By Sylvia Hampton
April 6, 2010 (San Diego) --Congressman Duncan D. Hunter, in his monthly report to the district, continues his opposition to the Patient Protection and Affordable Care Act and its accompanying Health Care and Education Reconciliation Act signed into law recently. Hunter says he opposes “any approach that imposes higher taxes and onerous regulation.”
What he is missing with this statement is the rising cost of health insurance premiums (like a tax out of control,) the obvious need for stronger regulation of the insurance companies and the over-all rising cost of care. As the nation faced increasing numbers of uninsured and under-insured, Hunter ignored the issue and didn’t even include “health care” as a priority on his website.
While Hunter voted against the reform bill, he supports the proposals in it that provide “coverage for individuals with pre-existing conditions and allow parents to keep children on their health plans to age 26.” But he is far more critical of the bill than Ruben Barrales, president and CEO of the San Diego Regional Chamber of Commerce, Ruben Garcia, District Director, U.S. Small Business Administration, San Diego and Imperial Counties, and small businessman Richard Ledford--all of whom appeared on KPBS “These Days” recently to express their opinion of the reforms. As Garcia said in the interview, “Congress has passed a comprehensive healthcare reform bill that’s going to be a very important tool to helping small businesses grow and to compete. And the bill helps small businesses in two critical ways. It provides better access to options and it reduces the overall cost.”
Barrales said the reviews of his members are mixed, but they do support the goal to cover more workers and provide incentives for businesses to do so. Richard Ledford, small business owner, said, “I guess when Mr. Barrales talked about some of the smaller business members at the Chamber that are enthusiastic about the reform measure, I would be one of those.” He went on to explain that over 95% of the businesses in our region have fewer than 50 employees, the ones that qualify for tax incentives in the reform bill and the cost of covering employees has been a huge problem for small businesses in San Diego County.
When health care reform takes full effect, up to 7 million uninsured Californians will get access to affordable health care and 400,000 small CA businesses will get large tax credits when they provide health care to their workers. Everyone in California benefits from consumer protections that ensure they will never be denied coverage because of a pre-existing condition or be dropped from their health plan because they or their family member gets sick. The biggest problem with the bill is the lack of direct cost controls, which got pushed to the back burner in negotiations and by powerful lobbying efforts. They don’t call this “sausage making” for nothing.
For example, when Massachusetts passed their health reform program in 2005 under the leadership of Governor Mitt Romney, it included mandatory insurance for all residents but no measures to contain costs. Scott Brown, the new U.S. Senator from Massachusetts who was then a state legislator, voted for it. So the taxpayers subsidize the premiums for those who cannot afford the payments, but the program is now experiencing out of control costs and will have to be reined in.
The reconciliation bill improved the original health reform bill with greater funding for Medicaid programs and higher payments to doctors and hospitals. Low-wage workers and their employers welcome these changes. Any increase in taxes for small businesses will be off-set by the help in getting employees covered, something every responsible employer wants.
Would Hunter, a fiscal conservative, support “Medicare for all,” the most cost-effective way to provide universal coverage? He says not. But he surely must support the provisions in the reform bill that include opportunities for demonstration projects that could work out ways to improve primary care and prevention tools —all cost cutting measures that will take time to show up.
There are also provisions in the new federal bill to address complications that patients too often acquire during hospital stays, like infections related to surgery; Medicare will reduce the hospital's payments by 1 percent if their record is poor. That starts in Oct. 2015. And starting in 2012 Medicare will reward efficient providers in something called “accountable care organizations” or primary care doctors, specialists and others who have their own businesses but partner in treating patients. In theory, the coordinated care will avoid duplicative tests and examinations, a large cost savings. Plus, a new Medicare-Medicaid Innovation Center, which the reform bill requires to be started within nine months to study new ways of paying providers more efficiently. These cost savings will take time to show up on the bottom line.
Hunter is correct to worry about the costs. We all are. But how do we achieve a healthier population and save money at the same time? The new reforms are a great start, and savvy small businesses are recognizing that.
Sylvia Hampton is a community activist inducted into the San Diego County Women’s Hall of fame for 2008 for her work in the fields of healthcare reform, social justice and reproductive health. She is the past president of the League of Women Voters of San Diego County and served on President Nixon’s Title X Family Planning Council. Her monthly Community Forum column is published in the Rancho Bernardo Sun, Diamond Gateway Signature, and her Soapbox in the East County Magazine.
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