Whatever the Supreme Court Decides on Healthcare, Nurses See the Real Crisis Continuing

 As the Supreme Court justices pass judgment on the law even the President now calls Obamacare, the sad fact is that that health care will remain beyond the reach of millions of Americans no matter how the court rules.


In contrast, nearly half the justices who will pass judgment on the law are beyond the age where they have to worry about their access to care.Four of the nine judges already qualify for guaranteed healthcare, two more will within three years when they reach age 65.

That guarantee could be achieved by extending Medicare to everyone, without raising constitutional questions posed by the individual mandate that forces everyone without coverage to buy private, commercial health insurance.

The stark reality is far different for people under 65 today. Whether the Court throws out or upholds Obamacare, they will still not have universal coverage, medical bills will still push too many Americans into bankruptcy or prompt them to self-ration care, and insurance companies will still have a choke hold on their health.

Let’s credit the law with some positive elements, such as ending lifetime coverage caps and banning exclusion of patients with pre-existing conditions, and permitting young adults up to age 26 remain on their parents’ health plan.

But the law falls fall short of what is needed to bring our national healthcare nightmare to a close.

Despite its name the Affordable Care Act has done little to actually make healthcare affordable. Out of pocket health costs for families continue to soar. Nurses now routinely see patients who have postponed needed care, even when it might be life saving, because of the high co-pays and deductibles.

Delayed dental care illustrates the problem. A February Pew Center report cited a 16 percent jump in the number of Americans heading to emergency rooms for routine dental problems, at a cost of 10 times more than preventive care with fewer treatment options than a dentist's office. 

Premiums have jumped 50 percent on average the past seven years, according to a November, 2011 Commonwealth Fund report. More than six in 10 Americans now live in states where their premiums consume a fifth or more of median earnings.

Medical bills for years have been the leading cause of personal bankruptcy. Increasingly they ruin people’s credit as well. Another Commonwealth Fund report earlier this month found that 30 million Americans were contacted by collection agencies in 2010 because of medical bills.

Fifty million still have no health coverage. The percentage of adults with no health insurance at 17.3 percent in the third quarter of 2011 was the highest on record. Another 29 million are under insured with massive holes in their health plans, up 80 percent since 2003, according to the journal Health Affairs. The U.S. may once have had the best healthcare in the world; today that’s only true for the wealthiest among us in a system increasingly defined on ability to pay.

More than 80 percent of U.S. counties trail life expectancy rates of nations with the best life expectancies, the University of Washington found last June. Some U.S. counties are more than 50 years behind their international counterparts.  The U.S. ranks just 41st in the world in death rates for child bearing women, and it has been getting worse, according to the World Health Organization. The average mortality rate within 42 days of childbirth has doubled in two decades, partly due cuts in federal spending for maternal and child health programs the past seven years.

Our economic meltdown has made things worse. For the past year, nurses have seen a big jump in health problems brought on by job loss, high medical bills, poor nutrition and other economic factors.   

Those who favor outright repeal of the law believe more handouts to the private insurers and other healthcare corporations will solve the crisis. But going back to where we were on healthcare is what got us into this disaster in the first place.

Healthcare corporations, with their focus on profits, not patient need, is exactly what produced the falling health barometers on access, quality, and cost.

There is an alternative, one most other industrialized countries have long discovered, a single payer or national healthcare system.

We have our own version, Medicare, the plan that has for two decades provided quality care to all seniors at costs that are affordable—in fact.   It’s time to deal with the reality of a nation in desperate need of quality health care for all.   Medicare works, it’s more cost efficient, and far more humane than the ongoing stranglehold of the insurance giants. 

For those judges who already qualify for Medicare, that means no concerns about being bankrupted by medical bills, denied needed treatment because some insurance agent deemed it ‘experimental’ or ‘not medically necessary,’ barred from choosing the provider of their choice because they were ‘out of network’ or forced to keep an unwanted job to maintain their present employer-paid coverage.

Regrettably, every one of those barriers would also exist under the Affordable Care Act. But none of them exist for Americans who have reached 65 and become eligible for healthcare. 

If Medicare is good enough for our grandparents, it should be good enough for the rest of us.

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