Commentary - Special to CFK

• See also: Health Care Reform: What's in it for Kids & Families -Fact Sheet

I was in high school in the early 1960s when there was a lot of talk about making sure the elderly could get health care. I am embarrassed to say I took a hard line: people should not spend so much when they're working and save for their old age, so they can pay for medicines and doctors themselves, I said, speaking with the arrogance of youth and good health.

Now, having worked hard, spent little and saved for my old age, I am healthy and have the means to pay for health insurance-with a hefty deductible to keep premiums lower. But I am also happy that I was proven wrong about how important it is to have the peace of mind and access to affordable, quality care when you need it.

I can't wait to get Medicare when I'm eligible next year. It will lower my monthly premiums and pay for many of my doctor-ordered screenings and consultations.

I met a ghost of my past the other night at an expensive fund-raiser for our local Buy Fresh, Buy Local campaign sponsored by the Piedmont (Virginia) Environmental Council. My dinner-mate and I gingerly tested the waters for  a political discussion. I said I thought now that we had a president who acknowledged the serious problems we had in our society, we would see if we could meet the test of finding solutions for them. My neighbor replied, "Like what?" And I replied, "Like getting health care reform." He looked at me for a moment, and said, "I am happy with my health care."

It took me a minute to find an appropriate answer.  When you're relatively healthy and you can get good insurance coverage, it's easy to be happy with your health care. But of course, that's not the case for nearly 46 million people in this country (and one in 10 children, according to the Institute of Medicine). My table-mate countered that those people still got care by going to the emergency room.

There's plenty of evidence that people with high co-pays or no insurance at all often postpone care, and tend to be sicker when they finally do get to the emergency room. And the cost of emergency room visits—generally notably higher than preventive care—is passed onto the rest of us. (For statistics, see CFK's Quick Fact Sheet.)

We might be happy with our personal health care, but our health care system has big problems. It costs too much and leaves out too many.

So here's the thing: those of us with good health insurance should keep it—but we should try not to get in the way of others being able to get similar levels of coverage. Right now our marketplace for health insurance has three major players:

1. Private health insurance companies, whose job, at least in part, is to keep costs down and profits up.

2. Medicaid and the State Children's Health Insurance Program (SCHIP), public insurance plans that serve those who are low-income and chronically ill; together, they covered more than 37 million children in 2008, according to the U.S. Department of Health and Human Services and Families USA. When lower-income families lose their employer-based or private health insurance, Medicaid and SCHIP USUALLY do a good job of protecting the kids by adding them to the public insurance rolls.

3. Medicare, another public insurance plan, pays the major costs for doctors' visits, diagnostic tests, medical interventions and prescription drugs for the vast majority of people over 65.

What's missing? Affordable, quality health care for the roughly 46 million people who are without it, and those whose premiums are unaffordable because of pre-existing or other conditions.

Let's hope we're smarter as a nation today than I was in the 1960s.  I thought only about personal responsibility and not about how a system of quality, affordable health coverage can keep people healthier. I didn't understand how even responsible people can face financial catastrophe when diagnosed with chronic or crisis medical conditions.

Then, I didn't understand how a public option could provide a safety net for high-risk groups while at the same time setting a competitive standard for the private sector-showing how good governance can improve care while cutting costs.

Now, I believe it can, and my decades as a child advocate tell me it must. If we can change the system so that we all get good health care at costs in line with outcomes, it'll leave us healthier and restore a competitive advantage to our economy.

>> Do you agree with Jan? Disgree? Have ideas to share? Weigh in below!

Resources:

Want to see how each health care proposal stacks up? Visit the Kaiser Family Foundation for a side-by-side comparison of the major initiatives.

Families USA, a nonpartisan organization advocating for high-quality affordable care, offers additional resources on the current health care debate and ways you can get involved. 

The Center on Budget and Policy Priorities gives a comprehensive break-down on funding implications of health care reform.

The Population Reference Bureau has a fact sheet on the challenges facing uninsured children today.

Take Action:

Stand Up for Health Care! This advocacy site has tools to empower ordinary Americans to be part of the health reform movement. Check out www.standupforhealthcare.org.

Jan Richter is former outreach director with Connect for Kids; she writes the biweekly CFK Update (which she created in 1996!).