Make care available to those in need

By WILLIE ANDERSON and JEFFREY BRENNER • For the Courier-Post • July 5, 2009

This month, as Congress releases preliminary versions of health care reform legislation, families around the country are watching anxiously hoping that reform actually translates into better, more affordable and accessible coverage.

We both are working to improve health care in New Jersey -- one of us as a health care provider and the other as a clergy leader engaged in community organizing with Camden Churches Organized for People (CCOP) -- and we both regularly hear from families about their struggles to afford health care. Many have no coverage and others have bare-bones plans that don't cover the care they need and come with high out-of-pocket costs for deductibles, co-pays and steep premiums. High costs are leading families to delay care that they need, especially in these difficult economic times.

CCOP leader and Camden resident Zoraida Gonzalez-Torres is facing this very situation. Both she and her husband are retired and have a five-year limit of benefits. She is dealing with a variety of health conditions that require long-term medication including arthritis, chronic stomach issues and glaucoma. She needs to see the eye doctor every three months, and each visit now costs $200. When her husband recently retired, they were offered a chance to maintain their insurance through COBRA at a cost of $927 per month, which they could not afford.

She recently told us, "We're looking at options right now and there aren't any good ones out there. I'm due for a mammogram, colonoscopy, an upper GI exam and follow-up for the arthritis. Thank God my husband's health is good."

While the momentum on health reform is a cause for much hope, it is crucial to remind policymakers that legislation won't work unless it addresses the number one reason people don't get the care they need: it is too expensive for everyday Americans.

The PICO National Network has been working with New Jersey Consumer Voices for Coverage to identify what families can really afford to pay for health care. They will be releasing a report next week based on family budget data collected from more than 600 families across the state. The sobering headlines are that most New Jersey families have expenses that outstrip their income, and concerns over cost are leading too many families to delay getting the health care they need.

And so it is particularly worrisome that the U.S. Senate, in its effort to reduce the overall cost of legislation, is considering reducing subsidies for low- and moderate-income families. Health reform will not succeed if it fails to make coverage accessible and affordable for everyone. That message must continue to be heard, even as special interest groups pressure Congress to scale back and water down the scope of reform.

Of course, people need both affordable and quality health coverage. Too many insurance plans currently exclude important health care services (prescriptions, mental health coverage, etc.) and have low lifetime benefit limits. Therefore, the legislation should also grant a comprehensive set of benefits that cover the care people need and deserve.

While there will be up-front costs associated with making these changes, the American people know that this investment will pay off over the long-term, with more families able to purchase quality coverage and able to afford to access care to stay healthy and prevent costlier illness in the future.

As New Jersey's congressional delegation weighs in on health care reform legislation this summer, we hope that key architects such as U.S. Sen. Robert Menendez and U.S. Reps. Frank Pallone and Rob Andrews will champion the issue of affordability. Otherwise, we'll miss the mark of providing quality care to everyone.