Matthew Holt

Why health insurance reform really matters

Just occasionally we get a really heartfelt comment on THCB that is passionate and rational, and reminds us why for all the bile spewed about the topic the essential part of the health care bill—making insurance available to everyone—is really important. This comment from CF Mother was left on my post “Thinking the unthinkable” on Friday. And of course, this could happen to anyone—including you. And frankly the Democrats need to do a better job explaining this—Matthew Holt

Questions for those who do not support health care reform:

Twenty years ago our cheery toddler was diagnosed with cystic fibrosis. Afraid, we dug into the medical research to understand the disease that threatened his future. We healed through optimism, roused by the news eight days after his diagnosis that the gene that causes CF had been found, opening the door toward a cure. We knew that our heroes, the researchers and his doctors, would continue to find ways to protect his future. We were no longer afraid of CF.

The fear that woke me in the night was of losing our health insurance because our son was on every insurer’s no-fly list. While my husband’s profession was periodically roiled by layoffs, he decided against the security of opening his own firm because the cost of carrying coverage for our eldest son was too high, the thread on which his health care dangled too slight.

With luck, we made it through our son’s childhood without a gap in coverage. Now 22, he’s kept his health thanks to his medical care and his own glorious determination not to allow CF to cramp his style. He earned his black belt, went to college, joined a fraternity, and drives a 1961 Buick LeSabre. He spent a year in China, learned Mandarin, and discovered that even the drug that enables CF patients to digest food couldn’t help him digest raw sea cucumber. He backpacked through Thailand, had his wallet and passport stolen, but managed to hang on to his meds. This spring he will graduate with a degree in chemical engineering from UMass Amherst’s honors college, with a concentration in biochemistry. His resume includes summers researching the transmembrane conductance regulator, the protein channel in our cells that, when malformed, causes cystic fibrosis.

We can’t wait to see what this kid is going to do next. Next, however, has filled me with that old middle-of-the night fear. Our son will age off our family policy in April. He must shape his future not according to his dreams and ability, but in ways that will ensure that he keeps his health insurance. He must find an employer with health benefits that will hire a new college graduate in a poor economy. Or he must extend his full-time student status until he’s 25, putting off career plans and his desire to support himself. Despite his wanderlust and world-wide opportunities, he must remain a resident of Massachusetts, an isolated island where CF patients are not pariahs to health insurance companies.

I tell our story not because it is unique. Other families have been harmed, rather than merely threatened, by the ruthlessness of American health insurance. I tell it to ask a question. It is for you, the person reading this who does not wish the current effort to reform health care to succeed, who calls it “Obamacare” and “socialized medicine”. Help me understand your position, because I am mystified.

Are you a parent? Do you know that the bill under debate will prevent insurers from dumping people with pre-existing conditions, like my son or, perhaps, someone in your family? Do you believe that anyone who needs health care can get it somehow, or that illness happens only to other families?

Are you a fiscal conservative concerned about cost? Do you realize that the current system discourages small business development and blocks young adults’ opportunities to succeed, the foundations of a growing economy? Do you believe access to health care is not as essential as access to education in preparing our next generation of skilled workers?

Are you are an insurance executive? Do you devise new ways to make it difficult for my son to obtain prescriptions and services as cost-saving measures? Would you prefer to cover the cost of his lung transplant, because he has not been able to get the treatments he needs to stay healthy? Or have you decided that the ultimate cost-saving measure is to let CF patients and other chronic burdens to your bottom line die young?

Help me understand why, rather than reforming the American health insurance system, we should turn our backs on my son and the promise he and other young Americans like him offer all of us.

Categories: Matthew Holt

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26 replies »

  1. I am appalled at the post by Nate. The CF mom isn’t asking for a handout here. I too have a child diagnosed with CF at the age of 18. One prescription alone cost $1,200.00 a month. This medication will be needed by my daughter for the rest of her life. Who can afford that amount? I know that I can’t and as a full time college student she is unable to work enough hours to afford the medication herself. The issue here isn’t the fact that anyone is looking for a handout…the issue is the high cost of health care and medicines in this country. It is a sad moment when one medication alone is more than a months rent payment and close enough to being a mortgage payment on a modest home. What is our nation coming to when we are so concerned with helping third world countries but fail to be able to tend to our own children’s needs.

