Medicare and Medicaid
Health Care Savings in CBO Mirror Are Larger Than They Appear
Published August 26, 2009 @ 11:24PM PT
The Congressional Budget Office is the “umpire” for legislation moving through Congress, including health care. But they’re not staffed by Nostradamus. An Op-Ed in today’s New York Times reminds us, their predictions about savings and costs for health care provision have a bad habit of being quite wrong.
What do I mean by calling the CBO the “umpire”? Anyone proposing legislation, be they Republican or Democrat, must have their bill scored by the non-partisan battery of accountants and economists, who will report on a.) whether the bill is “paid for” or not, and b.) if it’s not paid for, by how much will it increase the deficit. You can either pay for a bill by creating new revenue or by achieving savings. Of course, proponents of the bill will always tell you proposed savings are a sure thing while opponents of the bill will accuse the authors of being unrealistically optimistic. The CBO’s role, then, is critical – whatever numbers they score the legislation at, that’s the number both sides have to use, whether they like it or not.
But much like the use of an instant-replay “pitch tracker” on baseball TV broadcasts has made us all aware of how often umpires get the call wrong, so the Op-Ed by Jon Grabel of the University of Chicago. His thesis: “In each of the past three decades, when assessing major changes in Medicare, it has substantially underestimated the savings the changes would bring.”
- In the 1980s, a change in the way Medicare reimbursed hospital admissions was supposed to be $10 billion over 3 years. Instead, the savings in 1986 alone were $11 billion.
- In the 1990s, as part of the Balanced Budget Act of 1997, a change for reimbursement for skilled nursing facilities and home health care services, and new investments in fighting fraud in Medicare were supposed to yield modest savings. Instead, they “Medicare spending fell so much that Congress increased payment levels to hospitals and other providers in 1999 and 2000.”
- And of course in this decade, the CBO’s projection on increased costs through Medicare Part D’s prescription drug program have been spectacularly wrong – they overestimated by 40%.
Many are looking at the health care bills coming out of the House and the late Senator Kennedy’s committee through the lens of the CBO’s projections for savings. This is only natural, since long-term cost containment is a critical component of health care reform and a lot of the cost is tied up in investments like comparative effectiveness research, primary care, Health IT and other items that have dramatically brought down costs for the VA and other countries.
But don’t be dismayed if CBO seems to be low-balling the savings we can expect. If history is any guide, the savings in the mirror are closer than they appear.
(Photo credit: JoelZimmer on Flickr.)
Canada's Rebuttal to Our Health Care Ghost Stories
Published August 25, 2009 @ 04:17PM PT
For the country that gave us William Shatner, Wayne Gretzky, and Celine Dion, Canada sure turns into a punching bag quickly whenever we talk about reforming American health care. All of a sudden, we hear about the horrors of Canadian socialized medicine (even though, since hospitals and doctors are mostly private, Canada doesn’t even have socialized medicine – they have single-payer, which only deals with financing.) Somehow, all the scary stories – most of them debunked long ago – surface even when we’re not talking about following the Canadian model at all. Well it seems our brothers and sisters to the north have a message for us about the difference between Canadian and American health care.
It can be summed up as, “Knock yourself out – as far as we’re concerned, the joke’s on you!”
Let’s make one thing clear. The health care bills moving in Congress would leave about 160 million Americans right where they are in employer-sponsored insurance, and add about 20-30 million more people into a transparent marketplace (the Exchange or the Gateways) where they’re given subsidies to purchase insurance sold either privately or publicly. That’s the structure that people are yelling about – one that leaves maybe 160, maybe 185 million Americans in private insurance. We can and will debate that, but let’s be honest: it really looks nothing like the health care system in Canada.
What does look like Canada is the health care system that every American over 65 enjoys – and which it seems Republicans are heavily resistant to change (today, at least). Who knew there’d be so much American love for single-payer health care?
