When our child was really sick, we took her to the emergency room, where we waited forever, while people, seemingly far less sick, went before her. I was utterly furious. I wondered if everyone who went before her was insured. A lot of people go to the emergency room because they have no insurance and can’t see a doctor otherwise. We talk about the uninsured, but they are not the untreated. No, they go to the emergency room, instead of a primary care physician’s office, and many can’t pay the huge hospital bills. This cost shifts to those who do pay. And our premiums go up and up.
So, more and more people can’t cover the cost of those inflated premiums. The pool of uninsured grows, putting more burden on the shrinking group who still pays. The current arrangement is unfair and unsustainable. Our system already carries the woeful inefficiency many fear of a “socialist” system.
Meanwhile, insurance companies have an understandable financial incentive to knock the weak off their rolls, keeping the paying healthy on their lists. This is simple economics. That’s why insurance companies look for reasons not to help you if you do fall ill. It’s a revenue-versus-expense issue. So, they pull out some fine print detail that exempts them from payment, something you never knew about, something utterly cold given your dire straits. You thought you were covered. Oops. No, you’re not. Sorry, but it’s financial disaster for you on top of your ailment.
Get a horrible diagnosis and your doctor tells you that such-and-such treatment or medicine is what you need. Well, let’s run that by the insurance company. Nope, it’s not covered. Want to see the best doctor? Sorry, he’s out of network.
If you could just get a government job, you could get nice government benefits — you know, like our lawmakers enjoy. But everybody’s lining up for government employment. Meanwhile, your company is laying off folks. They ultimately fold.
You’re now among the uninsured. You worked hard all your life. Now, that’s no longer good enough. Some folks will judge you quickly. “Get a job,” they say triumphantly, as if they’ve just scored a touchdown on you. It’s such a fun dagger to throw, so simple and sharp. They don’t know the first thing about what you’ve been through. But how can you expect them to care?
You wake up in horrible pain. It’s been nagging you for a while, but you couldn’t go to the doctor, because you don’t have insurance. A manageable problem has turned catastrophic. A small cost is now exorbitant. So you go to the emergency room. Should they block the door since you don’t have insurance? Some would say, “Yes, let him suffer on the curb. He deserves it.”
Of course, a lot of those judgmental folks smoke, eat big fried chicken dinners and don’t exercise. They will ultimately add huge costs to our health care system, too. Many of them are one personnel move away from landing in the same boat. But who are you to judge them? Your company failed and you lost your job. You should have worked harder. Then maybe your company could have stayed afloat.
Thankfully, you find another job. Sorry, though, you can’t get coverage, ever. You have a pre-existing condition.
We all have fears and they are out in full force in the health care debate. I’m afraid and bitterly angry, too. Can you tell? I’m sure you probably feel those emotions, too, but your reasons may be entirely different from mine. These things touch on our deepest emotions. And to try to convince people to see things as we do is ultimately futile. We’re all deeply rooted in our own convictions and have little patience with anything contradictory. I’m as guilty as anyone. I can only say that I believe my deepest anxiety is well warranted. And it’s based on this: I used to think there was no way my family could find ourselves among the uninsured so long as I just worked hard. Hard work — that will see us through. Now, after all I’ve seen, I’m not so self-assured. Hard worker or slouch — we can all get hit with devastating misfortune, whether it’s physical or economic. We see it all around us. And it happens to good, good people, not just those who want a free ride.
Amid all this political nastiness, I just wish we could agree that the central intent of current reform efforts is needed — something must be done to address the inflationary forces that are pricing people out of coverage. Think about it, the consumer market determines a reasonable price for Tylenol at your local CVS, but the health care market prices the very same Tylenol at an astronomical rate in the hospital. This is senseless. And this inflation infects the entire health care system. It warrants corrective action. Because if we don’t address these unhealthy inflationary forces, more and more middle income people are going to be left out in the cold in years to come. Consider that since 1999, employment-based health insurance premiums have increased 120 percent. Another decade like that and a lot more people aren’t going to have any coverage.
One needed reform is to push for preventive care and to get many of those uninsured folks into primary care offices — instead of the emergency room. Our society already pays for the uninsured in an incredibly inefficient emergency-room manner, an arrangement that jacks up our premiums and puts many of us at risk. It seems sensible to steer the uninsured toward preventive measures that will help eliminate more expensive treatment later.
But I don’t expect any such healthy measures in coming weeks.
When it comes to health care, many prefer to just grin and bear whatever pain comes, so long as Uncle Sam isn’t in the room.
Zach Mitcham is editor of The Madison County Journal.