Have We Forgotten Why We Wanted Health Care Reform?

America is discontent with change. Only a couple years ago, we were calling for change, particularly in health care. Now change has come — and we are again grumbling. I witnessed this at a dinner party. The loudest dissenter was the epidemiologist, alongside the psychologist and mountaineer, who loathed being mandated to participate in a health insurance pool, and resented more the threat of a fine. I felt like I had fallen into the “Twilight Zone.” These were good people, educated people — PhD-holding, NPR-listening trusted friends. Such words would only be spoken at a tea party rally!

But these friends are not extremists. They identified with the tenets of liberalism — responsibility and empathy — but as middle class white collar workers, they were not immune to conservative fears of higher taxes and excessive government regulation. The media was saturated with such claims, claims that are frightening in a time of economic uncertainty. Fear makes us forget.

The American health care system was a child of World War II. During the war, the U.S. government capped wages to deter inflation, so private companies began luring workers with health insurance as a perk. By the time the war ended and the wage cap was rescinded, health insurance had become the standard to attract good workers, and thus America — quite accidentally — fell out of step with the rest of the industrialized nations that had already established universal health care by the 1940s.

Our market-driven health care system never made good on capitalism’s usual promise: that competition drives down costs and improves the quality of services and goods. Costs didn’t decrease with competition and eventually were the cause of 60 percent of the bankruptcies in the U.S. Quality of care paled in comparison to that in other developed nations; the life expectancy rate is 78.11 years in America, but 82.6 in Japan (did you know you’d actually live longer in Cuba than in America?). And don’t even try being a baby here; we have the worst infant mortality rate of all developed countries (Cuba trumps us in baby survival, too). To top it off – America actually spends the most on health care than all other members of the UN.

Health care never yielded the success of laissez-faire public policy typical for industries like entertainment and electronics. The World Health Organization notes this anomaly in its 2008 World Health Report: “Today, it is clear that left to their own devices, health systems do not gravitate naturally towards the goals of health for all through primary health care...Health systems are developing in directions that contribute little to equity and social justice and fail to get the best health outcomes for their money.”

The free-market U.S. health care system was not working. Do you remember how badly it was not working?

Christina Turner must remember. I found her story in The Huffington Post. The 45-year-old suspected drug-induced rape when she accepted a drink from two men at a bar and woke up hours later lying road side with cuts and bruises. Taking precautions, Turner took her doctor-prescribed month’s batch of anti-AIDS medicine. Now she is uninsurable. Insurers would not sell her a policy — telling her that maybe in a few years, they would reconsider if she could prove she was still AIDS-free.

It’s a dilemma many Americans faced: perverse insurance policies blocking access to affordable health care. Stories like Turner’s saturated the media only two years ago — but since the reform, the same media is suspicious of the change that was requested. Have we forgotten the Reuter’s investigation of insurance company Fortis?

Reuters reported that Fortis sought, found and targeted every policyholder who had contracted HIV and looked for any excuse for policy cancellation. In one case, Fortis used an obviously misdated handwritten note by a nurse, who wrote “2001” instead of “2002” to claim that the policyholder had concealed HIV as a preexisting condition. Fortis, now known as Assurant Health, made $150 million in profits alone between 2003 and 2007 by utilizing policy cancellation tactics.

And there is Mike Pyles, a 49-year-old man driven to homelessness by $230,000 in medical bills from his fight with renal cell cancer. Pyles lived out the statistic that every 30 seconds, an American goes bankrupt from medical bills.

Didn’t we used to rally at our dinner parties, denouncing the unfairness of the health care system? Instead, the epidemiologist asks me, “But if you use more health services—shouldn’t you pay more?” Bless his soul, but my friend’s innocent question is a kinder version of “Why should I pay for other people’s health? If you are the one sick, why should I pay for it?”

So I ask him, and the rest of America: “Why shouldn’t I help you? What’s so bad about you anyway that I cannot help pay for your health?”

Have we forgotten how our hearts went out to the millions of uninsured, to the bankrupt – how we once wanted to help them, how we once feared being victims of the same injustice? Now from our pedestal of optimum health, we ignore that the reform bans insurers from dropping coverage for the sick, prohibits denying coverage for preexisting conditions, and eradicates lifetime limits. We slump on our pedestal, lamenting how the reform will affect the healthy. Can we not see from our height – the old, the sick, and the poor?

Maybe with the new health care reform, we will want to help each other again.

The opinions expressed in this commentary are solely those of Suphatra Laviolette and not of Marguerite Casey Foundation.