Why would anyone want to make the health care system worse?

Too often in lawmaking, there are winners and losers. We are used to national news stories that report that industry groups like insurers, hospitals, clinics and doctors are lining up on opposite sides. It seems like most health care proposals will benefit some groups and cost others. Patients and the public are caught in the middle, wanting every community to have good coverage options and affordable, high-quality care.

The U.S. House and Senate health bills make losers of all of us.

There is no doubt our health care system needs improvement, but these bills don’t improve anything. Both proposals will leave more than 20 million people without health insurance. Congress is claiming to be returning control to the states, but that is meaningless when federal regulations, Medicare and Medicaid have so much power in the marketplace.

There is little doubt that the current health system, including parts of the Affordable Care Act, needs improvement and change. Our goal is not to protect Obamacare, but to support non-partisan, data-driven reforms that will stabilize the health care marketplace and improve patient care.

These bills don’t benefit anyone, which is why our state and national organizations are working to defeat them.

They don’t help patients: The heartless cuts to Medicaid will hurt rural communities and low-income people. While parts of the Puget Sound are awash with cash and job opportunities, not all boats are getting raised. The people hurt by the Medicaid cuts are likely to be 50-65 years old, or are in rural areas, working part-time, or are in jobs without insurance benefits. The House bills also remove protections for those with pre-existing conditions.

They don’t help insurers: Health insurance works by creating groups of people who can share payments and risk over time. The congressional proposals destabilize that balancing act and increase unpredictability. Removal of purchasing requirements, scaling back subsidies and allowing states to waive consumer protections is a perfect recipe to undermine the fragile insurance market.

They don’t help providers: Hospital emergency departments don’t turn people away, but that is the most life-saving and the most expensive care you can get. It’s also not the right place to treat chronic conditions like diabetes, asthma or hypertension, so patients get treated for the crisis, but keep getting sicker. Doctors, especially those working independently, simply can’t provide large amounts of free care for uninsured patients. Community health centers take care of roughly a third of the state’s Medicaid population, so Medicaid cuts will significantly impact health centers.

They don’t help communities: We’re already starting to see Washington counties without exchange plan offerings. The lack of options is at a crisis point in many other states, and millions of people do not have the insurance options they deserve. Congress is right to want to fix that, but it needs to be done in ways that do not revoke the improvements made in states like Washington.

These are serious issues with lives in the balance. The changes that Congress is providing now are shockingly bad for the entire system. As organizations, we want what you want as patients: more information, more control, more prevention and treatment, less time in doctors’ offices and more time living your life.

If the House and Senate are sincere about their desire to improve the health care system, we urge them to kill these bills, drop the “repeal/defend” rhetoric and take up serious discussion about the real problem: The U.S. spends too much money on a health care system that doesn’t provide enough health.


This guest editorial was signed by Jennifer Hanscom, executive director and CEO of the Washington State Medical Association; Cassie Sauer, president and CEO, Washington State Hospital Association; and Leanne Berge, CEO of Community Health Plan of Washington and Community Health Network of Washington.

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