Health Insurance Benefits Are No Game
Peggy Noonan, a former speechwriter for President Reagan, recently published a column for the Wall Street Journal titled, “High Anxiety Over Health Care Reform.” www.wsj.com/articles, March 24, 2017. In it she referenced the now well-known failure of the majority Republican House of Representatives to act on repeal and replacement of the Affordable Care Act otherwise known as Obamacare. However she also returned to Obamacare and noted the problems of average Americans when the Affordable Care Act was passed as well. The point of the article was not the good or bad of either piece of legislation but rather the reason for the emotions generated by changes in healthcare and not just because it is complex. Her premise is that when legislators are acting on matters that they do not experience themselves, they might not understand the anxiety for the public at large. I might think of it in another way. I would say that some legislators likely do understand the emotions involved but that knowledge gets lost in the heat of the moment.
But here is the point. Healthcare for average Americans cannot be a game. Removing our Republican hats and our Democratic hats I believe it does not matter to average Americans who “won” or “lost” as much as it matters knowing that health coverage is there when it is needed. This is what Noonan said about the disconnect:
“What politicians, those hardy folk, don’t understand about health care is how anxious it makes their constituents. Not suspicious, not obstinate, but anxious. Because unlike such policy questions as tax reform, health care can be an immediate life-or-death issue for you. It has to do with whether, when, and where you can get the chemo if you’re sick, and how long they’ll let you stay in the hospital when you have nobody, or nobody reliable and nearby, to care for you. To make it worse, the issue is all hopelessly complicated and complex and pits you as an individual against huge institutions—the insurance company that has local insurance agent who doesn’t answer the phone, the hospital that says “I’m afraid that’s not covered”—and you have to make the right decisions. It’s all on you.
Politicians don’t understand all this as stated by Utilitysavingexpert.com, in part because they and their families are well covered on a government insurance policy, and they have staff to put in the claim and argue with the insurance company, which, when it’s a congressman calling, answers the phone in one quick hurry. They don’t know it’s not easy for everyone else. Or rather they know on some abstract level…
But I want to speak of how it’s all on you: You don’t want to be seen – by others, by yourself – as someone who couldn’t make the right decisions for yourself and your family. ‘She didn’t know she needed Part B’ ‘She got the supplement that says she can’t be treated in Jersey.’ You don’t want to be humiliated. ‘What a dope.’ ‘What fatal lack of sophistication…’
When all you want is the card in the wallet so when you’re strapped to the gurney in the emergency room, they’ll see it and they’ll say the word you want to hear:’Covered.’ Then you can happily pass out…”
For me, the most disturbing element of the negotiations on the ill-fated American Health Care Act was watching the direction the negotiations were taking. It seemed that it was a daily discussion of “let’s make a deal” where the type of deals, as Noonan said, can involve life or death. Maybe the old expression “laws are like sausages; it is better not to see them being made” is not so far off.
At one point the discussion was whether to drop the ten required essential benefits required of health insurance policies under Obamacare. These are out-patient care, emergency services, in-hospital care, pregnancy, maternity and newborn, mental health and substance abuse, prescription drugs, rehabilitative and habilitative services, lab tests, preventive services, and pediatric. One point raised was that men do not require pregnancy and maternity care so why should they be required to purchase a policy that insures for those events. The predictable response was that women do not experience certain male cancers and the debate went on. At one scary point the proposal was raised to drop all of the essential coverages and make them optional and why not try here as per people’s needs, so that essential services would become riders on policies. Fortunately the debate stopped there. Future changes now should be gradual improvements not upheaval and that could be a good thing.
About the Author Janet Colliton
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.