Moving healthcare up on US agenda

Social Security or healthcare reform?

A coalition of more than 150 major corporations, unions, healthcare organizations, religious groups, and pension providers representing more than 150 million Americans came together this week to tell Congress and the president that they're focusing on the wrong issue.

"The healthcare system is in crisis today. Social Security is not," says Henry Simmons, president of the National Coalition on Health Care in Washington. "Healthcare is a far more serious, immediate, and destructive problem than Social Security."

While few quibble with the forecast that in 40 years Social Security may be able to provide only about 80 percent of promised benefits, coalition members say the nation's healthcare problems are dragging down the nation's overall economy: They're increasing the cost of doing business as they undermine Americans' standard of living.

In fact, 45 million Americans have no health insurance at all. And insurance premiums are rising so fast - by double digits annually - that corporations are requiring individuals to pay more, and many small businesses are forgoing coverage altogether. And as those costs go up, American businesses are becoming less competitive in a global marketplace, where most industrialized nations provide some kind of national healthcare.

The bipartisan coalition, which is made up of groups as diverse as General Motors and Calpers, the nation's largest public pension plan, has called on Congress to embrace a plan for universal coverage - that is, every American would have some kind of healthcare coverage within five years. It also presented an analysis claiming such reform would save the nation as much as $125 billion annually within the decade.

"The upfront investment needed to fund systemwide reform ... would be far offset by the savings," says Dr. Simmons. "The savings would be huge ... and they would grow year after year thereafter. In addition, employers who now provide coverage would save massive amounts of money, compared to the costs they'd incur in the absence of reform."

While many healthcare experts applaud the coalition's analysis, many believe that in the current political and economic climate, their urgency is misplaced because it is politically unsustainable. Despite polls that regularly show that Americans are more concerned about healthcare than Social Security, the administration has opted to focus on small incremental healthcare reforms.

"The president's agenda is not the agenda of the public," says Prof. Robert Blendon, one of the nation's leading researchers on healthcare public opinion at Harvard's Kennedy School of Government in Cambridge, Mass. "But people are more passive because the war and terrorism continue: That's what got their attention and has taken the steam out of other issues, like healthcare."

There's also a split in the business community, in terms of the best way to cope with the healthcare problem. While many older-line companies that have unions are in favor of comprehensive government action, others believe in continuing to shift more costs onto employees, at the same time that the government offers tax breaks.

"There's no doubt that there's a crisis in healthcare, particularly in small business. We've been seeing the heaviest increases in the last five years of anyone," says Amanda Austin, manager of legislative affairs at the National Federation of Independent Businesses, the nation's largest lobby for small businesses. "But in this climate ... nationalized healthcare just isn't an option at this point. Right now we think it would be easier to get incremental changes passed rather than a large overhaul."

Many healthcare experts agree with that analysis, but it frustrates others who believe that the healthcare problem is damaging the whole economy.

"That just won't do it," says Simmons. "This crisis has now grown so large that it's no longer just a health issue. It's a major economic issue affecting the deficit, jobs, and our global competitiveness."