My Turn

Op Ed - My Turn - Cornelius Hogan, Plainfield, VT

How I Will Know When the Country is on the Right Track Again

I was in a position to have an impact on the health care debate in my little state in the 90's. But I didn't. I wish I had. At the time I was Secretary of Human Services for Vermont. Things on the health care front were doing well. At our best, out of a population of 620,000 people, only 42,000 didn't have health care coverage. Virtually all of our children did. As a result we were lauded as having one of the highest percentages of people having health care at 93%, with the prospect of covering everyone if we put our minds to it. Most of it was comprehensive health care. We were fat and happy.

Then the wheels came off. The price of health care started going through the roof and more and more people simply couldn't afford it. The federal government got enmeshed in a series of ideological battles that resulted in gridlock, even around the idea of covering our children. Various states, including mine, tried a variety of things to upright the situation, but things continued to get worse. The number of people uninsured in Vermont has now reached 69,000 in a mere 6 years. We dropped from 93% insured to 89%, along with approximately one third of the workforce watering down their health care coverage with the use of health and medical savings accounts. (HSAs and MSAs).

The problem is accelerating. Even as Vermont (and quite a few other states) has tinkered together efforts to subsidize health care for those that can't afford it, the number of people opting out of coverage because of rising cost is rising faster than they can subsidize. Now, in this recessionary period, they have run out of money. It is very possible, that in little Vermont, which over the decades has prided itself on taking care of its people while balancing its budgets, will see 100,000 uninsured people in the near future. That will bring our uninsured rate down to 84%. These numbers look good in the face of what is happening nationally where there are 47,000,000 million uninsured, with 9,000,000 million being our children. THIS IS NOT ACCEPTABLE.

An expression of the problem hit home for me during one of the Democratic debates in Iowa which was focusing on health care and economic security. At that time there were still seven candidates in the race. I remember vividly, Judy Woodruff from NPR asking two straightforward questions. The first question was "What do you think of the Medicare program?" Every candidate was unequivocal. Each extolled the virtues of Medicare, with one candidate even crowing that Medicare was the "crown jewel of our nation's health care system". Then Ms. Woodruff asked the follow-up. "Would you support a single payer health care program for the nation?" Each and every candidate firmly said 'No' with little elaboration. What hypocrisy!

What is it about this issue that brings politicians to their knees? Is it the sheer size and complexity of the problem? Is it the influence of the entrenched interests? Is it being out of touch with the suffering of regular people these days? Whatever the reason, we are being let down by the very people who could do something about this problem.

Over the last 9 years, I've had the privilege of working in nine different countries, including England, N. Ireland, Scotland, Norway, Denmark, Holland, Australia, Israel, and even Chile. I mention them, not for frequent flyer bragging rights, but to enumerate them in the context of each and every one having a health care system that covers ALL of their citizens. None of them have perfect programs. Each has significant challenges that must be met. But they cover all their citizens at about half what it costs us and with ever increasing quality, many of them matching or exceeding the quality of our health care system.

The United States faces many challenges and world wide responsibilities. Our economy is laboring, our middle class is shrinking, many of our schools are wanting, and we are in a fundamental struggle with extremists around the world. All of those challenges must be met, and given our history, over time, will be. But until we achieve one of the most fundamentally important challenges of our lives, namely having high quality health care for EVERY citizen of this nation, at a cost that ALL people can afford, we will not be able to successfully deal with the multiple challenges facing us. The current health care situation is the canary in the national coal mine.

By Cornelius Hogan
Hogan lives in Plainfield, Vermont

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