Stand up, don’t sit down, There’s a health care crisis in this town!

That was one of the many chants from the crowd of nurses I marched to the Capitol building with this afternoon. They were in DC to rally for safe nurse to patient staffing ratios and affordable, quality health care for all. 

Senator Max Baucus was the unintentional villain of the event — he made the mistake of expelling supporters of single payer health care from two Senate Finance committee hearings over the last two weeks (most of whom were at the rally), rather than just giving them a microphone and hearing their views.

I had to add a little fuel to the fire.

I spoke briefly about one of the most devious pieces of the current health care debate in Congress – the so-called “individual mandate” that would require every individual to prove they have health insurance or pay a fine if they can’t afford it. That’s not what I call “reform.”  I call that an HMO bailout that would guarantee customers to the health insurance industry, but do nothing to rein in the outrageous profits, administrative costs and executive salaries that have driven the cost of health insurance through the roof.

President Obama said it himself during the campaign: Americans don’t refuse to purchase health insurance because they don’t want to be able to see a doctor if they get sick. They don’t buy private health insurance because they can’t afford it.

But the health insurance lobby is twisting arms in Congress. They want to make the individual mandate a central plank of health care reform. And they have a good chance, considering that they’ve contributed over $2.2 million to members of Congress in just the last four years. Senator Max Baucus is the third-largest recipient of health insurance industry dollars — he took $183,000 from health insurers in that time. And Senator Baucus is carrying water for the insurance by becoming the defacto champion of the individual mandate.

That money is why the nurses’ voice is so important on Capitol Hill today. 

The good news is: We know the mandate can be beat. We joined with the nurses to kill Arnold Schwarzenegger’s mandate plan in California last year. We were able to beat it because the numbers behind a mandate just don’t add up.  You just can’t force people to buy something they can’t afford.  And, because supporters of the mandate in California refused to take on real cost controls, they couldn’t make it affordable — just like they’ve refused to take on tough cost controls in Congress today.

I don’t mean long-term ideas like disease prevention or electronic medical records. Prevention and technology are great, but they’ll take years, if not decades, to bring down costs.

I’m talking about the fact that both Schwarzenegger’s plan in California (and the proposals before Congress today) refuse to limit excessive spending on profits, executive salaries and overhead by private insurance companies. We’re talking about up to 25% of the HMO dollar, or more, that’s just wasted. And they do nothing to regulate rates.  I don’t think it’s the best strategy to let insurers continue to price-gouge patients and taxpayers when you’re trying to require everyone to buy their product.

The mandate in California failed on costs, but it also failed on coverage – because it didn’t guarantee meaningful benefits to patients.  (We all know that insurance isn’t insurance if you can’t afford to use it and it doesn’t cover the bills when you get sick.)

Now we’re having the same debate over high-cost, bare-bones junk insurance on Capitol Hill. 

I was here three years ago, and brought a woman named Dana Christensen to DC to tell Congress what happened when she bought just this kind of junk insurance policy with her husband Doug. They thought they were covered – they even bought a special chemotherapy rider just in case Doug’s cancer returned. But Dana was left with almost half a million dollars in medical bills when Doug’s bone cancer returned and he passed away.

This is the kind of junk insurance that Americans will be forced into if a mandate becomes law. That isn’t what the American people meant when they told their representatives in Congress that they want health care reform. Luckily for patients, the nurses aren’t afraid to stand up and say so to Congress.