Health Care

Here’s an excellent explanation of how important rural hospitals are to the life and death medical needs of nearby citizens.  Any discussion of health insurance  and general health care should include allowances to maintain rural hospitals. Production services by Firefly for Columbia County Health System.

Rural Hospitals


 Health care - A Human Right

Health care in America has evolved as a moral decision between two camps. Is health care a right and not a business; or is the primary purpose of the health care and insurance industries to simply create profits for stockholders? While republican attempts to repeal and replace the Affordable Care Act (ACA) have failed so far, those efforts are predicted to resurface in 2018. Democrats concede the ACA could be improved, but the GOP appears only interested in eliminating the ACA.

Before the Affordable Care Act

Prior to the ACA, access to health care was a privilege. You were fortunate if you were afforded the opportunity for health insurance via your employer. Or, if you were 65 or older, you were lucky to be eligible for Medicare. Additionally, you could purchase health insurance on your own, which typically meant ultra-high premiums or very limited coverage, and dismal preventative care. Alternatively, if you were poor, and met the criteria, you may be covered by Medicaid.

That left 47 million people without access to health insurance or affordable care. It meant many people didn't seek medical attention until they were in crisis mode. The end result was usually a visit to the emergency room at the local hospital because hospitals must provide medical assistance, regardless of a person’s ability to pay. Because people were not getting preventative care, their illnesses would become more severe than necessary. This jeopardized many small, rural hospitals because they were trying to absorb the costs of treating people without medical insurance.

If you were working, but didn't have insurance, you worried that one accident or illness could throw your family into bankruptcy.  And yes, in this rich and generous nation, people died because they could not afford medical care. Before ACA, we were the only developed nation in the world that did not provide the opportunity for health care to all its citizens. People suffered while health insurance companies reported record profits and paid their CEO’s millions in annual salary.

With the Affordable Care Act

The Affordable Care Act was debated publicly for well over a year and the process allowed for Republican amendments. Congress conducted 79 committee hearings on features of the bill. Since the inception of the ACA, 20+ million previously uninsured citizens are now covered across the country. In our state alone, more than 500,000 Washingtonians benefit from coverage provided through the ACA.

The uninsured rate in our state has been cut in half, and is down to 7.3 percent. People were able to afford the insurance, in part, with tax credits or subsidies. To share costs and create a balance of both healthy and sick people, the ACA includes a mandate that all people must have insurance or pay penalties. The ACA offers benefits to all, even people who already had coverage via their employment.

Here’s a list of some of the universal benefits included in the ACA:

  • Discrimination on pre-existing conditions ended.
  • Premium cost equity for women and men.
  • No annual or lifetime limits.
  • Children up to age 26 covered on parents’ policy (50,000 benefited in Washington).
  • Free preventative care.
  • All health plans must include 10 basic services.
  • Insurers must spend 85 percent of premium on care.

It's not hard to see why the ACA, or Obamacare, has become so popular with people, and a target for insurance companies. Polls indicate 60 percent of Americans now want to keep the ACA. But the ACA is not without problems. For some, the premiums and/or deductibles are too high. And in some areas there are too few insurance companies willing to offer acceptable plans. Despite their on-going criticism of the landmark health care opportunity taken advantage of by more than 20 million Americans, Republican leadership in Congress refuse to allow any consideration of amended legislation that would enhance the benefits of the ACA.

The 4th Congressional District has a large population of working poor and low-income families. Without the ACA, many of those individuals would lose their health insurance and be back in the cycle of bankruptcy with one major illness or accident. Many are older, disabled or veterans. It’s estimated 50,000 of our neighbors in the 4th Congressional District would lose health insurance if ACA is repealed. That would have a significant impact on the individuals, but also our communities. There would be job losses in health services, hospitals would have to struggle with uncompensated care, and the strides made in public education on health issues would be set back. One of the most relevant benefits of the ACA has been preventative care. By spending $1 on prevention now we save $7 to $10 when the condition escalates as debilitating or even life threatening.

My Approach to a Health Care Policy

I believe health care is a right, and not a privilege for the rich or folks lucky enough to be employed by a company offering medical coverage as a benefit. I would work tirelessly to continue the basic coverage features of the Affordable Care Act. In addition, I would encourage my colleagues in Congress to push this to the next level, which is health care for all.

All of the other advanced countries in the world have found a way to accomplish this goal. My confidence in American ingenuity and innovation to solve this problem is steadfast. Nation-wide polls indicate nearly six in ten Americans want a single-payer system. Even Republicans support the idea with roughly 40 percent favoring a single-payer system.

Medicare is the model we are most familiar with as a single-payer program and most people have favorable opinions about it. Medicare-for-All would require people to pay premiums on a sliding scale. In addition, people would have access to regular doctor’s visits to provide them with preventative care, which keeps people healthier and happier, thus reducing costs.

We need to reduce the reliance on hospital emergency rooms for non-emergent health care. For example, it's so much cheaper to treat high cholesterol with medications, than treating diabetes. By proactively making drug, alcohol and mental health care treatment widely available, we get much closer to solving these devastating public-health issues.

Most people now believe Medicare-for-All is the future. But to get there legislatively we need bold and committed leadership. We don't have that right now. Republicans control the House, Senate and the White House. Their goal is to cut your health care benefits and give big tax breaks to the richest people and put insurance companies in the driver’s seat of our health care.

Republican Congressman Dan Newhouse has repeatedly voted to repeal the ACA, without any alternative. In doing so he is telling his constituents in the 4th Congressional District that he is using our vote to take our health care away. He is putting the greed of the wealthiest Americans and lobby-rich insurance companies in line for an unprecedented pay day.

During my visits to communities throughout the congressional district, it's clear the ground-swell of resistance to repealing the ACA without a better alternative continues to grow. You can play a key role in deciding the direction we go on health care. Change who represents you. Your vote can elect an independent leader who will work for all of us. Vote to make a difference.