Healthcare is the issue that I care the most about. I stayed with a company far longer than I would have had I not been worried about being uninsurable due to preexisting condition clauses prior to the ACA. Although I lived with the almost daily fear of layoff (they happened frequently in my industry), I’m fortunate in that I reached early retirement age before getting laid off, so I had the option of obtaining retiree medical coverage to bridge the gap to Medicare. Things could have been very dire had I been laid off earlier in my career.
I had already lived that life when I was still in grad school in the 1980s. Saddled with a childhood diagnosis of a potentially life-threatening medical condition requiring on-going treatment, I fell off of my mother’s insurance when I turned 23 even though I was still a full-time student. At that time, I had to take the only coverage I could get, a conversion policy that, in the mid-1980s, cost $500/month for catastrophic in-hospital care. It covered nothing else. It had no prescription coverage, no out-patient coverage, no routine office visits, nothing else, and it had a lifetime maximum of $100,000.00 with a very high deductible and no out of pocket maximum. Of course, I was still a student and couldn’t afford this premium, so again, I was fortunate that my mother, at great personal sacrifice, covered that for me. I had two major surgeries while on this insurance. These were not elective surgeries, they were necessary to keep me from bleeding to death, so I personally care about having access to healthcare without the fear of being bankrupted. The advent of the ACA gave me hope for myself and for others like me.
The Affordable Care Act (ACA) has been under attack since before it was signed into law by President Obama on 23 March 2010. There is no argument that the legislation was cumbersome and not without its faults, but it was a start. It was a start down the path toward making health insurance accessible to all Americans. Health insurance isn’t the same thing as healthcare, but in the U.S., it is the primary means for paying for healthcare services, which, without insurance would be completely inaccessible for the vast majority of the people in this country.
After trying for over seven years to repeal it, the House of Representatives passed HR 1628 entitled American Health Care Act (AHCA) on 4 May 2017 voting in favor 217 – 213 with one abstention. The roll call results from this vote should be noted and remembered when people lose their insurance, and by extension, their access to healthcare.
One of the many critical provisions the ACA includes is protecting people with preexisting conditions from being gouged by insurance companies. Preexisting conditions of course include life-threatening conditions like cancer, but they also include any ongoing conditions that are well-controlled such as Hashimoto’s Disease (hypothyroidism), or even one-time accidents or events that affect their medical status. This key protection is one of many provisions that are actively removed from the law via the AHCA. Those who penned this legislation gave it the acronym AHCA. Funny thing about acronyms though. They can have many interpretations, and one could argue that a more fitting title for this bill might be the American Health Care Assault given all the protections it strips away.
Those who supported the AHCA in the House must be held accountable for their actions as happened during the Tom MacArthur Town Hall meeting held in Willingboro, NJ on 10 May 2017 as reported by NPR and others. The meeting lasted just under 3 hours, punctuated by numerous concerned constituents’ statements and questions, and culminated with this powerful statement by a man who had waited patiently for more than 2.5 hours to have his say. The meeting would have gone on longer, but the congressman walked out without answering the questions being posed.
Healthcare isn’t an optional service. It’s a service that everybody needs to a larger or lesser degree. There are many who advocate for capitalism with competition as the mechanism for fair pricing, but healthcare, being the critical service that it is, shouldn’t be predicated on a person’s ability to pay for the preventative, acute, and chronic care they need. In the U.S., unless one is extremely wealthy, or fortunate enough to be extremely healthy (not something necessarily within one’s control), the threat of financial ruin and the possibility of an early death (or a greatly reduced quality of life) hang over their head if the AHCA becomes law.
The continual attacks and misrepresentation by conservatives claiming that the ACA is a failure as discussed in this opinion piece from the Chicago Tribune last September, are inaccurate. This Daily Kos article from March explains how that isn’t a failure of the legislation, it’s working as designed. The ACA should be improved, not destroyed, and the addition of a public option would go a long way toward helping stem the insurance industry’s greed. If there is a failing of the ACA, it’s that it doesn’t have enough regulation. It allows insurers to opt out thereby causing the current shortfalls in some portions of the country where few insurers choose to operate under the current system.
Many progressives have been calling for a nationwide, single-payer system, essentially Medicare for all, and that would indeed bring us in line with the rest of the industrialized world where people aren’t living with the constant threat of financial ruin if they get sick.
Trumpcare 2.0 May Prepare the Way for Medicare for All from May 2017 poses an interesting outcome from the latest conservative attack on our healthcare system, but I suspect a slightly different course if the AHCA succeeds. The more progressive states are already working on statewide legislation to bring some kind of universal healthcare system home. If that happens, then the disparities across the country will increase, and people in the less forward thinking states will suffer even more than they already do because the insurers will end up gouging them further.
A Medicare for all system is really where we need to go, but with some additional regulations that require all medical service providers to accept it. It would also need to be required for everyone, but if it were kept to its current standard of covering only 80% of medical expenses, that would still keep the private insurers in business to offer supplemental plans to cover the gap. In fact it would likely increase their business because everyone would need a Medicare supplement of some kind. If this were enacted nationwide, then we really would see the melding of a progressive and a free market approach, each with its own piece of the pie, with everyone protected, at least to 80%. Healthcare would then be realized as a right, not a privilege of the financially well-endowed.
Friday, May 19, 2017 · 11:31:49 PM +00:00
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Reedy Wonder
Things are happening fast with respect to Congress now. Thanks to this Health Care Action Alert, we have a very small window to act. The alert outlines the importance of taking action now and details where the information came from, but the net of it is to send an email to HealthReform@Finance.senate.gov by 23 May 2017 with what you want to see in the Senate’s new Health Care Reform bill.