Betsy McCaughey, Meet Jon Stewart
Published August 21, 2009 @ 08:11AM PT
Betsy McCaughey, the paid board member for medical device companies and former lieutenant governor of New York who has made her political career on doing “close readings” of health care legislation that scare the living bejeesus out of the general populace, was on Jon Stewart last night. Those with a low tolerance for flapdoodle should avoid the following:
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Exclusive - Betsy McCaughey Extended Interview Pt. 1
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Two observations:
This absolutely was not the medium for the McCaughey style of argument. In a 700 word editorial for the NY Post, she can make a claim, cite the bill, and explain what it “really means” without ever being asked to explain how her assertion relates to the original. Hence she’s able to take a provision that’s intended to make sure that end-of-life directives are followed (including, as Jon Stewart notes, if that directive is “keep me alive by any means necessary”) connect to people on Medicare being denied or delayed on hip surgeries, living in pain, etc. It becomes absolutely clear that her citations in the bill are a means to the end. What she really wants to talk about is the emotional fear of being denied the care you need when you’re in pain, something those of us with HMOs are all too familiar with but Medicare beneficiaries generally are not. Finding a small provision in a bill that most people agree with – heck, if I had an end-of-life directive and the doctor didn’t follow it, you bet I wouldn’t want him/her to get paid full price – and using a leap of logic to get to an unconnected fear works in print, but it doesn’t work when you have someone in front of you saying, “Wait, that’s not what this says.”
Second, this is “mushroom cloud” logic. It’s all absolutes where all cuts to Medicare have equal weight and you’re left with a stark choice – invade Iraq or have St. Louis nuked. It turns out that wasn’t the choice there, and it isn’t the choice here, either. Cutting overpayments to insurance companies for Medicare Advantage will result in denied profit margins, not denied care. Reducing a payment rate for MRIs which was set when we believed they’d be in use half of the time because we now realize they’re in use 80% of the time or more won’t lead to my grandmother being denied her MRI when she needs it. (Indeed, the worry I’ve heard is that it will cause doctors to prescribe even more MRIs, whether necessary or not).
But let’s give McCaughey a taste of her own medicine. In this clip, she doesn’t want to see Medicare get cut at all, or any treatment denied at any time, no matter the cost and no matter the evidence. She also wants, as she says, for the uninsured to be subsidized. So the question is why does McCaughey want us to devote the entirety of the federal budget to unlimited health care for the entire population at a time of war? If you never deny any care for any reason and cover everyone, as she suggests, clearly health care will jump from 20% to 50% of our budget next year. I love this country too much to see our Department of Defense downsized so radically during a time of increasing danger around the globe. What good will our unlimited MRIs for every age and health condition be when North Korea launches nuclear missiles against us?
Yes, this is preposterous logic. So is McCaughey’s.
Rushing Health Care Legislation
Published August 15, 2009 @ 10:53PM PT
It’s not hard to get a health care bill passed in Congress, provided you want it in the worst way.
The recipe: take a presidential candidate’s plan to address a big problem that directly affects millions of Americans, but on which the two parties irreconcilably disagree on the solution. Then adapt the overall principles from the campaign plan but largely ignore the details – start from scratch. Construct a bill hundreds of pages long largely in secret and with the heavy influence of lobbyists, particularly from Big Pharma. Also, make it as broad and expansive as possible – pile lots of other goodies that you wouldn’t suspect in there. Then get Congressional leadership to put their foot on the accelerator. Bypass the committees, and severely curtail any chance of amendment or debate. Pass it in both houses of Congress as soon as possible, using every parliamentary trick at your disposal to get it signed off on before anyone – including the public – has had a chance to read the bill, let alone discuss it.