  2. This is so American, talking of humans that might possibly die without healthcare, as a price tag. Out of all the developed countries, this might be the most religious country. Yet so selfish and only concerned about money. How funny the irony is. Especially Nate who left a comment where he said he is scared people will take advantage of the system, and not paying for insurance until they get sick. This is the core of the right winged mentality; there is always a fear of some evil creature lurking around the corner, waiting to take everything you have. Wake up people; we do not live in the wild wild west anymore. This is enough; I’m going back to my country Sweden, where we care about each other!!!! And where all the politicians are old teachers and professors, who create policies that help the people.

  3. Nate,
    The HIPPA laws you refer to apply to HIPPA compliant (mostly group) insurance policies.
    Your creditable coverage in no way guarantees your approval for an privite major med policy. Neither does in waive your pre existing condition period (normally 12 months). In fact, most privite major med policies do not honor your creditable coverage.

  4. nl, versus those mothers who freely admit their kids have no potential and should be garbage men? The mothers of all the gardeners and labors in this country when did they know their kids would never amount to anything meaningful like a biochemist or cultural link and thus aren’t worthy of CF mother’s kid’s special privilages?
    What if her kid ends up q failure or normal and never does anything meaningful will we get a refund? What CF Mother and the rest of you are asking for is myself and others to subsidize them so they don’t need to worry about taking responsibility for their bills. In return for me working harder and more to pay his bills on top of mine your trying to sell me he is going to accomplish something great. I’m further suppose to trust you know how to identify these people. This apparently will be unlike welfare, Katrina, or public housing or anything other idiotic liberal scheme where by helping these people will lead to rich and just returns.
    Everyone can’t get a free ride, it is not sustainable, I would think after looking at Social Security and Medicare you clowns would get this. You can’t pay the bills you already owe and your out wanting to give away even more.
    notice your use of the world easily…so finally someone is honest enough to admit that he will always be ableto get insurance….it just might not be easy. I do appreaciaite you at least being truhful and not pushing the lies and propoganda CF mother and the others do but that leads me to one question. Do you think it is “easy” for me to make the extra money to pay his bills on top of mine? The left seems to think tax dollars are like tap water, just turn it on and there is as much as you need. You either don’t know or choose to ignore all the risk, long work days, 7 day weeks, and failures it takes to make the money you want to tax. When is my easy? When is someone going to pay my mortgage, where is my grant, when do I get a free ride? I don’t have it “easy” why should this kid? Let him get off his ass and put in half the work I have then come ask for a handout. If he is so smart and has such potential then he shouldn’t need it easy or should be able to EARN it himself.

  5. Any kid with a degree in biochemistry who speaks fluent chinese is not asking for sympathy or a handout, and is not going chasing bands on the public dole. The mom’s point–and it’s not a sob story–is that the young man has got a lot of potential to be a real contributor, but his chance to succeed is limited by his need to not risk losing his health insurance because he can’t get it back that easily. He can’t work for a start up and invent a new biofuel for the rest of us. He can’t live in China and become a cultural link for the rest of us. He’ll be fine. The rest of us will lose out in the long run because of the limited options for any smart young person with a pre-existing condition.

  6. anyone recall the saga of the “Little Mother” floated during the Great War? A little mawkish, perhaps, but a remarkably effective recruiting tool.
    So we need someone to fund for the young fellow under discussion a broad policy of insurance of the type typically provided by employers to employees. And just who might that “someone” be? The insurers? And they are not going to pass this expense to the rest of us? And what the many millions (including those covered by Medicare) who do not enjoy such broad coverage?
    Well, you’ve driven me into a corner here, and I see nothing for it but to admit that nothing short of “universal single-payer health care” can avert a catastrophic collapse of the system.

