My son was killed in a car accident 25 years ago this month. He was proud of my work for health reform so I cannot remain silent now as major changes loom. We live with a system that can be soul crushing wrong. We ignore it at our peril. Here’s why.
43 million people are driven into debt, bankruptcy or lose their home from medical costs. 43 million people is roughly the combined populations of Ohio, Illinois and Florida.
Only we don’t see their faces or combined numbers. Their stories are one at a time. News media too often turn away or feature just one heart rending story: “Medical bankruptcy? We did a story on Medical Bankruptcy last week.” I know. A reporter told me. All stories aren’t told, just trickles. There are no collective faces. We don’t see them as the massive group they are.
It is wrong that the Mississippi governor and legislature fought over whether or not to cut 13,000 Medicaid nursing home beds to balance the state budget in 2003. It’s true. I know. I called the Governor’s office to verify. The fact this was even considered is soul numbing.
In the end those cuts didn’t happen. But, we’re failing our citizens again if we repeal the Affordable Care Act and eliminate Medicaid expansion in those states that chose to expand their programs. Medicaid is for the poor and disabled–mostly for women and children. It is based on poverty. Poverty now—for one person—is $11,676/year. If your income is more then you are not eligible for Medicaid. Where in the US can you live on $11,676 a year?
Medicaid does cover some limited long term care. A parent or spouse with Alzheimer’s disease face monthly costs of $6,000 to $7,000 or more for the necessary nursing home or personal home care. That’s $72,000 to $84,000 per year. Medicare does not cover those costs. Long-term care insurance or families pay. Even long-term care insurance is often inadequate for the long term. Many people ‘spend down’ their assets to qualify for Medicaid. This means getting rid of your home and other assets.
Health savings accounts? How many of us earn enough to save $70,000 to $200,000 for heart surgeries or $100,000 plus for cancer treatments? Some cancer drugs are $10,000 to $30,000 per month.
But, it is not just catastrophic costs that harm people. Many who worked all their lives can’t afford their health care costs. I know one such person well. She was a secretary in an international law firm. Her salary was modest. Her social security and retirement are modest. Her diabetes costs are not. Between her mortgage, Medicare supplement premiums, other prescriptions and groceries, she cannot afford the $700/month insulin costs when she hits Medicare’s so called “Donut Hole.” Months without insulin could literally mean her death. She is not alone.
Our health care system is just flat out wrong for far too many people, not just the 43 million. That is the real “bottom line.”
Repeal the Affordable Care Act and more uninsured end up in hospital emergency rooms again. Hospitals raise costs again. Those costs are passed along to everyone again. Health savings accounts cannot possibly fix this scenario.
Ultimately it is not really the dollars that matter. What matters is that we as a nation have been willing to turn a blind eye, our backs and our moral compass on tragic human consequences of our health care system. We must deal with those consequences. We cannot walk away.
Nothing can bring back my son. But I can still advocate. Someone once told me: “Fate is the cards you are dealt. Free will is how you play your hand.” I write to play my hand. We repeal the ACA at our own moral peril. We must preserve it, improve it and not walk away from it. Flawed as it is, it is our best path forward for an effective and humane health care system.
Kathleen O’Connor (c), December 3, 2016