Friday, June 29, 2012

Obamacare is upheld

I was listening to an NPR report this morning, about a health insurance agency impacted by the health care law. (I urge readers to play the audio in the link, which is more complete than the transcript). The company in question sells health insurance to private individuals, and based on the pre-reform system, denies coverage to anyone deemed to have a pre-existing condition, or who doesn’t otherwise fit into their narrowly defined parameters. But the Patient Protection and Affordable Care Act, upheld by the Supreme Court yesterday, outlaws denying coverage based on pre-existing conditions – including a lack of previous insurance. It allows those without insurance to buy into an online health exchange, which means companies like the one in the article will soon be obsolete.

Frankly, I have little sympathy for these people. These are the middlemen of health care, a prime factor in driving costs through the roof. In most advanced countries, the middlemen have been removed from the healthcare equation, helping keep costs down. Fully 5% of our GDP goes to administrative costs in health care – not health care delivery – just pushing paper or the electronic equivalent. That’s one reason why health care costs a lot less in Canada even though life expectancy is three years longer there than in the United States.

As someone who’s held a Property and Casualty license in all 50 states and the District of Columbia, I’ve come to some conclusions about private insurance – its benefits and its limitations. In my opinion, private insurance is a necessary and beneficent safeguard for those wanting to protect their homes or vehicles in the event of a loss. After all, if your home or vehicle is destroyed, the insurance can provide a reasonable replacement. But it’s not the best solution for protecting one’s body - which cannot be replaced. That’s why I’ve long favored a single-payer system and have been lukewarm about Obamacare. Unfortunately, single-payer is not going to happen anytime soon, so a reform of the existing system is the best we can get for now. Within the parameters of the present system, Obamacare gets the most people covered, which means more people paying into the coverage pool and more people getting preventative care, which is less expensive than uninsured people showing up at emergency rooms and winding up financially devastated - often unable to pay the bill and raising the costs for everyone else.

I have had experience with needing health care while being uninsured. It was on July 4, 1987. A very hot morning in Haverhill, Massachusetts, I awakened bathed in perspiration. Groggily, I went to open the window when suddenly my sweaty hand slipped off the wooden frame and went through the glass, opening a bloody wound on my wrist and damaging a tendon. I was rushed to the hospital by my brother-in-law, where the first question asked was about my health insurance coverage. I had none. While in the administrator’s office, I started to go into shock and was taken to an operating room. The very able surgeon repaired the damage to my tendon, closed my wound, and immobilized my wrist in a splint. I was also given his card as I would need therapy afterwards. And there were the medications to pay for. All told, the bill was several thousand dollars – a hefty sum for a young person earning little above minimum wage. (For the record, I paid that bill in its entirety, although it took several years.)

The fact that I didn’t have insurance can be laid on the fact that I had two part time jobs – neither of which afforded me coverage. Also, I can blame my youth and naiveté for not buying my own coverage – hardly uncommon for a 20 year old.

In the aftermath of this crisis, I began to realize that I needed health insurance – and that is when the salesman showed up. He pulled out his three-ring binder, handed me his pamphlets, and explained how the insurance offered by his company offered such great benefits and such a reasonable cost. All I had to do was allow a nurse to visit and administer a routine health exam. We set up the appointment, the nurse visited, and I was examined. As she left, she smiled “you’ll be receiving the results in a few weeks.”

A few weeks later I received a letter, noting that the results of my medical exam indicated that I really needed to get coverage and I should contact that company “right away”. I did, and when I was quoted the cost (which was higher than quoted due to some health condition they wouldn’t discuss with me) I nearly experienced another health crisis. It follows that I did not purchase their coverage – I simply couldn’t afford it. Instead, I experienced anxiety worrying about this mysterious medical condition that no doctor since has been able to confirm. (In retrospect, it was obviously a fabrication designed to frighten me into buying overpriced coverage.) But my anxiety was short lived as I became a full time employee at one of my jobs, and was afforded health insurance as part of the benefits package.

With the confirmation of the health care law by the Supreme Court, people like this travelling scam artist will need to find new jobs. Perhaps they can become televangelists.

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