Derrick Z. Jackson

Laying down the law on health reform

By Derrick Z. Jackson
Globe Columnist / December 19, 2009

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HEALTH CARE reform is now so bizarre that the Republicans are the ones screaming that the Democrats’ proposals are terrible because they will not insure enough Americans.

Republican Senator Jim Bunning of Kentucky said, “The authors of this bill will try to argue that since their bill leads to ‘near universal coverage,’ most Americans won’t be affected by this tax. That couldn’t be farther from the truth. . . . Twenty-four million people without insurance is not ‘universal coverage’ or anything close to it.’’

This is the same Bunning who says single-payer coverage is a “disaster for our country’’ that will “undermine private insurance.’’ From his twisted perspective, since we cannot get universal coverage (precisely because conservatives condemn it) we should not try at all.

When the Republicans feign care for the uninsured, the Democrats had better get a grip before the entire health care moment is lost. Liberals already have conceded they are not getting anything close to single-payer coverage. It is time for Democratic leaders to tell centrist renegades such as Senator Ben Nelson of Nebraska to stop threatening to destroy reform unless it bans coverage for abortions. It is time for them to tell party turncoat and anti-public-option insurance industry hack Joe Lieberman that if you block reform, the door is barred to their side of the aisle.

President Obama promised during the election campaign that special interests would no longer rule the day in Washington. There is no better place to start than with Lieberman. In Lieberman’s 2006 reelection campaign and his bolting of the Democratic Party, he was bankrolled to the tune of $11 million in campaign contributions and political action cash from the insurance, health, finance, and real estate industries. He was the nation’s top recipient of pharmaceutical cash and second-leading recipient of insurance industry money.

It is time for Congress to say that two-thirds of a loaf, roughly speaking, is better than none. Should reform pass, the Congressional Budget Office and the Medicare actuary say the uninsured rolls will be knocked down to between 18 million and 24 million. Without reform, the CBO, the actuary, and the Robert Wood Johnson Foundation estimate we will have between 54 million and 66 million uninsured Americans by 2019.

To be sure, the reductions will not keep America from being a global laughing stock on health care. We will remain the only industrialized nation without universal health coverage. Democratic Party chairman Howard Dean is correct in saying that reform is a giveaway to the insurance companies that historically put profit before coverage.

The system will remain chaotic, and families still may be bankrupted with catastrophic illness or injury. Ten years ago, a United Nations report found the United States to be the top per-capita spender on health care in the world, but ranked only 37th for health system performance. That report cited single-payer Canada as having North America’s “fairest mechanism for health system finance.’’ Our unfairness has a human toll. Of the 25 top-ranked countries in the UN’s 2009 Human Development report, the United States has the third-highest income gap and is tied for the second-lowest life expectancy.

Last month in the Philadelphia Inquirer, Princeton University health economist Uwe Reinhardt said the United States has “the most complex, bureaucratic health system in the world. There is just no other nation that spends as much on paper and computers . . . just claims-processing. . . . To my mind, we get very little for that in terms of social value added.’’

That said, it is important to get 30 million more people insured, even in this highly flawed system. Democrats need to grab the debate back and not completely cave in to Republicans who are making a mockery of health care reform.

Derrick Z. Jackson can be reached at

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