I haven’t read the new GOP health care bill that passed a couple of days ago, because I simply haven’t had time. The things I heard about it – from both the right and the left – have not been positive, but given the vast amount of misinformation out there about it from both sides, I’d rather read it for myself before commenting on the legislation. And I will. It just might take a while.
Instead, I’d like to talk about this idea that somehow people like me and my family – and hundreds of thousands of others – should be victimized to ostensibly “help” people for whom programs already exist that ensure they have access to health care.
First, a couple of actual facts.
The “pre-existing condition” hysteria is just that. There are very few Americans who are actually denied insurance coverage because of pre-existing conditions. As Avik Roy points out in Forbes, prior to ObamaCare, “Employer-based plans were required to offer coverage to everyone regardless of pre-existing conditions. So were Medicare, Medicaid, and other government programs like the VA.”
And since 90 percent of Americans obtain coverage through one of those means, the number of uninsured due to pre-existing conditions is actually pretty small. How small? Roughly 115,000 small.
As Roy notes, the government after passing ObamaCare created the Pre-Existing Condition Plan designed to help the roughly 10 percent of Americans who ostensibly were denied coverage due to pre-existing conditions.
PCIP was designed to work from the years 2010 to 2014, as a bridge until Obamacare’s insurance regulations took effect. During those years, Americans could sign up for heavily subsidized coverage under PCIP if they had documented proof that they had been denied coverage by an insurance company and had a pre-existing condition.
At the program’s peak, 114,959 people signed up for its coverage. That’s not even 1 percent of the population.
Now, I do understand this coverage is important for these folks. It sucks that they are either denied coverage or forced to go broke paying for it because of their illness. The PCIP was created to alleviate that problem.
I’m not a fan of entitlements, but if this is the major problem health insurance reform was trying to fix, why not institutionalize this program as a safety net for less than 1 percent of the population and leave the rest of us alone?
But beyond that, let’s remember that lack of insurance coverage =\= lack of actual health care. The 1986 Emergency Medical and Treatment Labor Act explicitly forbids hospitals to deny care to indigent or uninsured patients based on a lack of ability to pay. Beyond emergency treatment, doctors and hospitals are under no legal obligation to provide care to those unable to pay.
Ethical obligation? That’s a different story.
Doctors do take charity cases, and they do treat the indigent pro bono, as well as people who have lost their jobs or have fallen on hard times. They provide payment plans, and do try to work with patients. But medical practices have bills to pay, staff to compensate, equipment and drugs to buy, and malpractice insurance as well as other overhead to pay. At what point does it become untenable for a doctor to provide free services to people who can’t afford it? They certainly can’t do so if they leave their practice!
Pharmaceutical companies also offer relief to patients who are unable to pay for their medication.
So, what I’m saying is, there are programs available to help those who need it. Will they cover everyone fully? Probably not. Will they save every single person who is in dire need of care? Probably not. No matter how many fixes you provide, some will always fall through the cracks.
And I feel for these patients. I really do.
But the overhaul of the entire health care system that screws over millions of Americans, forcing them out of policies with which they were satisfied and which they could afford, and obligating them to pay thousands of dollars more for coverage, in favor of a relatively small number of patients?
That’s not justice.
What makes these patients more important than you or me?
My monthly insurance premiums more than doubled partly because ObamaCare forced a one-size-fits-all coverage requirement on all insurance companies and partly because Rob’s insurance coverage, for which he was paying out of pocket, consequently doubled, forcing us to put him on my government policy.
Why is my family’s financial health less important than providing pregnancy coverage for a 70-year-old man?
Two years ago, I had an underwater house I couldn’t sell, tenants whose rent didn’t even cover my mortgage payments, and who ultimately first stole my house, and then trashed it, causing tens of thousands of dollars in damages. We were living paycheck to paycheck, despite both of us working. Mortgage payments combined with our rent ate up 80 percent of my paycheck. And yet, I was taking home only a little more than 50 percent of my pay – in part because my insurance rates went up significantly.
Why is my ability to provide for my family, to make a payment for my old, 2003 Jeep, and to buy groceries less important than providing contraception coverage for someone who claims they can’t afford a box of condoms at their pharmacy?
Why is forcing those who choose to pay their physicians directly, instead of using health insurance, or those who choose to risk it without a policy, to spend their money on purchasing health insurance, preferable to allowing them that choice? Why are those who choose not to purchase insurance less important than those who demand the latter pay for their policies?
Why are doctors less important than other members of society? Why are they reviled as rich fat cats for demanding fair pay for their skills, their knowledge, their years of hard work and study, their sleepless nights, and ultimately for providing services very few in this society are capable of providing? Are they not entitled to fair compensation? Are they so unimportant that they shouldn’t be allowed to set a value for their labor, while unskilled fry cooks demand a $15/hour minimum wage for theirs?
Why is a small percentage of the population, whose inability to pay for needed medical care can be mitigated by already existing public and private programs, more important than the people who are going broke paying obscene premiums, who lost their doctors, or who opted to be penalized at tax time, rather than pay thousands in premium increases?
Why are people who got health insurance through ObamaCare more important than those who lost it, or lost access to their doctor because of it?
Why is the federal government deciding whose “need” is greater?
Why is my need to feed my family, to pay my bills, or to help my kids with school bills less important than someone else’s need to be covered just in case they can’t afford a doctor’s visit or a box of condoms, especially given the fact that programs do exist to help those truly in need of life-saving care and can be institutionalized so they can continue helping this small percentage of patients?
Why are people who are able to provide for their families less important than those who can’t? And they’re SO MUCH less important, that their loss, their hard work, their pain, their efforts to eke out a living and provide for their families are denigrated as “the rich trying to hoard wealth.”
Why is the appearance of doing something to help the poor more important than actually helping them, and definitely more important than protecting people like me, like Rob, and like millions of people who don’t qualify as “needy” in the government’s eyes?
Why are we less important?