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Columbia Missourian

Misinformation hides the real cost of ignoring the uninsured

By Brian Wallstin
September 7, 2009 | 12:01 a.m. CDT

At a town hall meeting at Howard University last week, Michael Steele, chairman of the Republican National Committee, literally turned his back on a young woman whose mother died of cancer because she couldn’t afford the chemotherapy.

Steele dismissed her sad tale by accusing the woman of trying to get on the evening news.

Back in July, a 27-year-old waitress with two kids and no health insurance asked Rep. Lynn Jenkins, R-Kan., why she opposed the government-funded option proposed by the Obama administration.

Jenkins chuckled condescendingly, then told the woman she needed to “be a grown-up,” accept a proposed “tax credit” and buy her own insurance.

In Oklahoma last month, a woman wept as she told Sen. Tom Coburn that her husband’s health insurer cut off treatment for his traumatic brain injury. Coburn, a Republican, offered his office’s assistance, while, oddly enough, insisting, “government is not the solution.”

He added, “What’s missing in this debate is us as neighbors helping people that need our help."

That’s a beautiful sentiment. But the most distressing realization of this summer’s debate over heath care reform, beyond the cold political calculus and gun-bearing *tea protesters, is that so many appear to care so little about the well-being of their “neighbors.”

You might have noticed that among the most rabid opponents of the so-called “public option” are seniors, who would appear to have little skin in the game. They, after all, have guaranteed health coverage, even if some of them only now seem to understand that the government provides it.

I don’t consider politicians, even my own duly elected representatives, as “neighbors.” So allow me to use the thoughts of someone who is to illustrate how the “I’ve got mine, so everything’s fine” game is played.

In a recent op-ed published in the Missourian, J. Karl Miller, a retired Columbia resident, called the debate over health care reform an “overly emotional catfight.” Shades of Michael Steele!

If that weren’t insulting enough to the tens of millions of his “neighbors” who have no insurance, Miller compared reform to “maintaining an automobile.” Health care in America, according to Miller, is purring along like a new Lexus and only requires “preventive maintenance — oil changes, tune-ups, new tires and, in some cases, a visit to a repair shop.”

In an attempt to convince readers that this callous analogy is one shared by his “neighbors,” Miller cherry-picks from a recent poll that found that more than eight out of 10 Americans who have insurance are happy with it.

More like “happy to have it.” What Miller neglects to point out is that, according to the same poll, seven of 10 Americans also believe “major structural changes are necessary to reduce health care costs or provide insurance coverage to all Americans.”

Sounds to me like it’s Miller who’s in the minority.

He also bemoans the “cavalier treatment” of the costs associated with the public option by trying to pass off a recent op-ed in Investors Business Daily as a “bipartisan study.” The only thing remotely bipartisan about it was that one of the authors once identified himself as a Democrat; he’s now a member of Minnesota’s Independence Party.

More to the point, the “study” was little more than polemic constructed around carefully chosen facts about the increase in Medicare costs. While those facts — Medicare spending went from $5.1 billion in 1968 to $436 billion in 2007 — will surely catch your eye, they are the rhetorical equivalent of a shiny object.

The truth is that, in the last two decades, Medicare has been much better at reining in costs than private insurers. As Jacob Hacker, of the Center for Health, Economic & Family Security at the Berkeley School of Law, explained in a 2008 policy brief, Medicare’s annual rate of “excess cost growth” — the per capita growth in health care spending compared to per capita growth in income — fell from 5.6 percent from 1975 to 1983 to 0.5 percent from 1997 to 2005.

Meanwhile, between 1996 and 2004, excess growth for the nonelderly, 97 percent of whom rely on private insurance, was 3.4 percent.

The proverbial wheels come off Miller’s thesis when comparing cost per beneficiary. Thanks in large part to the administrative expense of looking for reasons to deny coverage, a practice known as “recission,” spending by private insurers was 37 percent higher per beneficiary than under Medicare. “(N)ot only has Medicare more successfully restrained the rate of increase of per enrollee spending,” Hacker explained, “the rate of growth is also on a steeper downward trajectory under Medicare than under private insurance.”

Miller’s intellectual dishonesty is fairly common these days, and it shouldn’t surprise anyone. He is, after all, a senior, not to mention a retired Marine who, along with Medicare, receives taxpayer-funded health benefits through Veterans Affairs.

In other words, Miller is what the Nobel Prize-winning economist Paul Krugman calls an “insider”— someone who has good insurance and receives everything modern medicine can provide. As Krugman pointed out, under our current market-driven insurance system, “insiders” benefit partly from the exploitation of “outsiders,” the uninsured.

Or, as some of us like to refer to them, our neighbors.

Brian Wallstin  is a Columbia resident and a former city editor for the Missourian. He is currently living without health care coverage. E-mail him at bwallstin@gmail.com.