Democrats Put a Human Face on Health Care Issue

Not long ago, a Republican political consultant was asked about the prospects for congressional action on health care reform in 1992. “I just don’t see it, not until there’s a health care Willie Horton,” he responded.

Senate Democrats, having reached essentially the same conclusion, took to the road last week in an effort to find the health care equivalent of the black inmate who became an icon of racial politics in the 1988 presidential campaign.

They found not one, but many. At hearings across the country, people from virtually all walks of life stepped forward to offer gripping testimonials of losing homes and life savings, of living in fear for themselves and their loved ones--all because they have little or no medical insurance.

They heard from people like Conni Wells of Wauchula, Fla., who took her child to a veterinarian because she could not afford a regular doctor. People like Gail Phillips of Cleveland, who sold her home to pay for medical insurance. People like Cindy Nagel of Tampa, Fla., who dropped coverage for 40 employees when the premium nearly doubled overnight.

In sessions that seemed at times more like tent revivals than congressional hearings, the Democrats spotlighted these gut-wrenching tales in the same way that George Bush’s 1988 campaign focused on Horton, a Massachusetts prison inmate who raped a woman while on furlough.

“Statistics are necessary, but they don’t tell the whole story,” said Senate Majority Leader George J. Mitchell (D-Me.), who led the five-city road show sponsored by the Democratic Policy Committee. “It’s hard for people to really understand what it’s like to be without insurance until you hear and see someone who doesn’t have it.”

Through such hearings, Mitchell said, the Democrats hope to forge a national consensus for action. Despite their display of resolve, however, the prospects for meaningful reform are far from certain. It is one thing to demand reform, but quite another to enact legislation on such a complex and costly issue, especially when there is no real consensus on potential remedies.

“Reforming the health care system will be difficult,” Mitchell conceded. “A perfect solution doesn’t exist.”

As if to illustrate that, from Tampa to Atlanta to Cleveland to Detroit to Denver, individuals and advocacy groups alike complained of being excluded from the congressional hearings. Among them were groups vehemently opposed to any government-imposed solutions whatsoever, organizations that criticized the many competing proposals in Congress as being inadequate, and still others that advocated such solutions as home care and long-term care.

The Democratic road show was clearly partisan in nature, with Mitchell and company lambasting the Bush Administration at every stop. In each state but Michigan, a Democratic senator is up for reelection next year.

But the senators nevertheless managed to underscore the growing public desire for fundamental reform by calling on a wide range of voices.

Among them were:

--Frustrated small-business owners like Nagel, who wants to provide insurance to the 40 workers in her three Tampa hair salons but cannot afford to do so.

--Big-business executives like Chrysler’s Lee A. Iacocca and Georgia Pacific’s T. Marshall Hahn Jr., both of whom endorsed Mitchell’s universal health insurance plan, which would require all businesses to provide coverage or pay a special tax.

--Distressed hospital administrators like Ira Clark, whose Jackson Memorial Hospital in Miami marks up charges to insured patients by as much as 30% to recoup its losses from treating the uninsured.

Under a similar burden of providing uncompensated care, 23 hospitals in Michigan have closed, said Edward S. Thomas, president of the Detroit Receiving Hospital and University Health Center. This year, Thomas said, his own hospital will provide more than $33 million worth of unpaid services.

But it was people like Joan Massie of Elyria, Ohio; Ray Quinnelly of Atlanta; Sue Wesley of New Baltimore, Mich., and Paige Plant of Aurora, Colo., whose plight resonated with the large and angry crowds at each stop.

Massie, 36, has a collapsed cervical spine, the result of a car accident two years ago. Because the injury is classified as a “pre-existing condition,” she cannot afford health insurance.

During a recent pregnancy, Massie was diagnosed with kidney cancer. After a successful operation, which plunged her deeply into debt, she gave birth to a healthy child, Jordan, who is now nearly 6 months old.