I am, of course, describing the Medicare Prescription Drug and Modernization Act of 2003, which gave us the Medicare Part D prescription drug plan. Then-Governor George Bush had proposed a subsidy for Medicare seniors to go out and buy a private prescription drug plan, with some caps out-of-pocket expense. The whole plan was supposed to cost $158 billion over 10 years. But the bill that emerged in 2003 only partially set up the large and ultimately confusing bureaucracy to carry out President Bush’s model of subsidies for private plans. It was chock full of giveaways to the pharmaceutical companies in the form of waiving the ability for the government to negotiate for the best rates, providing a big subsidy for employers who were paying drug costs for retirees already, and creates an unexpected “donut hole” where Medicare patients would see their coverage cut off entirely at a certain dollar value and not resume again until they had paid an even larger dollar amount in out-of-pocket expenses. At least half of this bill has nothing to do with prescription drugs. It restructures and expands the deal with HMOs for Medicare Advantage plans, allowing them to market to seniors and get paid 14% more per beneficiary, all of of the taxpayers' pockets. Finally, the CBO said the final price was actually $372.5 billion over 10 years – more than double the Bush campaign proposal – and every dollar of that would add to the deficit.
But no matter what you think the merits or problems of the Medicare prescription drug plan have been, the process stunk. The bill was 600 pages long. It was submitted on the House of Representatives on a Wednesday. It bypassed any and all committees of jurisdiction and went right to floor for a maximum of 3 hours of debate. One Congressman put forward a motion to at least get it reviewed by a committee, but that motion was squashed. The bill passed at 2:30 in the morning on Friday, meaning it couldn’t have been available to members of Congress for more than 50 hours before the $372.5 billion bill passed. How many representatives do you think read all 600 pages? How many read any? Congress broke for the 4th of July. When they came back, the Senate passed the bill on the same Monday they received it from the House, with a few amendments.
Including days off for vacation, the whole process for the largest expansion of government health care obligations since the creation of Medicare and Medicaid in the 1960s had taken 13 days to pass the House and Senate.
That, my friends, is what cramming a bill down our throats looks like.
Contrast that with the reform bills moving in Congress. The Senate Health, Education, Labor and Pensions bill was worked on in committee for 38 days after the bill was released, and hundreds of amendments from Republican and Democratic Senators got an airing and a vote. It’s now hanging out, waiting for the Senate Finance Committee to complete its work, meaning we’re likely talking about at least a hundred days before it reaches the Senate floor. The House bill has gone through even more committees – three separate committees had public mark-ups and hearings, each with dozens of amendments from members of both parties getting a hearing and a vote. The most optimistic projection would be the bill would have been public for 87 days before a full House vote could take place. (And if the rules limit HR 3200 to a mere 3 hours of debate, I will not only be shocked but call Congress myself to complain.) Suffice to say, nothing like the town halls – where provisions of health care reform are getting a both a loud and public airing – happened for Medicare Part D.
And no matter what you think of the policies of HR 3200, the health insurance reforms and regulations, the Health Exchange, the establishment of minimum level of benefits, the creation of subsidies for low- and middle-income Americans to make coverage affordable, and the public health insurance option are all to be found in Senator Obama’s campaign health care plan.
GOP political spin-master Alex Castellanos came up with the tactic of pretending Congress is rushing reform, with the implication that they’re getting it wrong. But let’s not kid ourselves – that’s a political talking point, not a description of an actual precipitous rush to throw process out the window in order to pass a bill before dissent can be registered and the surprise details come to light.
We know what that looks like. This ain't it.
(Photo credit: amarine88 on Flickr.)
Top Five Health Care Lies -- and How to Fight Back
Published August 12, 2009 @ 10:44AM PT
[Editor's Note: This guest post from Nita Chaudhary, Campaign Director at MoveOn.org Political Action, tackles a number of the strangest fabrications about the health care reform proposals moving in Congress, as well as a bevy of primary sources so you can read and decide for yourself. It was originally posted here.]
The health care fight has turned ugly, fast. And lies about reform are spreading via anonymous email chains. Here are the real facts that you need to know:
Top Five Health Care Reform Lies—and How to Fight Back
Lie #1: President Obama wants to euthanize your grandma!!!
