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Commentary -- Health reform can't fail

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By Niel Ritchie

Opponents of health-care reform have stepped up their threats in recent days, alleging that congressional plans mandate such things as death panels, forced abortion and rationed care. These charges are so over-the-top and have been so soundly debunked that it's beyond imagining they persist.

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The truth is health-care reform does represent a real threat--but only if it fails, which will put additional millions of Americans and thousands more small businesses at risk. And nowhere is that truer than in rural areas.

In nearly every way rural health care lags behind that available in and around U.S. cities. According to the National Rural Health Association, rural residents are twice as likely to die from non-auto-related injury, receive less treatment for chronic disease and report lower rates of overall health.

Rural seniors also are least able to afford life-saving drugs given higher rates of poverty and lower rates of prescription coverage. And private insurance is sparsest in these areas because exploding costs forced many small businesses to drop the benefit. At this point 75 percent of uninsured rural residents own or work in such mom-and-pop operations.

But it's not just health that's at stake; it's also basic access to care. Over the last 25 years, 470 rural hospitals have closed for lack of funds and thousands more areas--2,157 at last count--suffer from doctor shortages. And these trends show no sign of abating. In hard-hit places like Ohio, four of 10 hospital layoffs in the next year are expected in rural communities.

With so much already conspiring against the health of rural Americans, we cannot allow lies and deceit to derail much-needed reforms.

There is no truth to the frightening myths being spread by politicians doing the bidding of big insurance companies and their super-wealthy executives (who donate millions to campaigns). What is true is that an industry reaping historic profits will do whatever necessary to maintain their bottom line--and that includes spending millions to scare the wits out of people who have every reason to demand better care.

In 1993, 95 cents of every private health insurance premium dollar were spent on claims; today that's dropped to only 80 cents. Put another way: As more Americans fell into the vast pool of uninsured, profits of the nation's 10 largest health insurance companies soared 428 percent between 2000 and '07. And life's been good since.

Last year the CEO of Aetna was awarded a pay package exceeding $24 million.

Wendell Potter understands the tactics at work and the motives behind them as former head of corporate communications at two of the nation's largest health insurance companies. While with Cigna in the 1990s, he was charged with devising a scare campaign to kill the Clinton administration's reform effort, authoring many of the myths being shouted these days at town hall meetings. Witnessing the catastrophic results of his work in one rural county, he recently blew the whistle and now speaks out against the industry as senior fellow for health care at the Wisconsin-based Center for Media and Democracy.

"What insurance companies do to manipulate public opinion is tell lies and throw off misleading information; fear-mongering is a big part of their strategy," he recently told me. "They've done it every time health-care reform was brought up since the 1920s, and every time the American people were duped."

So it is today that profits, not people, remain what's healthy in this broken system, and the elderly and uninsured once again are being prescribed large doses of manufactured smear to kill the reforms that would help them most.

Controlling health-care costs is critical everywhere, but that alone won't cure all our ills. For rural residents driving further for less care at greater cost, only a strong public option will rebuild what's been lost in our communities and reverse other needlessly tragic trends that have brought our system to crisis.

Niel Ritchie is executive director of the League of Rural Voters, a Minnesota-based nonprofit.

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