Tag Archives: Patient Protection and Affordable Care Act

The Promise of Affordable Health Care

English: Barack Obama signing the Patient Prot...

English: Barack Obama signing the Patient Protection and Affordable Care Act at the White House Español: Barack Obama firmando la Ley de Protección al Paciente y Cuidado de Salud Asequible en la Casa Blanca (Photo credit: Wikipedia)

The initial roll-out of Obamacare‘s insurance exchange has been plagued by problems. It makes me wonder about what could have been. We will never know how things might have been if we had come together as a country to help people like me who could not get insurance from the private market.

This country has done great things in its history by everyone pulling together for a common goal. Affordable health care could have been one of those things. Instead this ideal has been sacrificed at the altar of political power. Republicans preferred scoring political points against a Democratic in the White House. Their supporters have cheered them on.

Our current mode of operation in this country is to battle each other rather than to co-operate. I fear this spells decline for our nation unless we the citizens  wake up and change course.


A Mandate By Any Other Name

Newt Gingrich

Image via Wikipedia

Newt Gingrich opened a can of worms when he was asked about the Republican plan passed by the House which radically changed Medicare. Gingrich called it “right-wing social engineering.” More importantly his comments brought to my mind and to others the uncomfortable contrast between the Republican plan and what they have been saying about the Affordable Care Act (ACA).

Republicans have been egging on the states to sue the government claiming that Health Care Reform (ACA) is unconstitutional because it mandates people to buy health insurance.

There’s the rub. The Republican plan does the very same thing, except in a bigger fashion. The Republican plan takes money that would fund your healthcare and uses it to subsidize your private health insurance premiums.  In other words, the only way you’re getting any of that money that you’ve spent your life paying into Medicare is for you to buy health insurance. Government financial rewards for buyers of insurance is precisely what the Republican plan offers, and it is precisely what they’d like to claim is unconstitutional about the Democrat’s plan.

Now, I have read some conservative commentators who write that this comparison is not fair. (see: National Review) However, on page 46 of Paul Ryan‘s “Path To Prosperity” it states, “This is not a voucher program, but rather a premium-support model. A Medicare premium-support payment would be paid, by Medicare, to the plan chosen by the beneficiary, subsidizing its cost” (italics mine). I don’t get it. Is there a difference between a voucher and a deal that pays premium-support money to a service provider rather than directly to you?

What I do get is that words matter. In politics, it isn’t as important what you are saying as how you say it. But it is the job of the electorate to see behind the curtain and to call out politicians who are trying to use words to mislead. To me Ryan’s plan calls for replacing Medicare healthcare with a voucher to buy insurance from a private insurer. And if his plan is taking money that currently is designated to fund my healthcare and directs it in a way so that I cannot receive its benefit unless I buy insurance, then that sounds to me like a mandate to buy health insurance.

Insurance: It’s a Business, Stupid

This is a diagram depicting the percentage in ...

Image via Wikipedia

Today I received a much delayed notification in the mail that Blue Cross Blue Shield is going to deny my request for personal health insurance. This is actually good news in sort of a perverse way. Several professionals had warned me that there was no way I would be accepted for personal health insurance. In order to benefit from our government’s new Pre-Existing Condition Insurance Plan (PCIP), I must demonstrate that I have been rejected for a pre-existing condition (plus I must endure 6 months without health insurance). Without the PCIP plan, I would not be able to get health insurance.

What was my crime that disqualifies me from receiving health insurance and the resulting guarantee of health care? I had the audacity of being diagnosed with cancer in July, 2007. I was treated for cancer, and my prognosis is excellent. There is a very slim chance that my cancer will return.

I had health insurance when I got cancer, so an insurance company paid for a portion of the cost of my treatment. Based on my calculations, within five years that insurance company would have received enough money in premiums to completely repay every penny I had ever cost them. Similarly, I estimate that the insurance industry has received three times as much money in premiums paid by me than they have had to pay out for my benefit. And yet I am considered to be too much of a risk to deserve ANY coverage.

I learned from my rejection letter that it wasn’t just my cancer that they didn’t like. You see, in order to check that no cancer has returned, my doctors perform regular CT-scans. So far there has been nothing but good news from those scans. But Blue Cross Blue Shield looked at the same images and found much cause for concern. They were terrified by the presence of a schwannoma and hemangiomas in my liver, spleen, and both kidneys. Before you shed a tear for my imminent demise, you might want to look up these fancy terms up. You’ll learn that none of these are of any real concern.

So why are people with ANY anomalies whatsoever in their medical history denied insurance coverage? It’s because insurance is provided in America by for-profit financial institutions.  Keep in mind that regardless of claims to the contrary, the top priority for publicly traded companies is to provide a good return on investment for their stockholders.  The profit margin is much better for a business if it can figure out a way to ensure a continuous bounty of revenue while eliminating as many expenses as possible. Now of course, one expense is executive pay, but I doubt you will be surprised to learn that this is NOT an area that insurance companies aggressively try to reduce.

Instead, they figure they can take money from healthy people until they actually start needing their insurance. At that point, the insurance companies use every trick in the book to deny coverage for the needed treatment, and then they try to get rid of customers who have been defiled by disease altogether.  Keep in mind that they already get a bonus from Medicare: they no longer have to cover the medical expenses for anyone over 65. This is one reason why all that trumped up outrage over a “public option” conveniently ignored the fact that Medicare is a “public option”.

Our nation depends on private companies to provide people younger than 65 the means to afford healthcare.  This means that sometimes the government needs to step in to ensure that the objective of affordable healthcare is possible for all of its citizens.  After decades of trying, the government finally took a step in that direction with the Patient Protection and Affordable Care Act (PPACA).

Thanks to PPACA  I will be able to receive health insurance in six months.  The insurance industry, of course, would like to be able to operate without any interference, so they have always lobbied against health care reform. As a result of their money and efforts, many people misunderstand what this bill does. We have all sorts of people who don’t like it because it is “job-killing” or a “takeover of the healthcare industry.” If the insurance industry’s efforts are successful in repealing this law, then PCIP will disappear, and I will be back to the situation of not being able to get health insurance precisely because I might actually need it.