If Scott Brown's victory spells the end of health care reform, then the Americans who really lost out last night were the uninsured, and the scores of others bankrupted by health care costs. This morning's coverage of the Massachusetts Senate race focused on Democrats and Republicans, politicos and pollsters and it has ignored the Americans dying without health insurance. The uninsured weren't just ignored in today's coverage; they have been largely voiceless in the health care debate thus far.
Sure, last night was embarrassing for Democrats. Scott Brown's win must have been humbling for President Obama; it certainly marks the end of Martha Coakley's political career; and it, no doubt, has left quite a few Democratic legislators pondering about their future. Nevertheless, they will all be ok. President Obama will continue to govern; Martha Coakley will return to a good life in Medford Massachusetts; and most legislators, even if they're voted out of office, will do just fine. What is remarkable is how little attention has been paid to what this means for the people who needed health care reform in the first place.
As the health care debate evolved, the discourse about it became technocratic and it became impersonal. Coined phrases and terms like the public option, insurance exchanges, and taxes on Cadillac plans all became part of the American vernacular and the debate became callous. That level of detail was fun for health policy wonks, but it insulated everyone from remembering precisely why health care reform is important.
Here's a reminder about why it is important. Forty-six million people lack health insurance at some point during the year in the US. Without insurance, about 20,000 people die annually who would have lived had they been fully insured. It is estimated that between 2000 and 2006, 137,000 people died because they lacked insurance coverage. And this loss of life costs money. In addition to their suffering, the uninsured receive around $35 billion worth of uncompensated care per year that ultimately gets paid for through higher taxes and higher insurance premiums for the insured. Further, the price of having that huge a segment of the population without insurance coverage costs the US between $65 and $130 billion annually in economic losses and lower productivity.
It wasn't just the uninsured who got sidelined. Somehow, over the last few months, health care also got divorced from the economy. Critics of the President argued that he should focus on the economy, not health care reform as if the two were completely unrelated. However, those critics on the left and the right forgot that with health care accounting for 16% of GDP and projected to rise to 30% of GDP over the next thirty years, at some level, health care is the economy. Medical costs are the leading cause of personal bankruptcy in the US; health insurance premiums have grown faster than wages over the last decade; and rising health care costs have left millions choosing between buying medicine and making other necessary purchases.
Health care costs are also hurting businesses big and small. Large companies can't compete in a global economy when the cost they bear to insure their workers is double what is spent in other countries. Small companies can't survive and the self-employed are struggling with the cost of buying health insurance in our dysfunctional individual and small-business insurance markets.
Maybe the filibuster is an arcane tool that is keeping us from successfully addressing big issues like health care reform. In Switzerland, health care reform passed with just over 50% of the vote. In the UK, Margaret Thatcher and Tony Blair were each able to radically reform health care with less than 50% of the country behind them. Then again, maybe the filibuster is a useful check on power.
Regardless, health care isn't a Democratic or Republic problem; it's a problem for all of us and a test of our society's ability to address a tremendous source of human suffering. If we fail to get the US health care system moving in a better direction, last night won't be President Obama's Waterloo, nor will it be a resounding victory for Republicans. Instead, it will be an indelible mark on our collective inability to tackle one of the most dramatic problems our country is facing.