  7. To Lynn, Paolo, and anyone else out there who sympathizes with the hijacking of the American healthcare system. For decades Congress has had the opportunity to control healthcare – who gets it and who doesn’t – through legislation. It’s legislation that requires emergency rooms to take patients no matter what their ability to pay. It’s legislation that enables employees via COBRA to take their health benefits with them when they are laid off. It’s legislation that tells companies that executives cannot have a better plan than their subordinates. It’s legislation that sets coverage levels, the ability to model pre-existing conditions after mortality rates, etc. The Congress is pulling the wool over the eyes of the American public with pure smoke and mirrors. THEY set the rules and the rest of the parties to healthcare – facilities, payor providers (insurance commpanies), lawyers, pharmaceutical & medical supply companies,and the docs/nurses – have to comply. The bill being negotiated in Congress today is solely for hijacking a $2.5 TRILLION industry because Congress gets its own control from controling money. “We The People” can control the kind of healthcare we get by electing officials to represent the laws we want passed. This scheme was cooked up by Congress – hence, they want it passed before “We The People” have a chance to see the “devil in the details”.
    To Lynn specifically, you say you trust your elected officials if you have a problem with your healthcare. Where’s your leverage to get your elected officials to do anything? You’re just one vote, and that vote may not take your official out of office for at least a year. Even if it does, the cancer represented by government bureaucracy won’t go away. It usually only gets bigger and more cumbersome. Why do you think that Federal employees don’t want to be included in the proposed healthcare system? As the adage goes, “If it’s so great, why isn’t everybody doing it?” Federal employees were in an uproar when a Senator threatened to include them in the bill. Nice. Our insurance carriers though, and their CEOs, can be held accountable for losing your company’s business or by conducting disreputable activities, can be called before Congressional hearings and the news media, and are already held accountable by the laws that “We The People” established and can continue to establish through Congress. If you remove the private companies whose interest is in shareholder return – which by the way is part of what pays dividends on retirement investments – then you only have Congress and bureaucrats to complain to. This is akin to letting the fox run the hen house.
    Our federal government was established under the Constitution to be a system of checks and balances to avert one group (the President, Congress, or Supreme Court) from having too much power. It’s reference to “We The People” is put prominently in the beginning on purpose to reinforce that it’s the people who have the final authority. However, if you grant Congress the right to hijack private industry like healthcare, you grant them more power than the Constitution intended. If you think that they’ll stop at healthcare, you are a fool. Power begets power. They’re already criticizing the banking system – a system established under the FDR administration to recover from the Great Depression. These are conditions establishing socialism. Hitler was no radical conservative. He was a socialist. Look up NAZI in the dictionary. The difference in his politics is that he used the military to intimidate his political enemies. This group in Congress knows that the real power in America is in controlling the money. So even though Congress has less than a 35% approval rating from Americans, Congress and the President demonize the companies who provide us with jobs, innovation, healthcare benefits, and the opportunity to improve our lives – benefits that the Federal government cannot offer using legislation or its control of our tax dollars. You’re buying into the bs of the biggest snake oil salesman ever created – the politician. The Germans & Italians in the 1930’s bought into the same bs and look where it got them. Oppression and subjugation. We are headed down the same path, just under different mechanisms. Our tax dollars are the Holy Grail to career politicians. You think that I’m an alarmist painting an unrealistic picture? Do a little review of history and you’ll see that I’m correct.
    What we need to do is pass term limit laws to keep politicians from making a career of public service so they can have such absolute power. Wake up.

  8. jlg I see you don’t know anything about insurance and just regurgatate the crap your feed. Not sure what they based this on but it doesn’t appear to include non state sponsored plans. i.e. in Nevada the local chamber sponsors a guarantee issue plan for small businesses. In Ohio they have health something pools sponsored by an organization with another primary purpose like a chamber that is exempt from premium tax. There are all sorts of options out there, proof that we don’t need government to solve this we just need government out of the way.
    Paolo her son is covered by her husbands group policy so everything I said was true. Her sob story and gripes was nothing but lies and propoganda. If this is really such an important deal why does the left lie about everything? Why can’t you have an honest debate of facts instead of making stuff up that isn’t real. Her son is guaranteed access to insurance for life as long as be plays by the rules, that is the fact.

