NORTH LIBERTY – The current state of health care delivery in America
is so grim that U.S. Sen. Tom Harkin no longer uses the word "care" in
reference to reform.
"We need health reform," the Democrat told the roughly 200 individuals who gathered at an AARP forum
in North Liberty on Saturday. "I don’t say that we need health care
reform because you can’t reform something you don’t already have. We
don’t have a health care system in America. We have a sick care system."
Harkin said the World Health Organization ranks
the U.S. health care system 37th in the world, on par with Serbia.
Despite the fact that the U.S. spends twice as much per capita on
health care as European countries, he explained, Americans face twice
the number of chronic diseases.
"We spend 95 cents of every dollar on treating illnesses and
conditions after they occur," he said. "In other words, we’ve been
neglecting wellness and disease prevention. That’s the bad news. The
good news is that right now I think that we have a chance to make a
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Although Congress is not always known for its ability to act
swiftly, Harkin said President Obama "is adamant" that health reform be
complete by October of this year. In addition, Harkin is optimistic, if
not fully confident, that the deadline will be met.
"What we are doing is marking up our bill … during the last two
weeks of June," Harkin said. "We plan to be done with it before the
July Fourth recess. We will come back after July 4 and will be on the
floor of the U.S. Senate in July with both the finance bill, which
basically covers Medicare and Medicaid and the taxing part of it, and
our bill, the health bill. We plan to have it done before the August
recess. It will go to conference during August and September so that it
can be done in October.
"And I’m telling you, we cannot fail in this. We have got to get it done."
President Barack Obama invoked the same sense of urgency on health
reform during his weekly radio address, released Saturday. That drew
criticism from Iowa’s other senator, Republican Chuck Grassley, via the
social messaging site Twitter. Grassley complained that Obama had
"nerve" to tell Congress to deliver on health care while he was off
"sight seeing" in Paris. Obama is on an oversees trip that took him to
Egypt, where he delivered a major address intended for muslim nations;
Germany, where he visited the site of a Nazi concentration camp; and
France, where he observed the anniversary of D-Day with other world
Harkin said that because the country has come together in what
describes as "a critical mass," comprehensive reform is much more of a
certainty now than it was during discussions during the 1990s.
"I want to impress upon you: We aren’t dancing around the edges," he
said. "What we are planning on doing will change the very fabric – the
very fabric – of how we do health in America. It’s not just changing
medicine, but it is changing the kind of medicine we do."
Despite a recently published column by Grassley
listing reasons for his opposition to a public plan option, Harkin
confidently proclaimed that the reform will contain such an option, and
that it will be national. Harkin also lamented the fact that single
payer was not on the table despite his personal support and the growing
support of the majority of Americans for that option.
Noting that there is not enough support in Washington to pass a
single-payer system, Harkin said that "there are a lot of things the
majority of Americans support that Congress won’t do." Harkin also
praised members of the audience who carried signs calling for a
single-payer system, saying that one of the major reasons that a public
plan is now a real possibility is due in large part to their advocacy.
Although members of the audience grumbled during the
question-and-answer portion of the forum when Harkin indicated full
implementation of such sweeping change could take several years, panel
member Cathy Glasson, state president of the Service Employees International Union, pointed to the nation’s looming nursing crisis as evidence of why reform will take time.
"I don’t think people are considering [the shortage of nurses and
other health care professionals] in relation to reform of our nation’s
health care system," said Glasson, who has worked for more than two
decades as a registered nurse. "We are going to be adding between 47 to
52 million currently uninsured individuals into the system. If we don’t
have the qualified professionals to care for the influx of those folks,
we are going to have a major disaster on our hands."
Harkin also wanted to assure those in attendance that existing low federal reimbursement rates that have been negatively impacting Iowa hospitals and health care professionals will be revamped during the course of reform.
"Our Iowa doctors, nurses and professionals have a lot to be proud
of," Harkin said. "I don’t know how many more studies we need from the
Commonwealth Fund and Dartmouth and others ranking Iowa in the top
places nationally for providing quality health care delivery. But our
current reimbursement system is based on volume, not quality. Well, if
you reimburse on volume, you get volume. But if you start reimbursing
on quality, you’ll get quality."