Open Letter to Representative Austria     

by Brad Cotton

( Published Circleville Herald  8 Feb. 2011)


Rep. Austria, I thank you for inviting me to serve on your Health Care Reform Advisory Committee that  rowdy Summer of 2009 while Tea Partiers brandished firearms, shouted down speakers and outright lied about “death panels”. Your meetings in Springfield  and Lancaster were civil in allowing myself and other supporters of serious reform, that is reform more far-reaching than the Patient Protection and Affordable Care Act( PPACA), to present our case. I thank you for including us. Nonetheless,  I am troubled that yourself, as well as  your party  as a whole,  failed to publicly repudiate the anti-democratic mob tactics, implied deadly violence and calculated “death panel” lies ( no gentler word will do) of Tea Party/Republican health care reform opponents. I am further concerned that you voted last month to repeal the PPACA.

At your Committee meetings opposition to reform focused on ideological theories about the relationship of the free market and government. I spoke about rubber meets the road reality. The reality is that the free market does not work for heath care in the U.S. , nor anywhere else in the world. The reality is that although spending 2-3 times as much per capita on health care as other nations, we are the only civilized nation that denies care to 1/6th of our citizens while allowing 45,000 yearly to perish . That makes us uncivilized. Reality is that as I work in the emergency department I am face to face with the unspeakable  and deadly suffering of the uninsured and underinsured everyday. Such reality affords little tolerance for abstract free market theorizing. 

I share with you data on the negative impact on health care access and increased costs for your constituents from the January 2011 report ”Impact of Repealing the Health Care Reform Law In the 7th Congressional District of Ohio” from the House Committee on Energy and Commerce, Minority staff. Repeal of the PPACA will deny care to 115,000 to 297,000 of our neighbors with pre-existing conditions, throwing their lives on the sacrificial pyre of health insurance company profits. Severe life-threatening policy coverage limits can be imposed on 428,000 on your constituents. One child with leukemia will exceed policy limits in short order, rendering families bankrupt. The PPACA prohibits insurance companies from rescission  of coverage, wherein once one’s wife develops breast cancer the health insurer finds a way, any way, to cancel her insurance. Perhaps one’s wife neglected to mention on her policy application that she took Motrin for menstrual  pain as a teen. The health insurer will seize upon that innocent error of hers as an attempt to defraud the health insurer and leave her to fend off breast cancer alone, despite having paid years of premiums. These health insurers, these private “death panels”,  these you want to return  to unregulated control over our health.? 

Repeal of the PPACA will increase costs of preventative care for over 190,000 Americans in your district. Tax credits for buying insurance will be repealed for 163,000 families. Repeal will increase costs of prescription drugs for over 7,300 Medicare beneficiaries in your district by over $500 in 2011, up to $3,000 by 2020. Up to 11,000 small businesses will lose tax credits for providing health insurance, forcing them to drop coverage for employees. As  so many  of your constituents will be  thrown off the bridge to drown in the river of the uninsured, the costs of uncompensated care provided by hospitals in Ohio Congressional district #7 will rise by $40 million annually. According to the Congressional Budget Office, repeal of the PPACA will add over $1 trillion to our national debt, about $3,000 for each of your constituents.

Rep. Austria , some of your colleagues are pushing for the further privatization of Medicare. Private Medicare Advantage plans already cost the taxpayer 14% more than traditional Medicare as well as increasing administrative complexity and providing poorer care.  In answer to the free-market theorists at  your health care advisory committee meetings , I draw your  attention to the 2011 Index of Economic Freedom published by the  extremely conservative Heritage Foundation and the Wall Street Journal. The index “records countries’ commitment to the free enterprise-capitalist system.” The U.S. is ranked ninth in the world. Interestingly, the eight nations that beat us on free-market principles: Hong Kong, Singapore, Australia, New Zealand, Switzerland, Canada, Ireland and Denmark ALL offer government guaranteed health coverage to each and every citizen. ( Froma Harrop “Health-care repeal would boost deficit” Columbus Dispatch 18 January 2011).

Rep. Austria, come spend a shift with me in the emergency department. Look into the eyes of all those sick, suffering and dying because the health insurance industry finds their care unprofitable and explain to them, and me, why we must repeal  the Patient  Protection and Affordable Care Act.


Brad Cotton, MD is a full-time emergency physician and member of Physicians for a National Health Program.