  9. “Just occasionally we get a really heartfelt comment on THCB that is passionate and rational, and reminds us why for all the bile spewed about the topic the essential part of the health care bill”
    I would argue that we get those more than “occasionally”…

  10. Kim, your post is right on.
    The taxpayer should help provide a basic and humane level of care to all those in need along with strict supervision to ensure that the money is spent wisely. Then, people who can afford more can spend as much as they want on health care as long as it’s with their own money.
    Instead, we have a system where some groups of people get unlimited amounts of wasteful care (and feel entitled to it) at the expense of others (usually the taxpayer), while others get almost no care at all.

  11. ** Nate said: “Since HIPAA passes as long as you don’t have a 60+ day gap in coverage you are guaranteed the ability to buy insurance. Your entire BS sob story doesn’t hold water.”
    Not true. HIPAA only provides portability when moving to/from group insurance. HIPAA does not provide portability between individual policies. If you are chronically ill and your individual policy raises premiums (or treats you poorly), you are stuck with it, forever. No federal law helps you transition to another insurer.
    Of course, you could get a job that provides health care, or you could get a job that pays billions, or you could win the lottery. That would solve the problem. Realize, however, that not everyone who is seriously ill is in the position of getting a good job with benefits.

  12. The dilemma faced by CF mother, and even more by her son, is very real, very troubling, and shared by numerous others. Health care reform must address such situations. HOWEVER, any time one person knowingly is going to have other people subsidize their expenses — those other people could be other taxpayers, other insured people, etc. — then it is unrealistic to not expect that those other people will want/expect to have some say over how their money is being spent and how much of their money it will take. Calling them evil while taking their money seems like piling on.
    Among the many things our health system does badly is figuring out how to help people budget for predictable expenses versus unpredictable ones. People have developed an entitlement mentality that all of their expenses should be paid for…and by the invisible someone else.
    We all need a better understanding of where the money in our health care system is coming from…it is always us (or our grandchildren). We should spend it prudently.

  13. What a shock lies and more ignorance.
    “will prevent insurers from dumping people with pre-existing conditions”
    Insurers haven’t been able to “dump” people with conditions for 15 years. Your lack of knowledge of even basic facts is why you think the current bill will accomplish anything when educated people know it won’t.
    Since HIPAA passes as long as you don’t have a 60+ day gap in coverage you are guaranteed the ability to buy insurance. Your entire BS sob story doesn’t hold water.
    I would never want to buy insurance from a company that doesn’t have pre-exisiting limitations. That would mean they are open to people gaming the system and waiting till they are sick to buy coverage sticking honest people like me with the bill.
    “He must shape his future not according to his dreams and ability, but in ways that will ensure that he keeps his health insurance.”
    OMG your poor son has to take personal responsibility for himself that is terrible. He can’t travel the country following is faviorte band and live off the public and stick those without dreams with his bills? Wake up is called being an adult, do you think garbage men dreamed of growing up to collect trash? Tens of Millions of people get up every day and go to jobs that pay the bills and provide insurance.
    Or he takes COBRA for 18 months or possibly 36. Then he buys a state HIPAA plan or very likly a conversion plan. I notice you leave out the simple solutions that don’t support the sob story.
    “Do you realize that the current system discourages small business development”
    more BS ignorance. Name a state that doesn’t have small group reform allowing small employers to buy affordable coverage. Almost every state has guarantee issue community rated plans as well. Finally if you had the slightest idea what you where talking about you would be thanking Democrats for that, for 15 years they have blocked AHPs to protect the unions. If affordable insurance for small business was so important why have liberals blocked it for so long?
    “The private sector only responds when an overwhelming PR campaign appears on the horizon. ”
    Lynn apparently you have never heard of Medicare. That big plan your trusted politicians run that didn’t add drug coverage until 2006. The one that loses 10% of every dollar to fraud and waste becuase it is so well managed by your politicians. Oh and Medicaid, that is a gem of a policy can’t wait for us all to get that. Everyone but your trusted politicians of course.
    The problem is how liberals lie and kill straw men.
    The right is against reform – lie, we are against the terrible bill you call reform and for reform that would actually improve things
    Insurance companies are evil and cancel peoples policies when they get sick – lie
    honest hard working people like my son that have an illness can’t get insurance when they did nothing wrong – lie HIPAA solved that over a decade ago
    The left can’t have an honest debate about the issue then wants to cry when we disagree with their “solutions”. Wake up Medicare and Medcaid are financial failures bankrupting the country, the last thing we need is to expand upon liberal failure

