Now that the summer's "death panel" rumors about health reform legislation have been thoroughly debunked, right-wing extremists are resorting to other distortions in their fight against progressive change. A recent example is an article by hospital industry consultant Richard Baehr, published by the Republican Jewish Coalition.
Thousands of years ago, Jewish sages taught that a wise person "concedes the truth." Following this advice, let's acknowledge that Baehr correctly describes out-of-control health costs as a serious problem.
Unfortunately, Baehr misses the mark when he dismisses nearly 50 million uninsured as "a far less critical issue." According to the Institute of Medicine, people without insurance often go without essential health care, sometimes with grim consequences. Uninsured women with breast cancer may have their disease diagnosed too late for effective treatment, and patients with diabetes or hypertension may be unable to fill their prescriptions. The result: every month, thousands of Americans die needlessly simply because they are uninsured.
Under reform proposals, Medicaid would help the poorest uninsured, and premium subsidies on a sliding scale would cover low- and moderate-income families who earn too much for Medicaid but too little to afford insurance. Of the estimated 33 million uninsured who would qualify for help, 67 percent are ineligible for public coverage today, and only 18 percent have employers that offer insurance.
Ignoring how health reform would cover millions of low-income uninsured, Baehr focuses instead on the proposed public option, speculating that a plan modeled after Medicare would "under-price its private market competitors," "drive many corporations to drop private health insurance," and ultimately cause "the collapse of the private health insurance market." This fanciful scenario was emphatically rejected by the non-partisan Congressional Budget Office, which concluded that a public option would enroll fewer than 5 percent of all Americans. In fact, CBO found that with reform legislation, employers would cover more of their workers than under the status quo!
Baehr likewise disregards the truth by contending that proposals to research the comparative advantages of alternative medical treatments represent "a rationing type approach." Gail Wilensky, who ran Medicare for President George H.W. Bush, describes such research quite differently as "providing objective, credible information on the likely clinical outcomes of different strategies to treat the same medical condition." Most of us would gladly do without new and costly drugs and medical devices if such research shows that inexpensive alternatives are equally effective.
This is part of reform's broader shift away from handsomely rewarding the health care industry for providing the highest possible volume of expensive services, whether patients need them or not. Instead, financial incentives will encourage care that actually makes us healthy, and services will be more effectively coordinated and managed for the chronically ill, who generate 75 percent of all health care spending.
By contrast, Baehr would control costs by giving people skimpier insurance. Instead of comprehensive benefits, Americans would get "high deductible plans that make health insurance more of a catastrophic benefit, and leave the costs of more routine or day-to-day health care to consumers." This approach leaves untouched 80 percent of health spending, which is for the 20 percent of patients who incur catastrophic expenses of $4,000 a year or more. Moreover, Baehr overlooks most families' inability to afford routine doctor visits, prescription drugs and the like if their insurance does not cover those services. That's why 49 percent of people in high-deductible plans develop serious problems with medical bills, and 38 percent avoid necessary health care because of its cost.
Baehr's other big idea, recycled from John McCain's failed Presidential bid, is to eliminate the powerful tax subsidies that today favor employer-sponsored coverage. Without those subsidies, roughly 20 million Americans would be forced out of employer plans and into the individual market, where most people with health problems find it difficult or impossible to obtain affordable coverage.
Beginning with the Torah (the first five books of the Bible), Jewish tradition has long emphasized helping the widow, the orphan, and the poor. The Torah contains more laws commanding justice and kindness towards the stranger--the disadvantaged outsider from another nation--than it addresses to any other subject, including the Sabbath, the festivals, or even honoring God.
Along with other religions, Judaism thus teaches that a society is measured in God's sight largely by how its most vulnerable members fare. In the developed world, ours is now the only country that leaves millions of its people--mostly low-wage workers and their families--without any health coverage. And we are the only advanced nation that lets insurance companies deny health care to the very people who need it the most. Let's hope that right-wing falsehoods will not prevent our country from finally remedying this immoral state of affairs once and for all.