Written by Julia Kaye, Health Policy Associate,
National Women's Law Center
I, like some Presidents who shall remain nameless, happen to be a big fan of both arugula and Dijon mustard. When I can afford it, I love to splurge on Whole Foods produce and dairy. John Mackey, co-founder and CEO of Whole Foods Market Inc., clearly has a vision when it comes to creating a high-quality, environmentally-friendly grocery store.
http://nwlc.blogs.com/
However, his op-ed on health reform in yesterday’s Wall Street Journal reveals a significant blind-spot when it comes to the realities of low- and moderate-income people’s lives and the barriers they, particularly women, face to accessing health care. Mackey argues that health reform as currently envisioned is too expensive and unsustainable; that health care is not an "intrinsic right"; and that first and foremost, American adults are responsible for their own health (just eat better, ok?). In addition, Mackey’s op-ed promotes eight health reform policies that fail spectacularly to address the challenges women face in accessing affordable, comprehensive health care—and in some cases, exacerbate them.
Let’s assess his op-ed point-by-point:
- Health reform is too expensive: Though Mackey includes the perfunctory "While we clearly need health-care reform" before arguing that we nevertheless can’t afford health care reform that will create "new unfunded deficits," he fails to acknowledge the high costs of failing to pass health reform. The Urban Institute estimates in a new report that, "absent reform, total health care expenditures, public and private, will total $33.0 trillion, over the ten years 2010-2019." Without reform, "there would be considerable loss of employer coverage, particularly among the middle class, and a substantial increase in the number of uninsured." Additionally, "employer costs would also increase substantially, as would costs to individuals and families from higher premiums and out-of-pocket costs."
Moreover, the House Tri-Committee health reform legislation (H.R.3200) raises questions about Mackey’s dire warnings of so-called "unprecedented new taxes" and "unfunded deficits." The House bill is paid for fairly and responsibly. It achieves this through a combination of measures: reducing excessive subsidies to the insurance industry and pharmaceutical companies; reforms to slow the growth of health care costs; requiring individuals, employers, and government to share responsibility for obtaining or providing coverage; and proposing a progressive tax on the richest 1.3 percent of Americansfor a total tax increase that is far less than the amount this group received from the Bush Administration’s tax cuts for the 2001-2010 period.</span>
- There are eight reforms that would lower health care costs with "less government control and more individual empowerment": Several of Mackey’s policy recommendations would be actively harmful to women, such as expanding the use of high-deductible health plans (HDHPs) and health savings accounts (HSAs). While premiums for HDHPs are typically lower than those for traditional coverage, higher deductibles and other forms of out-of-pocket spending could counteract any financial benefit, particularly for people with greater health care needs—and women, on average, need more health care services than men over the course of their lifetimes. By exposing the insured to even greater out-of-pocket medical costs, HDHP/HSAs have the potential to contribute to the growing problem of underinsurance—having health insurance that doesn’t meet your needs—among women. Furthermore, the mechanics of HDHP coverage have specific consequences for maternity care; research demonstrates that pregnant women enrolled in an HDHP might be exposed to especially high out-of-pocket costs, often over the course of 2 years, particularly when complications arise.
Mackey’s suggestion to allow health insurers to sell health insurance across state lines may seem innocuous, but don’t be fooled. State insurance regulations provide critical consumer protections and require that important health services are covered, helping ensure that women receive coverage that meets their health care needs. Allowing insurers to hand-pick which state’s laws they’d like to governed by—while continuing to sell insurance in the states of their choosing—may enable them to sell cheaper policies, but such plans are likely to provide sorely insufficient coverage.
And let’s not forget that under the "Mackey plan", all federal and state benefit mandates would be repealed. Phew. So women don’t have to worry about insurers setting up shop in states with few consumer protections in order to sell inadequate insurance across the country—insurers can set up anywhere and refuse to cover which services they choose! Hospital stays following mastectomies? Nah. Annual cervical cancer screenings? Not worth the cost!
- Health care is not an "intrinsic right": Mackey argues that health care is not a right because it’s not included in the Constitution or the Declaration of Independence. I would argue that in the wealthiest nation in the world, health care should not only be available to those who can afford it. A privileged few seem to feel that the American health care system excels precisely because, with enough money, you can buy truly outstanding treatment—even if the flip-side of that argument is that, without enough money (and, as you’ll recall, women still make on average only 78 cents for every dollar paid to men), you often cannot buy any treatment at all.
- Every American adult is responsible for his or her own health: It’s true that prevention is critical. But today, preventive health services—never mind a healthy diet (we can’t all afford to shop at Whole Foods!)—are not available to, or affordable for, everyone. That’s why the health reform bills being considered in Congress would limit or eliminate cost-sharing for preventive services. That’s why benefit mandates, many of which require that health insurers cover preventive services like mammograms, must be protected and indeed expanded nationwide.
I’m impressed with the business model that Mackey has created—Whole Foods stocks delicious, healthy, environmentally-friendly food—but the health reform arguments and proposals that he sets forth in this op-ed are severely lacking. Millions of Americans know that it is the status quo that is truly unsustainable.
Premiums rising far faster than wages is unsustainable.
44,230 more people losing coverage each week is unsustainable. We can’t afford to wait any longer—we need health reform now.
Cross-posted from NWLC's blog.