TESTIMONY FOR THE HEALTH AND HUMAN SERVICES COMMITTEE
PENNSYLVANIA HOUSE OF REPRESENTATIVES
MARCH 19, 2008
Chairmen Oliver, Kenney, Representative Manderino and Committee Members,
Thank you for holding this very important hearing on health care. I know
that dealing with the health care crisis is a daunting challenge, but one of
great concern to the legislature and all residents of our Commonwealth.
I have been invited to offer testimony about House Bill 1660, the Family and
Business Health Security Act, as a professional social worker who has been a
proud member of the National Association of Social Workers for 34 years and
was just honored with a lifetime achievement award by the Pennsylvania
Chapter. In addition I am a founding member of Pennsylvanians United for
Single Payer Health Care (PUSH) and the Pittsburgh Chapter of the Network
for Spiritual Progressives. I am also a board member of Health Care 4 All
PA.
As a Licensed Clinical Social Worker who provides mental health and
addiction services I frequently witness the stress on individuals and
families when they are financially strapped to cover the escalating costs of
health care or cannot obtain all the needed services because of benefit
limits. Obviously, the uninsured and underinsured face substantially greater
challenges. Because I also work for a small employer who cannot afford to
provide health care insurance and a member of my family experienced life
threatening health care problems this past year, I have experienced stress
similar to the stress that my clients have experienced. Despite paying
$9,000 for insurance premiums each year, my wife and I had to refinance our
house to cover medical debt arising from deductibles and co-pays. This, in
turn, will at a minimum, delay our retirement by several years. It threatens
that retirement all together. We are fortunate that we at least had some
coverage to address over $100,000 in medical expenses. By the way, my
employer has lost excellent employees over the years because of the
inability to provide health care coverage.
We are all too familiar with the statistics—nearly 47 million Americans
without health insurance; 18,000 dying every year due to this lack of
coverage; life expectancy in the United States among the shortest and
maternal and infant mortality among the highest in the industrialized world;
health care costs adding $1,500 to the price of an automobile made in
America leading one of the Big Three automakers to locate a plant in Canada
instead of in the states; a fragmented, non-system of health care financing
that costs $2.3 trillion a year and wastes 25% on advertising, inefficiency,
excessive executive salaries, and profiteering. This information and more is
cited by the prestigious Institute of Medicine of the National Academies of
Science in their report “Insuring America’s Health: Principles and
Recommendations” (National Academies Press, 2004). Rose Ann De Moro, the
executive director of the California Nurses Association/ National Nurses
Organizing Committee recently noted: “As premiums have ballooned by 87% in
the past decade, insurance industry profits have climbed from $20.8 billion
in 2002 to $57.5 billion in 2006. During that same period, health care
interests spent $2.2 billion on federal lobbying, more than did any other
sector. . .”
Virtually all scholars of our health care system note that treating health
care as a commodity, a consumer product in a market system, that fewer and
fewer individuals and employers can afford, is a fundamental problem. It
leads to a plethora of duplicative and competing plans which results in
inefficient and expensive duplication of services and costly overhead. It
also leads to fragmentation, gaps in service, and a bloated private
insurance industry bureaucracy. Even those of us with comprehensive coverage
have experienced long waits for appointments and the “seven minute” exam
which precludes real exploration and discussion of our health concerns.
(More comprehensive exams with real communication between a physician and
patient who have established an ongoing relationship, protected from
interruption by changes in insurance plans or loss of insurance, support
patients to take more responsibility for their health.) This is what we
experience on the “front lines” of our health care system. In March of 2006
the New England Journal of Medicine published a study by the non-profit
Institute for Health Care Improvement of Cambridge, MA. Overall the nearly
7,000 patients surveyed received only 55% of the recommended steps for
top-quality care. Dr. Steven Asch, the chief author, commented “It doesn’t
matter who you are. It doesn’t matter whether you’re rich or poor, white or
black, insured or uninsured. We all get equally mediocre care.” A cautionary
note: While this system adversely affects everyone, uninsured and
underinsured patients are affected even more. They delay care and receive
less care to the extent that it increases morbidity and mortality.
Christopher Murray, MD, Director of the World Health Organization’s Global
Program on Evidence for Health Policy stated: “You die earlier and spend
more time disabled if you’re an American rather than a member of most other
advanced countries.”
Some defenders of the current system state that everyone can obtain health
care if truly needed, pointing to emergency rooms as a last resort. They are
required to provide emergency care to anyone, regardless of ability to pay;
however, there is no requirement to provide treatment beyond addressing the
medical emergency. It is the most expensive way to provide care and leads to
long waits at ERs.
Others argue that the federal government, not the states, should solve the
health care crisis. However, we have a long history of state governments
being the innovators of reforms that are eventually adopted by the nation.
Many New Deal programs began in New York. Pennsylvania has an opportunity
now to lead the way.
There are many other ramifications of a partially market-based, profit
seeking fragmented system:
1. Duplicative services in metropolitan areas and inadequate services in
rural areas;
2. Health care debt is the number one cause of personal bankruptcy;
3. Handicapping American business’s ability to compete in the global market
place where all other developed countries have government provided health
care;
4. Weakened public health ability to respond to pandemics;
5. Weakened ability to respond to security threats such as bio-terrorism;
6. Flattening of individual and family income because compensation increases
have to cover increasing insurance premiums;
7. Significant contribution to inflation;
8. The high cost of emergency room care for the uninsured passed on to
health insurance
premiums;
9. Increased taxes to cover health insurance costs for local and state
government and school districts;
10. And, increased stress on individuals, families, and communities.
To provide a concrete illustration of the financial benefit of HB 1660, I
have attached a Cost Comparison for a Family of Three under the current
system and under the proposed legislation.
Again, virtually all experts agree that solving the health care morass
requires simultaneously addressing issues of increasing access (preventive
care is a lot less expensive than acute care), cost control, and quality
improvement. Only a unified, comprehensive system that eliminates
profiteering and simplifies financing and delivery addresses all three
factors. Countries that have established health care financing systems
similar to the plan I am advocating spend less and achieve better results
than we do under our current system. That is why I implore you to support HB
1660.
Critics state that we cannot afford the financial burden of truly universal
coverage. I believe that the information I have already provided makes the
point that we cannot afford the current state of affairs where only some are
covered. No less than the General Accounting Office and the Congressional
Budget Office have estimated that the cost savings of a single payer system
would pay for the uninsured. In addition, recently the Lewin Group, a
nationally respected independent health care consulting group, estimated
that 99.6% of Americans could not only be covered without raising the total
national health care spending, but that the United States could actually
save more than $1 trillion over the next 10 years.
I have an even more compelling reason to seek your active support of HB
1660. Social workers are ethically committed to enhancing the fundamental
dignity of the individual and the well-being of society and believe that
health, as enshrined in the Universal Declaration of Human Rights, is a
fundamental human right. And as Americans what could be more basic than
ensuring everyone’s health as necessary to “life, liberty, and the pursuit
of happiness”? Quality, affordable health care for all is truly a family
value and manifests respect for the sanctity of life. Isn’t a world that
values everyone’s health the kind we wish to live in, the kind of world we
want to leave our children and grandchildren? Isn’t that what the founder of
our Commonwealth, William Penn would expect from us? Can we afford to do any
less?
Thank you for taking the time to read this testimony.
Sincerely,
Robert A. Mason, LCSW, CAC, CEAP
423 Fairmont Ave.
Trafford, PA 15085
Daytime Phone Number: 412-823-5155, ext. 659
