Most Americans are aware that buried somewhere in the 2,000-page health care reform bill are provisions for cutting the already- strapped Medicare program by billions of dollars. Few are aware that the bill also cuts expenditures on county hospitals currently serving the poor.In Chicago, for example, those without health insurance go to the county hospital where they are treated without regard to whether they have health insurance. If the bill is passed, however, many of these county hospitals will either have to close their doors or deny treatment to those without health insurance.

Although the bill passed by the Senate has been depicted as using coercive means to require those currently uninsured to buy insurance they cannot afford, or as imposing additional new taxes on the American working man and family, that bill is based on a fundamental lack of understanding of how the health care needs of the nation’s poor are currently served.The desperately poor, many of them unemployed, are not equipped to deal with complicated insurance programs, deductibles, co-pays and all the other accoutrements of the typical health care policy. They are poor, they are unemployed, they are sick, they need a place to go to be treated without red tape and procedural obstacles.

County hospitals across the country that have provided that place are now threatened with a cut-off of funding and in many cases with extinction by the current health care reform bill passed by the Senate.A number of proposals for making health care affordable for all Americans have been put forward by those who have sought to be heard during the legislative process. All these proposals have been rejected by a Congress determined to impose government control of health care.

The sudden halt to health care reform’s steady march forward came as a shock to many who saw an upset win by Republican Senator-elect Scott Brown in Massachusetts as all but impossible. But if many took delight in the election outcome’s impact on health reform legislation, Aetna Chairman Ronald A. Williams made it clear in a New York Times story last week that the country still needs meaningful health care reform – reform that addresses access as well as affordability.

 Everyone benefits by health reform that gets at the factors driving soaring health care costs and the loss of coverage for so many Americans. While Congress thinks carefully about its next steps, Aetna will continue to support meaningful health care reform and continue to offer responsible solutions to legislative leaders.

The election of Republican Scott Brown as the new senator from Massachusetts has derailed the Congressional health care reform train, less because Brown denies Democrats the 60th filibuster-proof vote, though that is certainly a major result, and more because it collapsed the Democratic political house of cards by highlighting the power of independent voters and the frustrated anti-incumbent mood of the electorate.

 

Republican governors are not alone in being concerned about what the proposed health care legislation might mean for their already overstrained budgets: Democrats share the same worries.         “We’ve got concerns,” Gov. Jack Markell of Delaware said in an interview Wednesday, hours before getting elected as the chairman of the Democratic Governors Association. “And we’re doing our best to communicate them. We understand the need to get something done, and we’re supportive of getting something done. But we want to make sure it’s done in a way that state budgets are not negatively impacted.”

From the start, Republican governors have been more outspokenly critical about the health care legislation – in particular, the bill proposed by Harry Reid of Nevada, the Senate majority leader – which they said would saddle them with millions of dollars in additional Medicaid costs as insurance coverage is expanded. At their own meeting two weeks ago in Texas, Republican governors declared Democrats felt the same way as they did, but were less apt to say it out of loyalty to President Obama.Asked about that, Mr. Markell responded: “Perhaps we’ve expressed some of our concerns less publicly. But I believe all governors are certainly concerned about what the potential impact is of some of these bills.”

Mr. Markell said that there was no division between governors and the administration on the need to get some sort of health care bill through; he said that he was reminded of the need in conversations with small businesses struggling with health care costs and constituents who have been unable to get health care coverage. He said his concern was some of the bills being considered would do that by shifting some of the costs to the state – but said he remained confident, after conversations with the White House, that would not be the case.