This is not an article about the pros and cons or the merits or lack of merits of the Republican-backed American Health Care Act recently passed by the House. Having not looked at it in depth, this writer feels uncomfortable endorsing it or dissing it until I have read more analysis on its costs to taxpayers, the costs to consumers, what it covers, etc. At this point, I do not care if it is Obamacare-lite, Trumpcare, Ryancare, or anything else. Instead, this is about four terms or phrases that need to be banned from the debate. Let’s start with:
Technically speaking, a pre-existing condition is a medical condition that existed before a person’s health insurance went into effect. As such, a consumer cannot, under Obamacare, be denied or discriminated against in price for having that pre-existing condition. A perfect example is diabetes. Prior to Obamacare, some insurance companies would not write policies or cover expenses related to a pre-existing condition. If I remember the debate over health care reform in 2009-2010, covering these conditions was a major tenet of Republican health care reform.
The question arises, why should I, being non-diabetic, be responsible for covering the expenses of the diabetic? The reason is simple: that is how insurance works. Take car insurance as an analogy. The premium the good drivers pay helps pay the costs of repairs to the drivers who actually get into accidents. I have car insurance and have never put in a claim because I have never had an accident in 30+ years of driving. Yet, I pay Progressive every month and those premium payments certainly pay for the repairs of cars that were in accidents.
Of course, if someone repeatedly has accidents, an insurance company can assume they are a risk and they can, when the renewal is up, increase the premiums on the “bad” drivers. And that is as it should be with health insurance which is where the idea of high risk pools enter the discussion. However, pre-existing conditions are often outside the control of the sufferer. A child born with a congenital heart defect is one such example.
The question is in the definition of a pre-existing condition and equally important the degree to which the sufferer is responsible for the condition. In some cases, diabetes is due to lifestyle and eating choices. Obviously, the child born with a congenital heart defect is at the mercy of nature. Hence, it makes perfect sense to be certain that the child with the heart defect and the care associated are covered without penalty while the diabetic who refuses to change their lifestyle to control their condition should pay more for their eventual care.
If Congress concretely describes what a pre-existing condition is, then it makes sense that insurance companies should cover the care associated and the costs diffused among the healthy population and, if absolutely necessary, have the government be a backstop in those efforts.
Before we rail about pre-existing conditions, perhaps we should concretely define the term first.
Let’s dispense with the niceties. When it comes to women’s health, the Left equates this with access to abortion services. Their objections have nothing to do with Pap smears, mammograms, maternal or neonatal care, or even contraception. It is abortion that motivates the Left to scare the living hell out of women.
Planned Parenthood is the number one provider of abortion services in the country. Under the AHCA, they are free to remain so. Denial of the annual $500 million subsidy they receive from the federal government will in no way create unhealthy women. Any plan under any insurance regimen would, if it is intelligent, cover the many things listed above because most of it is preventative which saves money in the long run. For example, it is cheaper to have a child vaccinated for chicken pox than to deal medically with chicken pox later.
If that money is diverted to certified community health centers of which there are many more than Planned Parenthood clinics, then women’s health- especially in vulnerable populations and areas- will actually be better served.
To those on the Right who complain why their insurance premium should help pay for the maternal or neonatal care of someone else, the answer is twofold. First, that is how insurance works. Secondly, providing maternal and neonatal care is pro-life. One cannot declare oneself “pro-life” only in the context of abortion. In fact, the opposite negates the basic tenet of the pro-life movement- that all life before birth to death- is precious and worthy of protection.
Democrats and their proxies in the media are quick to point out that the newest rendition of the AHCA was not scored by the Congressional Budget Office. Paul Ryan explained that it was and that the latest “improvement” is a 3-page amendment that likely will not change the original score.
Two points need to be made in this area. The first is the alleged 24 million people that will suddenly drop dead according to the hysterics on the Left. There are many people today without health insurance who live happy, healthy lives. Many of the “beneficiaries” of Obamacare are no more healthy today than they were before Obamacare. Are these 24 million people because states will be allowed Medicaid waivers? Are some of them counted as those who, absent a mandate, will suddenly decide to go without health insurance? Being that the bulk of those covered under Obamacare are actually covered under that law’s Medicaid expansion, is Medicaid reform the reason the CBO anticipates that 24 million will “lose” their insurance, or decide not to buy insurance? What if the new law actually lowers premiums and gives purchasers greater choice and leeway not allowed under Medicaid?
The second point is that the media and perhaps Congress places too much emphasis on the CBO. News flash: they have been wrong in the past. Computer models, numbers crunching and actuarial tables are a far cry from real life. With Obamacare, they underestimated not only the number of people eligible under Medicaid expansion, but also- more importantly- the associated costs. It’s a nice set of numbers to trot out, but it’s not sacrosanct!
Let me get the obligatory caveat out of the way upfront. We can all sympathize and empathize with the fact his child was born with a congenital heart defect. For the grace of God, hopefully not too many readers have had to deal with similar circumstances. And I am sure we all wish Jimmy Kimmel and his newborn child well.
With that out of the way- and not to appear cold- but since when should the anecdotal story/evidence of a late night talk show host who happens to make a seven-figure salary dictate public policy that affects 16% (at least) of the United States economy? That’s like Dennis Rodman dictating policy towards North Korea. For every sob story the Left trots out over the hysteria of a repeal of Obamacare, there are two or maybe more stories of people adversely impacted by Obamacare. I know because I am one of them as is my wife. My two-year experience under Obamacare was a nightmare with astronomical deductibles, a high premium even with a subsidy, limitation in choice of doctors forcing me to find a new one, not to mention limitations on the choice of plans (two insurers). And all for a person who has used his health care insurance exactly ONE time in the past 8 years! This year I opted for the tax penalty… it was cheaper.
With all due respect to Jimmy Kimmel, let’s leave his tears out of the discussion. Whether the AHCA is the answer remains to be seen. From personal experience, something has to be better than Obamacare.