Harm: Adding expense, complexity is not ‘reform’

Published 12:00 am Sunday, November 15, 2009

With due respect to the citizens who felt motivated to write letters thanking U.S. Rep. Bennie Thompson for being the lone Democrat from Mississippi to vote in favor of the House version of legislation to change how health care is paid for in America, this state and nation already offer medical services to those who have no alternative except reliance on the public purse and to those 65 or older, regardless of income.

The program for the poor and disabled has been around for 44 years. It’s called Medicaid and more than 600,000 of Mississippi’s 3 million residents are enrolled.

The program for seniors is called Medicare. It’s also been around 44 years and has recently been expanded to provide at least some prescription drug coverage.

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Medicaid, too, has broadened through the years, notably through the program that provides full medical, dental and counseling services through the SCHIP program into which parents earning up to 200 percent of the federal poverty level may enroll their children. About 90,000 Mississippi children not eligible for Medicaid are in SCHIP.

The people who are hurting — and who stand to hurt more via the “free” health plans so many seem to desire — are the paycheck-earners. As with all government programs, the burden of the House-passed bill will rest mostly on families of modest means and, due to America’s deepening deficit, children yet to be born. In a statement, Thompson equated the new approach to providing the same relief as Medicare and Medicaid, but that’s not true.

What seems to be lost in the discussion is that it is families for which the household income is $50,000 to $250,000 annually who are least able to afford insurance to pay for preventive care, doctor visits when they are sick and who must file bankruptcy if, per chance, one of them spends a week in a hospital or requires major surgery. What also seems to be lost in the discussion is that these individuals are being priced out of the market because in addition to affording insurance or paying their own medical bills, they also are (1) contributing most of the dollars that support Medicare and Medicaid today, and (2) subsidizing public program clients for whom the government reimbursements are so low that doctors, hospitals, clinics and other providers charge their private-pay clients more to make up the difference.

Rep. Thompson is exactly right in believing the system needs changing. But adding more complexity, bureaucracy and public expense — which the House bill will do — is not it.

Doctors take an oath. After they evaluate a patient, their prime duty under that oath is “first, do no harm.” Members of Congress might ponder that. If not, they may well make a bad situation worse.