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MAINE COMPASS: Health-care reform must happen now

Ann Schoenthaler-Ervin

We all know that good health coverage doesn’t come easy. And it certainly isn’t cheap. But if you don’t have your health, what do you really have?

Good health is the most basic of our needs, yet one in four Americans — over 70 million — remain without coverage or are underinsured. Every civilized country in the world provides health insurance, but millions of Americans risk losing everything if a serious illness or accident strikes.

We have a moral obligation to make sure that never happens.

In both my personal and professional lives, I know how personal health care is. During the early years of my marriage, my husband and I worked hard to make sure we never went without insurance.

Yet even with insurance, we were denied coverage for the births of our first two children and were left owing thousands. We have struggled more than 30 years to maintain health insurance. Even though my husband works two jobs, we have, until three months ago, been able to afford only policies with high deductibles — in effect, catastrophic plans.

And, we have fought hard to maintain health insurance for our children after college. My son was one of the last to be allowed to opt for Dirigo Health Insurance, but his girlfriend wasn’t as lucky.

Now, as my husband oversees a small family business with about 15 employees, every day is a struggle to keep his employees insured. Anthem recently asked for a 22 percent increase in his rates, and my husband wonders how he’ll be able to keep up with these rising costs.

In my own practice, I see many clients who have high deductibles. And, rather than obtain the professional help that they need, they often delay treatment until their jobs and marriages are at risk.

When is enough, enough?

The president’s health-care reform plan is an important first step in fixing our broken system.

I can think of many things reform will do. Here are just a few:

• If you have coverage now, you can keep it. If you are paying more than 8 percent of your salary on your premium, you will be able to get discounts to help you buy your own policy from an insurance exchange.

• Insurance companies will have to compete for your business in insurance exchanges where there will be oversight. If companies don’t play by the rules, they will be excluded from the exchange.

• Children will be able to stay on parents’ policies until the age of 26.

• Deciphering what an insurance policy will cover can be impossible. The reform bill requires that all companies use the same format for presenting their coverage options. Now we will be able to compare them side by side in one place on the Internet.

• Seniors will get more benefits and a more stable Medicare program through 2026.

• Members of Congress will need to choose from the same health-care coverage that we get.

• Preventative care and screenings will be covered 100 percent.

• Insurance companies will have to spend 80 percent — 85 percent of your premium on your care. If they don’t, they will have to rebate the difference. One recent study found some spend as little as 66 percent. Further, CEOs of top health insurance companies average $9.7 million each in compensation each year. This will change.

• And finally, this reform package is fully financed. Funding mechanisms built into the bill will pay not only for these changes, but they also are expected to help reduce the deficit by about $120 billion over the next 10 years, according to the nonpartisan Congressional Budget Office.

We have fought too hard for health-care reform for decades. We can’t walk away now from all that has been accomplished. If not now, when?

Ann Schoenthaler-Ervin of Waterville is a psychologist, a mother and the spouse of a physician and small business owner.