people really want to know. Not which version of nothing was our legislature able to come up with this time.

This is the problem with the health care debate in Tallahassee (and in Washington, DC). It is avoiding discussion of the fundamental problem with our health care system: That as long as private insurance companies are involved they will always put profits over people. That is what they are designed to do.

The legislature is partly correct by identifying some of the things that aren't working with our health care system: Runaway prescription drug prices, the denial of care to patients with insurance, millions of people left without coverage. But these are just symptoms--very bad symptoms--of the larger problem: A health care system controlled by insurance companies driven by profit.

We spend twice as much for health care in America than countries like Canada, Japan and Sweden. The disgraceful thing is how little we are getting for all that additional spending. Those countries have national health care systems that cover all their citizens regardless of age, income or employment status, while we are stuck with a system that leaves 44 million Americans without coverage and routinely denies care to the millions who do have insurance.

The main reason for this outrageous gap in cost and coverage is the amount of our health care dollars that are wasted on corporate profits, huge CEO salaries, administrative costs and advertising. Money that could and should be spent on increased care for patients and universal coverage for all citizens. If we took those monies that are being put toward profits and paperwork and used them for actual health care, we'd all have better health care. Until we get the insurance companies--HMOs and non-HMOs alike--out of our health care system they will continue trying to squeeze every dollar they can out of the system, patients be damned.

In an attempt to redirect the debate away from incremental reform and toward a real restructuring of health care in Florida, the Alachua County Labor Party is holding an organizing and strategy meeting to discuss initiating a ballot referendum in Alachua County which would give voters a chance to voice their support for a single payer health care system in Florida. The meeting will be at 6:30 p.m., May 19 at the Civic Media Center. Childcare will be provided but please call ahead, if possible, to arrange (373-4841).

The ballot referendum would be modeled on a similar measure that the Somerville, Massachusetts Labor Party Club sponsored in November 1999 and the Labor Party's Just Health Care campaign. Eightyfour percent of Somerville voters supported the creation of a universal, comprehensive and publicly administered health care system in Massachusetts. The Labor Party's Just Health Care program calls for for a national insurance fund which would include:

guaranteed benefits for the entire family
no bills or out-of-pocket expenses
access to quality health care whether you have a job or not
total choice of doctors, hospitals and other providers

The Somerville ballot question read: "Do you favor legislation to create a system of universal health care in Massachusetts that provides all Massachusetts residents with comprehensive health care coverage (including the freedom to choose doctors and other health care professional, facilities and services) and eliminates the role of insurance companies in health care by creating an insurance truest fund that is publicly administered?

"This public insurance trust fund (similar to the Social Security trust fund on a federal level) would receive the funds presently going to the numerous health insurance companies throughout the state."

Despite the fact that poll after poll shows that the public really wants radical health care reform, bills to create a universal system at both the state and national level are stalled or killed in committee. They never get to see the light of day on the floor of the legislature or Congress, where the voting public would have a chance of supporting them. The only proposals that make it out of committee are the band-aid, incremental solutions: Bills allowing us to sue our HMO under certain circumstances, bills requiring insurance companies to cover autism or child cancer or osteoporosis or birth control. Good things but they miss the point, they don't get at the root of the problem.

This incremental approach--deregulating HMOs, Clinton's failed health care reform, a Patient's "Bill of Rights"--isn't working. Every year more and more Americans are losing their health insurance or are being denied coverage that they have already paid for. It's not working because it does not address that fundamental problem with the health care system: Insurance companies and their drive for profits.

We are told that these band-aid solutions are the only practical way to fix the health care crisis that we are in. But even these bills aren't getting passed because they just don't improve things for very many people so there just isn't enough support for them. The problem isn't that the proposals coming out of the legislature are going too far, like we're told by the press and the insurance corporations, but that they are not going far enough, they are not really what people want. 60-80% of Americans polled support a universal health care system which eliminates the role of insurance companies.

It's time we show the politicians what we really want--Health Care for All, Everybody In, Nobody Out!