By NYCeve (Eve Gittelson)

Buried deep in an article in the Washington Post about the concerns of hospital executives on healthcare reform, is an extraordinary statistic.

What if new policies reduce revenue and increase demand? What if existing doctor shortages grow worse? What if some of the most vulnerable and expensive patients continue to have no coverage, like the nine people who made 2,678 visits to local emergency rooms in one six-year stretch and soaked up $3 million in expenses?

This is about $1100 per ER visit!

Imagine, if these nine people had health insurance and access to healthcare. Imagine if they could see a doctor before a small problem became a big and expensive problem. Financial incentives exist for treating people when they get sick, these incentives should be available for keeping people healthy!

Imagine if that mild cold or flu got treated before it morphed into expensive bronchitis or pneumonia?

So let’s talk about skyrocketing costs, an issue which seems to be one of the biggest concerns (ahem) of health reform obstructionists. Take a look at what happens when an uninsured American needs to access healthcare.

ER visits cost from $300 up, while doctor’s office visits usually run less than $100.00.

It’s estimated that 46 million persons a year walk into emergency rooms simply because they don’t have doctors or are indigent. Who pays for this? You and I—the ER bills of the uninsured are being paid by Americans with insurance. It is a hidden tax in the form of sharply higher premiums for those of us with insurance.

Unlike other areas of health care, federal law requires hospital emergency rooms to see patients even if they cannot pay. The American Medical Association estimates that, on average, more than half of treatment delivered by doctors in the emergency room is uncompensated.

The problem has worsened as the recession has led to an increase in the number of people without health insurance. More people are seeking treatment in emergency rooms for routine medical needs and a growing number of those admitted have serious health problems that have gone untreated because of a lack of preventive care.

Paradoxically, since healthcare is not a right in in the United States, as it is in all the other industrialized nations of the world, we have the highest costs (sicker uninsured making multiple ER visits), and we don’t get the best medical outcomes. All too frequently Americans are forced to use the ER as a primary care physician—the most expensive healthcare, simply because healthcare is unavailable for so many.

Bending our unsustainable cost curve is a critical component of reform. We can’t do this if we don’t provide affordable health insurance options for everyone.

And it goes without saying that a public option also addresses the other huge issue of healthcare reform. Americans utter contempt for the private insurance industry, which has proved itself over and over, to be an untrustworthy steward of the health of the nation.

There is overwhelming public support for the public option.

All: 79 percent favor/18 percent oppose
Democrats: 89 percent favor/8 percent oppose
Republicans: 61 percent favor/33 percent oppose
Independents: 80 percent favor/16 percent opposed

Throw the private insurance industry under the bus.

Americans don’t accept that people go bankrupt and face financial ruin though insured.

Americans don’t accept that they dutifully pay premiums to for-profit insurance companies, only to see claims denied in the name of increased profits.

Americans don’t accept that healthcare remains a privilege not a right in the richest country on the planet.

And Americans certainly don’t accept the horror that 18,000 Americans a year die as a direct result of not having health insurance.

The half a loaf strategy which for some includes throwing the public option under the bus, is simply unacceptable. The only way we cut costs is with vigorous competition. We assure robust competition with a public option. It is the only mechanism which will force private insurers to reconsider and amend their predatory and egregious business practices.

The political facts of life don’t change: Democrats remember the huge price they paid when Bill Clinton’s legislation failed in the early 90s, and they cannot allow that to happen again. The consequences of failure are simply too enormous, from both a political and moral standpoint.

In 2008 we bought the hope. In 2009 we need the audacity.