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Maria, Part Deux, and Health Insurance

Tuesday, January 23rd, 2007

Since my post of January 4 about Maria Leavey’s untimely death, tributes to her have popped up around the Internet. One in particular makes the case even more strongly than I could before that her death may have been preventable — if only she had health insurance. Since health insurance also happens to be rising to the top of the national political agenda right now, it’s as good a time as any to think about how we might think about protecting Americans like Maria from leaving us too soon.

When Maria’s obituary appeared on January 6, any trepidation I had felt about publicly raising Maria’s lack of health insurance went away — it was part of a well-written and touching tribute which captured her essence well. Her lack of insurance was obviously something of which her close confidantes were also aware — not just something she shared because she believed so strongly in the mission of Workplace Fairness. Her close friend and professional colleague, Michael Tomasky, a political writer and former executive editor of American Prospect magazine, summed up my own impression of her so well: “It was clear that she was putting the larger cause and other people’s needs before her needs. That’s not something you run into too often in this town.”

But an even more personal and insightful examination of the import of Maria’s death appeared in Salon just a few days later, written by Joe Conason. (I’m not just saying that because he linked to my prior blog entry about Maria, especially since he referred to this blog as “small…in the progressive blogosphere.” Ironically, Maria was planning to help us change that.) Entitled Maria’s Hope, the article pulls no punches when it says,

She had no health insurance — which meant that the hereditary heart condition that killed her probably went undiagnosed and untreated. That almost certainly killed her, as the lack of regular care prematurely kills thousands of other Americans every year. And while she was acutely aware of how that problem affected her fellow citizens, and worked hard every day to change that injustice, she was unable, like so many who work freelance and in small business, to help herself.

Whether or not her heart condition was undiagnosed, chances are good that it went untreated, as it’s hard to get adequate health care without insurance, especially when, as Conason noted, “[Maria] often worked for free — or got stiffed on her very reasonable bills — while the nonprofit executives and politicos who exploited her talents took down big salaries.”

But some of the progressive legislators Maria helped elect, and the liberal groups she supported, are wielding more power these days, and the idea of health care for the masses is being talked about more than it has been since Bill and Hillary Clinton tried but failed in 1994 to transform the way we look at health care. While it’s too late for Maria, is there hope for those who are not covered at work and can’t afford health care on their own?

Tonight, President Bush is expected to talk about his health care proposal in the State of the Union address, which would create a new tax deduction for those who buy insurance themselves or don’t currently have insurance of $15,000 per family and $7,500 for individuals. For those who currently have a health plan from their employers which costs more than $15,000 per year, they would be required to pay taxes on the amount over $15,000 paid on their behalf. (See Reuters article.) Reaction from the leadership on Capitol Hill was tepid, at best: critics charge the plan will cause employers to drop coverage for those who currently have it. (See Bloomberg article.)

One proposal that is receiving considerable fanfare these days comes from Yale’s Jacob Hacker. It’s called “Health Care for America,” — an ambitious agenda to be sure. How would Hacker, and the groups supporting his efforts such as the Campaign for America’s Future and the Economic Policy Institute, make this a reality?

What Health Care for America would do is simple: every legal resident of the United States who lacks access to Medicare or good workplace coverage would be able to buy into the “Health Care for America Plan,” a new public insurance pool modeled after Medicare. This new program would team up with Medicare to bargain for lower prices and upgrade the quality of care so that every enrollee would have access to either an affordable Medicare-like plan with free choice of providers or to a selection of comprehensive private plans.

At the same time, employers would be asked to either provide coverage as good as this new plan or, failing that, make a relatively modest payroll-based contribution to the Health Care for America Plan to help finance coverage for their workers. At a stroke, then, no one with a direct or family tie to the workforce would remain uninsured. The self-employed could buy into the plan by paying the same payroll-based contribution; those without workplace ties would be able to buy into Health Care for America by paying an income-related premium. The states would be given powerful incentives to enroll any remaining uninsured.

(See EPI Briefing Paper.) Hacker’s plan has some compelling elements, especially for those who are not yet ready for employers to completely abdicate their responsibility to the government to solve America’s health care crisis. Time will tell whether its direct, yet sophisticated logic, will win enough allies along the way to become reality.

Another reason why health care proposals are likely to stay atop the national agenda in the days ahead is the emerging alliances between groups who openly acknowledge that they are “strange bedfellows.” When AARP and Families USA can work in a coalition with the American Medical Association and the U.S. Chamber of Commerce, there’s some hope that progress is in sight. See Health Coverage Coalition for the Uninsured (HCCU). And when Andy Stern of the SEIU can reach common ground with the heads of AARP and the Business Roundtable to agree that “[p]olicymakers must act,” then perhaps the policymakers will act. (See Washington Post article.)

As Michael Tomasky wisely notes, “Her friends Harry Reid and Tom Harkin could do far worse than to keep [Maria’s] story in mind whenever they confront the subject of health care.” (See American Prospect article.) With the State of the Union tonight, and Maria’s memorial service tomorrow, now is a very good time to begin to confront the painful subject that is already on a lot of minds — especially those Maria counted among her friends and colleagues who have the power to bring about change. Let’s get it done, before we have to mourn and wonder “what if?” about anyone else we know and care about.

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