Tuesday, October 16, 2012

October 16, 2012 – Time to Close Down the Floating Medical-Insurance Crap Game

“We all make mistakes, and a humane government tries to compensate for our misjudgments. That's why highways have guardrails, why drivers must wear seat belts, why police officers pull over speeders, why we have fire codes. In other modern countries, Scott would have been insured, and his cancer would have been much more likely to be detected in time for effective treatment.

Is that a nanny state? No, it's a civilized one.”

The writer is the New York Times’ Nicholas Kristof. His subject is his college roommate, Scott, who just died of too-late-diagnosed prostate cancer.

The reason Scott waited so long to go to the doctor?  Lack of insurance.

The reason he didn’t have insurance? Because he was between jobs, and couldn’t afford to buy insurance on the open market. As Scott himself wrote:

“I didn't buy health insurance because I knew it would be really expensive in the individual policy market, because many of the people in this market are high risk. I would have bought insurance if there had been any kind of fair-risk pooling.”

I know other people who could tell similar stories. The one that comes most clearly to mind is a fortysomething single mother of 3, who discovered a lump, figured it was probably cancer, but didn’t go to the doctor because she was sure that, if a cancer diagnosis ever got recorded in her medical file, no company would be willing to insure her, ever again.  Instead, she immediately took steps to get into an employment situation with benefits, but that took a while.

By the time she finally did get back into a job with medical insurance a few months later, and saw a doctor, her unusually aggressive cancer had progressed much farther than she’d ever imagined.

The doctors are trying every desperate measure they can think of, but the bottom line is, she probably doesn’t have long to live. With an earlier diagnosis, things could have turned out differently.

She told me later she’d known she was gambling with her life. If she’d had one of the slower-moving cancers, she probably would have won the crapshoot. She would have had her cake and eaten it, too — avoiding utter financial destitution and getting reasonably timely and successful treatment, besides. She just didn’t bank on her odds being as bad as they were.

She was thinking about being able to afford college for her kids, when she should have been thinking about her own survival.

Not the wisest decision, in retrospect.  But, as Nick Kristof points out, how on earth can a civilized society expect a profoundly frightened person who’s just discovered a suspicious lump and has no experience dealing with cancer, to make a cool, calm, balanced and wholly rational cost-benefit analysis?

This is why the American Cancer Society now considers lack of insurance to be a risk factor for cancer. Just like cigarette smoking and working in an asbestos factory.

This is why those who are clamoring for the repeal of Obamacare are either deeply immoral individuals, or are deluded in thinking there is no moral dimension to this issue.

It’s a moral issue precisely because, if Obamacare is repealed, people like these two individuals will die needlessly.

What we really need is national, single-payer health insurance for everyone. Just drop the qualifying age for Medicare to zero. It’s as simple as that. And if Grover Norquist doesn’t like the tax increase that will be necessary to pay for it, patriotic Americans ought to shun him like the corrupt political boss he is.

Obamacare doesn’t go nearly far enough. But for now, it’s all we’ve got.

It sure beats the alternative.

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