Virginia Talks: Your voice, your opinion, loud and clear.

Politics Before Patients

Jason Wasfy, of Great Falls, is a clinical fellow in internal medicine at Harvard Medical School.

Despite doctors’ recommendations that the nation’s health care system is in dire need of repair in the form of reform, Virginia Attorney General Ken Cuccinelli has labeled the Patient Protection and Affordable Care Act of 2010 “antithetical to freedom” and appears determined to proceed with a lawsuit to block efforts to improve the system. Though the bill extends health insurance to millions and begins to rein in abuses by insurance companies for patients who have insurance coverage, Cuccinelli wants to use taxpayer dollars to challenge the new law.

This prospect of a drawn-out, political/legal battle does not serve Virginia patients or Virginia taxpayers well. One million Virginia citizens are uninsured and many of them have been denied care because of pre-existing conditions. Insurance companies’ exclusions for pre-existing conditions are problematic because they allow insurance companies to sell a bad product.

Insurance companies sell risk-pooling in the same sense that dairy farmers sell milk. Excluding high-risk patients from risk-pooling should be illegal in the same sense that the law prevents dairy farmers from selling sour milk.

Thankfully, the health care reform law renders these exclusions illegal and makes many of these sick patients eligible for insurance.

Physicians support the law’s provisions to extend insurance coverage because so many patients will receive much-needed care. Physicians also support the insurance provisions of the health care law because those provisions will extend compensation for charitable care. Extension of insurance coverage is a key issue for physicians because uncompensated care places a tremendous financial burden on health care providers.

The attorney general’s central objection to extending health insurance focuses on the law’s requirement that the uninsured purchase insurance. He believes that the requirement constitutes a heavy-handed federal intervention. In fact, the law provides a variety of mechanisms to make purchasing health insurance within reach for those who cannot afford it now. Individuals and families who make up to four times the federal poverty level will receive subsidies to pay for health insurance. Wealthy individuals who opt out of insurance, shifting the implicit cost of providing care should they suffer a serious injury or illness, will be required to pay back a tax penalty to compensate the taxpayers who carry their insurance burden.

By rejecting health care reform, Cuccinelli is denying Virginia, a state with a looming budget crunch, the crucial federal aid provided by the new law for state Medicaid programs and residency training programs at Virginia’s medical schools.

In Virginia, 131 health centers are eligible for federal aid provided by the health care law. Maintaining a confrontational approach with the federal government threatens to delay or even deny Virginia access to these federal subsidies and grants.

Even if Cuccinelli does not drop the lawsuit, he should open his efforts to public scrutiny. The attorney general has insisted that the lawsuit will cost only about $350. It is hard to believe the lawsuit will carry only the price tag of a one-time legal filing fee, and he has denied media requests for documentation of the public resources to pursue this lawsuit.

Virginia taxpayers are paying for the resources behind the lawsuit. All of us should insist that American leaders conduct the health care reform debate in an open and transparent manner. Continuing to pursue this lawsuit hidden from public scrutiny denies Virginians a voice in health care reform.

I am a doctor, and I know how much patients without insurance suffer every day.

In a recent commentary, the attorney general acknowledged that “Virginia’s challenge against the health care bill is not first about buying insurance. It is about the limits of the power of the federal government and its relationship to citizens.”

Cuccinelli acknowledges that his lawsuit has less to do with the needs of Virginia patients and more to stir the political pot with controversies, wasting state taxpayer resources. In Virginia, the challenges of our time demand competent governance instead of pursuing stale political battles like the attorney general’s lawsuit.