Sometimes, public health advocates have to play politics. I normally write about local public health problems, but given the events of this past week, it is necessary to tackle broader issues affecting communities like ours across the nation. Poor public policy has become the newest risk factor for poor health. Yet after the results of Tuesday’s election, we have a historic opportunity to make some real progress.
Since President Bush took office, the number of uninsured in our country has increased by five million. Instead of addressing this problem, Bush’s major health-care initiative, a prescription-drug benefit for seniors, has been a giveaway to the pharmaceutical industry and a bureaucratic nightmare for consumers. Meanwhile, other policies, such as a ban on stem-cell research and proposed cuts to funding for the Department of Health and Human Services, have stymied progress in other areas.
Republicans, of course, aren’t the only risk factor. Although Democrats generally recognize the importance of public health, they have also lacked the ability to articulate their plans and mobilize the political will to make real change. President Clinton’s failed attempt at health reform in the ’90s, for example, is evidence that good intentions don’t always translate into good results. Much has changed since the last time Democrats controlled the House of Representatives, but if anything, the lobbies resisting reform have only grown more entrenched.
Each day we wait to implement real health-care reform, the lives of many in our community are placed at risk. In Connecticut, 394,000 residents do not have health insurance, which is equivalent to the populations of Hartford, New Haven, Waterbury and Norwich combined. A lack of health insurance means a lack of access to basic preventative services, which leads to more serious and costly illnesses. The Connecticut Health Policy Project reports that in the fiscal year 2004, approximately 50,000 hospitalizations in the state could have been avoided through timely and effective outpatient primary care.
Our health-care system is not only bad for your health, but also bad for your bottom line. Connecticut’s 50,000 unnecessary hospitalizations cost about $900 million. This cost is shifted to taxpayers, businesses and those who buy private health insurance. If you haven’t realized by now, the cost of health care is only getting worse. Since 2000, health-insurance premiums have grown 5.8 times faster than incomes, and Connecticut is even worse than the national average.
The worst part of all is that we have clear, common-sense solutions to today’s health problems. By cutting loopholes for special interests, investing in prevention and ensuring that each American has comprehensive health insurance, we can fill in many gaps in our current system. Recent reforms in Massachusetts and Maryland, although not perfect, offer hope that we can actually achieve this potential.
Despite the opportunity for progress and the degree to which health policies affect us, discussion of health-care reform was relatively absent from this year’s campaign. A report published last week in the New England Journal of Medicine noted that concerns about the economy and terrorism continue to trump concerns about health care, and that voters express little consensus about the top health challenges facing our nation. Citizens are confused about the alphabet soup of health-care policies, and without clear, sustained citizen activism around this issue, politicians have been slow to take it up.
The Democrats, however, do offer the possibility for some real change in this upcoming legislative session. House Democratic leader Nancy Pelosi has laid out an aggressive plan for the first 100 hours of her term as speaker of the House, which includes reform of Medicare Part D to eliminate loopholes for the pharmaceutical industry and more funding for Health and Human Services and stem-cell research. Next fall, Democrats plan to fight for the reauthorization of the State Children’s Health Insurance Program. These efforts are clear steps in the right direction.
But what about overarching health reform for this country? Perhaps it’s a bit premature, given the fact that Bush is still in the White House, but we can’t lose sight of the overall goal. The powerful players who benefit from the status quo have an incentive to keep us confused, but we must avoid distraction. The message is simple: Fix the loopholes, cut the waste and ensure the right of every American to have quality, affordable health care.
This debate goes far beyond the Capitol in D.C. or Hartford. In the end, all politics is local. We must engage our newly elected officials to make health care reform a true priority.
Robert Nelb is a junior in Timothy Dwight College. His column appears on alternate Thursdays.