Thursday, July 16, 2009

Health care RX depends on trust -- July 16, 2009 column


As Congress struggles over various health-care reform proposals, a lot of numbers get thrown around.

Health care is a $2.5 trillion industry, one-sixth of the U.S. economy. Reform could cost upwards of a trillion dollars over 10 years. An estimated 50 million people lack health insurance, and 17 million could remain uninsured after reform.

Here’s a number that may trump the others: 93.

That’s the percentage of Americans who say it’s extremely or very important that their health plan cover any medical test or treatment they and their doctor think necessary, according to the latest USA Today-Gallup poll, released Tuesday.

The near unanimity of opinion says that the health care debate is fundamentally about trust. Can people trust that President Obama’s revamped system will allow them to have all the tests and treatments they believe necessary? Or should people trust Republican opponents who argue that reform will limit access to health care?

In the trust battle, both sides have ammunition. Congressional Republicans have an edge in worries that President Obama’s $787 billion economic stimulus package may not work. If the behemoth stimulus is a debacle, as some critics already claim, will a huge health-care overhaul be one too?

The president has the advantage of the bully pulpit, which he used this week to make the case for trust indirectly. In Michigan, he claimed the troubled economy as his own and leveled with auto workers that their jobs aren’t coming back due to changes in the economy. At the White House, nurses, a group everybody trusts, stood with him as he prodded Congress on health-care reform.

In Michigan, Obama was responding to critics who complain that he’s still blaming his predecessor for the nation’s economic woes.

“I love these folks who helped get us in this mess and then suddenly say, `Well this is Obama’s economy.’ That’s fine. Give it to me. My job is to solve problems, not to stand on the sidelines and harp and gripe,” he said.

In the Rose Garden, Obama stressed that the status quo in health care is unsustainable and cannot continue. He noted that the American Nurses Association, with 2.9 million members, supports a public insurance plan option as an alternative to private health insurance.

“Nurses aren’t in health care to get rich. Last I checked, they’re in it to care for all of us, from the time they bring a new life into this world to the moment they ease the pain of those who pass from it,” he said.

And he said, “few understand why we have to pass reform as intimately as our nation’s nurses.” Nurses often have to “buck up” patients and young medical residents, and now it’s time to buck up the Senate and House to pass reform before the August recess, he said.

When Gallup asked people whom they trust most to make changes in health care, 45 percent said doctors and hospitals. One third trusted Obama and congressional Democrats, hardly a ringing endorsement. They fared well, however, compared with congressional Republicans who gained the trust of just 10 percent. Only 4 percent said they trusted insurance companies most.

Obama suggested that those who support the status quo on health care are really backing insurance companies, whose premiums over the last decade have risen three times faster than wages.

Republicans argue that reform not only will limit access to medical care but will kill jobs, raise taxes and lead to a government takeover of health care – so what’s the rush?

Here’s Rep. Joe Barton, Republican of Texas, Tuesday on the House Democrats’ bill, “Their bill kills health care as we know it in America today.”

Those are strong words, and Obama continues to reassure people that people who like their doctors and health insurance will be able to keep both, and they’ll actually pay less. Reform will reduce costs, raise quality and make insurance companies treat people fairly, Obama says, and it will include an optional public plan.

The president and the Democrats in Congress have the numbers to pass a health-care overhaul without Republican support. But reform is about more than numbers. This battle is for the people’s trust.

(Marsha Mercer is an independent columnist writing from Washington. You can contact her at

© 2009 Marsha Mercer. All rights reserved.

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