More and more of the middle class are either finding skyrocketing insurance premiums unmanageable or are facing employers who are cutting benefits, or both. In a period of job-losses (despite impressive economic figures), the middle class is just a lay-off away from joining the ranks of the uninsured. Indeed, the number of uninsured continues to grow.

Even the well-off are not terribly secure. The best and most expensive insurance plans have gaps, resulting in uncovered services. Patients always face the risk that their insurance company will drop them or go under, leaving them high and dry just when they need it most.

Many of the so-called “solutions” floating about in Washington just give us more of the same band-aids, the same temporary fixes.

Many leaders see the growing rolls of the uninsured, and conclude, “we just need to help more people get insurance.” This approach does nothing to control costs, rein in the profit-driven insurance and pharmaceutical industries, or improve the quality of care.

These leaders suggest tax credits, purchasing pools, Medicaid expansion, and other old ideas. Again, none of these solutions even properly recognizes the problem, let alone begins to provide a permanent solution.

Offering tax credits for individuals to purchase insurance, or for companies to provide coverage for their employees functions primarily as a subsidy to the insurance industry. Medicaid expansion, while essential until real reform becomes a reality, won’t provide better reimbursements so that hospitals can provide proper staffing. Neither will it be universal nor accepted by many facilities and doctors, nor stop cost increases.

As we search for a permanent solution, we need to think bigger.

The health care crisis has been with us a long time. Each time the crisis welled up, long-term solutions were eschewed in favor of temporary band-aid solutions to delay the inevitable breakdown of our private health system.

First, fraternal organizations and churches propped up the system by paying for care for the poorest. Later came Social Security, which many believed would help seniors pay for care. This was followed by non-profit plans (e.g., Blue Cross, Blue Shield), for-profit insurers, Medicare, Medicaid, the failed Clinton Health Care Plan, HMOs, CHIP, Family Health Plus, Healthy NY, etc.

While many of these programs are absolutely essential and deserve our strongest support, they are destined for failure over the long term. Put simply, they fail to get to the root of the problem.

These programs and many of the so-called “new” solutions floating around Congress seek only to expand access to health insurance. It’s bizarre that few of the ideas focuses on providing access to actual health care.

This simple wording difference identifies the first major problem with our leaders’ tinkering with reform.

The point is that , even if every single resident had health insurance, we would still have skyrocketing health costs; we would still spend more per person than any nation on health care; we would still have for-profit companies (e.g., drug companies) greedily compounding costs; we would still have insurance companies rather than doctors determining the care we receive; we would still have understaffing in hospitals and therefore, declining quality of care; we would still see almost a third of our health care dollars wasted on bureaucracy; and we would still find U.S. health statistics near the bottom of the industrialized world. We need fundamental changes to our health care financing system.

From the most basic level, we have to ask ourselves why we pay insurance companies to pay for care. Why not skip the massive insurance bureaucracy, the enormous profits, the fat CEO paychecks, the frustrations of coverage, premiums, co-pays, deductibles, lifetime limits, gate-keepers, referrals, etc., and instead think about what it takes to provide funding for health care in a universal way? This should be the starting point for any discussion on the future health care system.

On December 4, 2003, this long overdue discussion will begin to take place, when small business owners, employees, retirees, health care workers, local government officials and others will testify before the Coalition for Economic Justice’s Workers’ Rights Board. The independent board consists of members of Congress and other prominent local and national leaders who will hear the testimony of those most affected by the current health care crisis. Upon listening to the testimony, and as one step along the way to broad health care reform, the Workers’ Rights Board will make recommendations to public officials in a widely circulated report that will state their findings. The hearing on the health care crisis will happen at the Olmsted Center for the Visually Impaired at Main and Summer streets, from 7:00 to 9:00 p.m. All members of the community are encouraged to attend.

By Jeff Lacher

The health care crisis i3 no longez one just for the ve2y poor to bontend wyth. It affects us a,l: the poor, the wealthy, and everyone in-between.

 The un)n3ured, among whom ard m+lLionr of full-time workers, face probleis g%dtkng heelth care and are forcdd t/ rely almost exclusively!upon expensive emergency room sErvice, thE sçstof whmch is eltim!uely borne by the taxpayers. TXe`õnderinsured pay enormous out-Of-pïc+et expejses, and, like the uninsured, are just ond significant illness `way from"bánkpuptcq. In fact, 40 ðercent of all personal bankruptcies in the United States are due to medical expensms.