  14. I’m very conflicted on the current health reform bill.
    On the one hand, the Senate bill does substantially expand coverage and prevents some of the selection games that insurance companies play.
    On the other hand, the Senate bill does not adjust the health care market in any fundamental way, leaving the same upwards cost drivers intact. People are still incentivized to over-insure, doctors are still incentivized to over-utilize, and insurance companies still have no real reason to contain costs.
    In addition, we can expect insurance companies to raise their premiums at a faster rate due to reform. Payers engage in selection games not because they are evil, but to control costs – remove their ability to do so and insurance costs will rise faster. Employer groups, in turn, will pass on the increases in premiums to employees – either directly (by decreasing the percent they cover) or indirectly (by slowing salary growth).
    What we can expect from reform then is that some will be helped but at great cost to many. At what point is the price too high? At what point would it be better to sacrifice a few for the good of the many? The answer is not clear. But what is clear is that health care costs are gradually beggaring us all.
    Personally, I would have greatly preferred to side-step the moral issues entirely by going directly after the cost drivers in health care: our fragmented delivery model, monopolistic provider contracts, and poor public health. Controlling costs would help almost everyone, and would eventually free up the capital to expand coverage. We’d get to the same place, but without actively harming large swaths of the population in the process.
    That’s not the bill we have though. We’ve got a bill that expands coverage but avoids making any tough decisions, focusing on hiding costs rather than containing them.
    Some say that despite its flaws we should support reform because it will help a few people. But I fear that in the end, health reform will do more harm then good by allowing the day of reckoning to be postponed. We will still desperately need to tackle costs, and until we have the political will to do so health care will continue to sap away our national resources at an extraordinary rate.
    This reform bill will make it easier to ignore our problems, which I fear is exactly what we will do. Hence, in the end, I cannot support it, although I reject it with a heavy heart.

  15. Mr. Chapman: Where are you most likely to find a compassionate exception, via the public sector or a private insurance financial giant? I have more faith in getting exceptional care via my Congressman or Senator than the CEO of the local BCBS or United Healthcare. The private sector only responds when an overwhelming PR campaign appears on the horizon.
    Covering everyone and changing our perverse incentives won’t hamper our creativity and innovation. With health security I expect more for unexpected sources — people no longer trapped in deadend jobs because they need to maintain their employer provided health coverage.

  16. I used to be against the reform bill as a physician because it did not do enough. Now, due to the constant drilling of politics into my head by everyone, I realize that we have to trick people into letting go of their oversized piece of the financial pie. Those guys with 97% of the money worked long and hard to cheat people out of that money and won’t let go without a fight. Slow progress is better than no progress.

  17. I agree with everything Diligence had to say. However, without the public option, Congress needs to take out the mandate! Forcing us to buy expensive health insurance coverage from private companies makes this bill a political football.

  18. The point is, though, that there is only one health care bill before Congress that has a chance of passing. It has become an ugly political football, but there is real change included in the bill, like a ban on rescission and consideration of pre-existing conditions. It does expand coverage to millions of people who currently are not covered. And there is nothing preventing future Congresses from making changes to it… except political weakness that in this current environment requires 60 votes in the Senate to pass anything meaningful.

  19. Dear CF Mother,
    I am in agreement with medinnovation. Having spent years working in government, the type of reform being advocated is not only irresponsible, but financially devastating to an economy that thrives on innovation and creativity, both of which are in short supply in the federal government.
    What is needed is a focus on specific areas of the payment provider component, research & development, and legal components. It’s been said that 85% of people like their health coverage, but it’s not a perfect system and it needs improvement – not to be thrown out as Congress, in its infinite “wisdom” is rushing to institute. If your child were deemed by some government bureaucrat to be ineligible for some currently received service or could not be seen during an emergency, who would you complain to or run to for that matter. They have rules, regulations and policies to follow. There’s no compassion in politics – only who wins and loses.

  20. medinnovation,
    Just curious, what sort of health reform are you for?

  21. Dear CF Mother:
    Everybody I know is for health reform. Certainly I am. I am just not for the health reform being offered. I think your son should get the care he needs. And we need to reform the system so he does.