A Health Reform Agenda for Black America

Why We Need a Public Option

As the health reform debate heats up, the public health insurance option is proving to be the main point of contention. The public option proposed by Obama and Democratic leaders would create a Medicare-like program that would guarantee coverage for everyone, regardless of pre-existing conditions. This is significant since nearly 50 percent of African Americans have a chronic disease.

The public option offers an immediate opportunity to reduce health disparities by expanding coverage to everyone who needs it. A study published in the April issue of the Annals of Internal Medicine found that with the “near-universal” coverage provided by Medicare when Americans hit 65, racial differences in blood pressure, glucose and cholesterol levels were significantly reduced. The researchers concluded that expanding coverage could not only improve health outcomes, but help black and Hispanics live just as long as whites.

But if Republicans, the American Medical Association and health insurers have their way, a public insurance option won’t be a part of the much anticipated health reform legislation this fall.

Republican leaders are using scare tactics, arguing that a public plan would limit choice, drive private insurers out of business and leave health decisions in the hands of the government. And the AMA recently announced that it would not support a public option that would mandate physician participation and Medicare-type reimbursement rates. The organization seemed to be backtracking from its opposition, but this is only the beginning of a concerted effort to eliminate the public option from health reform legislation.

The president squarely addressed these concerns during his appearance at the AMA meeting in Chicago on June 15. First, President Obama has expressed a commitment to a deficit neutral plan. The projected cost of a public health option is $1 trillion over the next ten years. In his FY2010 budget, the president set-aside $635 billion as a “down payment” for comprehensive health reform. Subsequently, he has outlined a number of new savings and cost-cutting measures.

With health care spending already out of control, we have to take action. A public option would use the bargaining power of the government to lower costs throughout the system (e.g., drug costs, administrative and hospital fees) and provide incentives for better quality and affordable care.

Private insurance will remain. The public option simply provides Americans with a choice of a government health insurance plan.

Last week the TriCaucus, comprised of members of the Congressional Black, Hispanic and Asian Pacific American caucuses voiced their strong support for the public option. “The public health option has to be there,” Rep. Mike Honda, a California Democrat who chairs the Congressional Asian Pacific American Caucus, said at a news conference. “If we don’t have a public option, there’s no discussion.”

Jointly, the three minority caucuses include 91 members and they’re threatening to flex their legislative muscle to see that a public option makes it out of Congress.

The TriCaucus is planning on introducing the Health Equity and Accountability Act of 2009 (Equity Act) as part of a comprehensive approach to health reform that includes provisions for addressing health disparities. Designed to address some of the root causes of health problems faced by people of color, the Equity Act includes a proposal for a public health insurance option that includes mental health and dental coverage, training minority health professionals and community-based prevention programs for HIV/AIDS, diabetes, obesity and other health conditions that disproportionately affect people of color.

Keep Reading: Pt. 3 Beyond Access: Medical Coverage is Just Part of the Equation

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