Who Will Help the Uninsured?
I recently saw a Facebook status which recounted the travail of the daughter of the person who was posting as she tried to acquire a health insurance policy. She had been using COBRA benefits, but the time allotted for the benefit was running out. She had applied for a policy with United Health Care, but had been turned down as uninsurable because she has a history of cancer. Her father asked rhetorically, "Can you do anything for her, Mitt?", which leads one to presume that he believes ObamaCare is an answer to this problem.
It is possible that were ObamaCare to be fully implemented, she might be able to buy a health insurance policy. Depending on her income, she might qualify for federal assistance in making the purchase, which she would likely make through a health exchange online. However, that is not the same as saying that the health care she would be able to receive would be affordable. As has been repeatedly documented here, making the premiums affordable comes at the expense of making the health care itself unaffordable. ObamaCare requires us all to purchase health insurance but leaves many doors open for health insurers to continue to game the system, pushing many health care costs onto the purchaser of their product. Having health insurance which leaves the family at financial risk in the event of illness or injury is not really a health policy achievement.
Mitt Romney is not offering a better solution, but he is also not offering a worse solution. He is proposing that we scrap ObamaCare and start over. Since ObamaCare is not the solution we need for our health system woes, getting past it is essential to progress in making American health care delivery better. Mitt is also saying that states should take the lead in fashioning health system reforms. Were that to actually happen, we would have 50 different possible solutions being organized at the same time, with the federal government holding out a minimum standard. Given that Mr. Romney passed a state-based reform in Massachusetts which remains the prototype for ObamaCare, it is likely that he would continue to support something similar in other states. This means that he would make virtually the same offer of mandated health care coverage in response to the question from the Facebook status quoted above.
Here is the flaw of both the Romney and the Obama approaches: The essential problem this family is facing is a problem with the health insurance industry business model. This young woman deserves to have access to high quality health care even though she had cancer during childhood. But American health insurance, because it is based upon a self-serving business model, does not intend to serve her needs. The only reasonable way forward is to eliminate the wasteful business practices of health insurance that place her (and all of us) in this quandary in the first place.
Make no mistake, everyone is at risk as long as health insurance business interests are the principle force behind American health policy.
Dr. Joe Jarvis