Gov. Martin O'Malley: The business case for health reform

These comments were excerpted from a speech by Maryland Governor Martin O’Malley to a plenary session of an annual healthcare conference hosted by FamiliesUSA.

Our country is now poised through the Affordable Care Act to help millions of American families and small businesses and their employees access high quality, affordable health care coverage.  This isn’t going to happen by itself.  This is not simple.  If it were simple, someone would have accomplished it years ago.  This is complicated, but it is not beyond our grasp [..]

We are ready in Maryland to turn the corner on the healthcare costs that have been sapping our productivity as a people and as a nation.  Sapping the productivity of our businesses.  Taking from them the ability to reinvest in their own plants and their own opportunities and their own markets. Costs that force moms and dads to choose between health care and paying for groceries, or tuition, or school supplies, heat, rent, mortgage payments.  These are the big decisions that happen in the most important place – the kitchen table of every family home.

In Maryland we believe we are gaining a competitive advantage by being an early implementer [of health care reform].  Last year we had the best year of new job creation that we’ve had since the recession hit [..] Why is it that at the same time we’ve cut 7.5 billion from our state budget, we’re increasing the ranks of those who are covered by healthcare so very, very dramatically?  It’s because there is an historic truth – not a Democratic truth or a Republican truth – but an American truth and an economic truth.  In order to create jobs, a modern economy requires modern investments.

Along with the investments we make in the education of our workforce, in the innovative capacities of our people, there is also the health of our people.  That too is an economic development investment.  It’s an investment in greater productivity, greater prosperity, and greater promise.  We’ve chosen to invest in healthcare [..] Our goal was to support the health of our workforce.  So moms and dads could go to work, so they could be productive, so they wouldn’t miss days from work or searching for work because they had to take care of sick kids or to take care of themselves.  It’s very hard to put in a full day’s work if you’re sick, if you can’t go to a doctor.  You see that played out time and time again in the economies of third world nations.  A healthy workforce is a productive workforce, is a profitable workforce.

In some places in our country Medicaid expansions are kept quiet.  States worry if you let people know the uninsured are becoming covered and they might go to the doctor, that this could cost money and that that might be something our neighbors scowl at.  In fact, some of our sister states in their legal briefs to the Supreme Court are describing people signing up for Medicaid as “one of the harms brought to states” because of the Affordable Care Act.  I encourage those who make that argument to read Matthews gospel 25[..] I want to mention the tragic case of Deamonte Driver, a little 12-year old boy in Prince George’s County who died because his family could not afford to go get a toothache looked at.  That toothache led to an infection that led to his brain that took his life.  Deamonte lived just outside this nation’s capital [..]

We might want to ask [those who say they want to repeal the law] what advice they would give to the millions of Americans who don’t have health insurance.  Crossing your fingers is not really a responsible option.  Do they believe, like that debate audience, we should allow hospitals with an injured uninsured patient to just ‘let him die’?  [..] That’s not how you move America forward and that is not what the vast majority of Americans in their heart expect of ourselves or our government.

We have a responsibility to make the business case for the Affordable Care Act.  What are the opportunity costs of inaction?  When a small business is paying another fifteen to twenty percent annually, every year for health insurance, how many fewer people are they employing? How many dollars could have gone into expanding markets for their products or services?   What are the opportunity costs for families when a mom has to choose between a roof over their head, food on the table, or healthcare?

People who are sick can’t work.  Mom and Dad can’t provide for their family if all of their dollars are going to rising healthcare costs, let alone keep paying the mortgage if all of the sudden they’re wiped out by some unanticipated hospital bills.  In the private sector rising costs are eroding the quantity and quality of health benefits for American workers.  In the public sector health costs are the single greatest threat to our fiscal sustainability [..]

Peter Orzag wrote these words:

It is no exaggeration to say the United States standing in the world depends on its success in constraining the healthcare cost explosion.  Unless it does, the country will eventually face a severe fiscal crisis or a crippling inability to invest in other areas.

Truly, bending the cost curve requires innovation [..] Innovations like the health information exchange which allows the sharing of data between hospitals, labs and thousands of doctor’s offices.  This isn’t something that we’re imagining.  It’s not something that we’re hoping for.  It’s something that we’re doing [..]

There is no area that cries out for better choices more so than the area of containing healthcare costs, of having better preventive care.  Making our workforce healthier, making the balance sheets of our small businesses better so that they can reinvest in more jobs and more opportunities.  We need to talk about this in terms of the business case for healthcare.  There are better ways to do this, virtually every country has shown that this is possible [..]

We’ve seen what works, but we’ve been too timid to do what our parents and grandparents had the courage to do.  Which was to do it at scale, to do it in an impactful, broad way.  To realize that in our America there is no such thing as a spare American.  Everyone is needed.  Are other countries so much more innovative than us that they can figure out how to do this to scale and we can’t?  I don’t buy that [..]  There are in fact challenges so large that we can only hope to tackle them together.  Making better choices in terms of healthcare is one of them.