Attacking Health Care Reform With Sixteen Year Old Arguments

Democratic pollster Geoff Garin, President of Peter D. Hart Research Associates is optimistic about the prospects for passing  health care reform despite the inevitable attack from Republicans:

“The Republicans wrote their talking points before the Democrats wrote their plan and we already know they’re going to make the same attack they made against health care, health reform in ’93 or ’94, even though we’re not talking about a plan that looks like ’93 or ’94. So it’s all going to be about ‘government-run health care.’ … They’re going to be making a 16-year-old-argument against something that is very different from the plan of 16 years ago … And at the end of the day, (if it’s) a debate between Barack Obama and (Senate Minority Leader Mitch) McConnell, Obama is a better and more credible communicator.”

Whether he is right depends upon two things–whether the plan is really different from HillaryCare (as looks probable) and whether the Republicans can still win the spin war. It looks likely that, despite Obama’s opposition during the primaries, there will be an individual mandate. This will give the Republicans some strong debating points. Most likley they will spin such a mandate as a policy of the left when it is the demands of the insurance industry which are really responsible for this change.

In the end if the Democrats win on health care it will be partially because of the Republican talking points being out of date. More importantly it will be because of how much conditions have worsened since the 1990’s. This has led to many who opposed health care reform in the 1990’s, including many in the health care field as well as many businessmen and indivuals who can no longer afford health care, to now support reform.

Bankruptcy From Medical Expenses

The American Journal of Medicine has published a study on bankruptcy due to medical expenses in 1977. Presumably the problem is worse now due to  the recession. The study found that 62% of bankruptcies in the United States were for medical causes with the share attributed to medical causes raising 50% between 2001 and 2007.

This was found to be far more than a problem of the poor and uninsured. Three fourths of those declaring bankruptcy for medical reasons had insurance, and most were well educated middle class individuals. Despite insurance, large numbers of people in the middle class wound up declaring bankruptcy due to being under-insured with high out of pocket expenses:

Out-of-pocket medical costs averaged $17,943 for all medically bankrupt families: $26,971 for uninsured patients, $17,749 for those with private insurance at the outset, $14,633 for those with Medicaid, $12,021 for those with Medicare, and $6545 for those with Veterans Affairs/military military coverage. For patients who initially had private coverage but lost it, the family’s out-of-pocket expenses averaged $22,568.

Among common diagnoses, nonstroke neurologic illnesses such as multiple sclerosis were associated with the highest out-of-pocket expenditures (mean $34,167), followed by diabetes ($26,971), injuries ($25,096), stroke ($23,380), mental illnesses ($23,178), and heart disease ($21,955).

Hospital bills were the largest single out-of-pocket expense for 48.0% of patients, prescription drugs for 18.6%, doctors’ bills for 15.1%, and premiums for 4.1%. The remainder cited expenses such as medical equipment and nursing homes. While hospital costs loomed largest for all diagnostic groups, for about one third of patients with pulmonary, cardiac, or psychiatric illnesses, prescription drugs were the largest expense.