But Massie has not married the child’s father, a small businessman, because she fears that without health insurance, her future medical needs could drive them all into bankruptcy. The two now simply live together--”a situation that we find morally disturbing,” Massie said.

“For the duration of my life, I cannot own any property or anything of value,” she continued. “ . . . This type of system leaves me angry and outraged.”

Quinnelly is the mother of a 5-year-old boy, Joseph, who has chronic acute asthma. But she and her husband have had no insurance since losing their jobs earlier this year.

“Joseph has not seen his allergist. He has not seen his pulmonologist,” she said. “When his condition took a turn for the worse last month, we gave him powerful drugs at home instead of taking him to the hospital because the expense would have been too great. I feel like a bad parent.”

Wesley, 22, lost her insurance when the small drug store where she works full time discontinued health coverage because of high premiums. Her husband, Bob, 26, is a laborer who also has no insurance.

In June, Wesley developed intense pelvic pains for which a doctor prescribed a diagnostic examination called laparoscopy.

The couple earns too much money to qualify for government assistance. When she went to a hospital, it demanded a $2,000 down payment, which they do not have.

Wesley canceled her laparoscopy appointment.

Plant has health insurance as a federal technician with the Colorado Air National Guard. But her 8-month-old baby, who was born with a gastrointestinal birth defect, has nearly driven her into bankruptcy because of out-of-pocket expenses, including the cost of home care.

Plant cannot change jobs, because in all likelihood her son would not be eligible for medical coverage. “I am effectively locked into my current job,” she said ruefully.

Interspersed with the poignant experiences described at each hearing were the cold statistics: America now spends about $671 billion a year on health care, yet 37 million people still lack health insurance--and two-thirds of them live in households with at least one full-time job holder.

“Our nation is in a crisis, one that affects every single American, regardless of income or employment status,” Mitchell said. “What we are hearing are not isolated cases and not unique circumstances.”

One of the senators who attended last week’s hearings was Democrat Harris Wofford of Pennsylvania, who made health care reform a centerpiece of his special election campaign against former Atty. Gen. Dick Thornburgh last month. More than any single event, it was Wofford’s upset victory that had an electrifying effect on the issue.

“I truly believe the iron is hot on this issue,” Wofford said. “The moment has come for national health insurance--now.”

“It’s moving so much more rapidly than anybody had expected even a few months ago,” agreed Sen. Timothy E. Wirth (D-Colo.).

Mitchell began planning for last week’s hearings in August. After Wofford’s victory, other Democrats moved quickly to seize on an issue that they now clearly regard as a vulnerable one for the Bush Administration.

On Thursday, the major Democratic presidential candidates will hold a round-table discussion on health care reform in Nashua, N.H. And next month, more than 200 Democrats in the House of Representatives plan to hold simultaneous town hall meetings in their districts to focus on the issue.

The political implications have not been lost on the Republicans. A day after Wofford’s resounding victory, President Bush promised he would have something significant to say about health care reform soon, most likely in his State of the Union address next month. So far, the Administration has urged states to impose limits on medical malpractice insurance, and pushed the insurance industry to cut down on unnecessary paperwork to reduce costs.

But the President quickly found himself preempted by 19 Senate Republicans who immediately unveiled their own health care reform plan, based largely on a system of tax credits to help individuals buy insurance, a proposal supported by some insurers.

During last week’s road show, Wofford clearly was pleased with the growing momentum for reform. “It’s good to get out and feel the heat,” he said, describing himself as “a messenger with an urgent message.”

Mitchell offered similar assessments in remarks to audiences in each city. “Your eloquence has renewed our determination to act,” he said. “Access to health care coverage is a fundamental right for all Americans.”

Such action “ranks as our highest priority,” along with improving the economy, Mitchell said. Added Sen. John D. (Jay) Rockefeller IV (D-W.Va.): “It’s simply a matter of: Do we have the political will to do it?”