The truth: These accusations—of "death panels" and forced euthanasia—are, of course, flatly untrue. As an article from the Associated Press puts it: "No 'death panel' in health care bill."1 What's the real deal? Reform legislation includes a provision, supported by the AARP, to offer senior citizens access to a professional medical counselor who will provide them with information on preparing a living will and other issues facing older Americans.2
If you'd like to read the actual section of the legislation that spawned these outrageous claims (Section 1233 of H.R. 3200) for yourself, here it is. It's pretty boring stuff, which is why the accusations that it creates "death panels" is so absurd. But don't take our word for it, read it yourself.
Lie #2: Democrats are going to outlaw private insurance and force you into a government plan!!!
The truth: With reform, choices will increase, not decrease. Obama's reform plans will create a health insurance exchange, a one-stop shopping marketplace for affordable, high-quality insurance options.3 Included in the exchange is the public health insurance option—a nationwide plan with a broad network of providers—that will operate alongside private insurance companies, injecting competition into the market to drive quality up and costs down.4 If you're happy with your coverage and doctors, you can keep them.5 But the new public plan will expand choices to millions of businesses or individuals who choose to opt into it, including many who simply can't afford health care now.
Lie #3: President Obama wants to implement Soviet-style rationing!!!
The truth: Health care reform will expand access to high-quality health insurance, and give individuals, families, and businesses more choices for coverage. Right now, big corporations decide whether to give you coverage, what doctors you get to see, and whether a particular procedure or medicine is covered—that is rationed care. And a big part of reform is to stop that.
Health care reform will do away with some of the most nefarious aspects of this rationing: discrimination for pre-existing conditions, insurers that cancel coverage when you get sick, gender discrimination, and lifetime and yearly limits on coverage.6 And outside of that, as noted above, reform will increase insurance options, not force anyone into a rationed situation.
Lie #4: Obama is secretly plotting to cut senior citizens' Medicare benefits!!!
The truth: Health care reform plans will not reduce Medicare benefits.7 Reform includes savings from Medicare that are unrelated to patient care -- in fact, the savings comes from cutting billions of dollars in overpayments to insurance companies and eliminating waste, fraud, and abuse.8
Lie #5: Obama's health care plan will bankrupt America!!!
The truth: We need health care reform now in order to prevent bankruptcy—to control spiraling costs that affect individuals, families, small businesses, and the American economy. Right now, we spend more than $2 trillion dollars a year on health care.9 The average family premium is projected to rise to over $22,000 in the next decade10—and each year, nearly a million people face bankruptcy because of medical expenses.11 Reform, with an affordable, high-quality public option that can spur competition, is necessary to bring down skyrocketing costs. Also, President Obama's reform plans would be fully paid for over 10 years and not add a penny to the deficit.12
P.S. Want more? Check out this great new White House "Reality Check" website: http://www.whitehouse.gov/realitycheck/ or this excellent piece from Health Care for America Now on some of the most outrageous lies: http://www.moveon.org/r?r=51729
Sources:
1. "No 'death panel' in health care bill," Associated Press, August 10, 2009. http://www.moveon.org/r?r=51747
2. "Stop Distorting the Truth about End of Life Care," Huffington Post, July 24, 2009. http://www.moveon.org/r?r=51730
3. "Reality Check FAQs," WhiteHouse.gov, accessed August 11, 2009. http://www.whitehouse.gov/realitycheck/faq#i1
4. "Why We Need a Public Health-Care Plan," Wall Street Journal, June 24, 2009. http://www.moveon.org/r?r=51737
5. "Obama: 'If You Like Your Doctor, You Can Keep Your Doctor,'" Wall Street Journal, 15, 2009. http://www.moveon.org/r?r=51736
6. "Reality Check FAQs," WhiteHouse.gov, accessed August 10, 2009. http://www.whitehouse.gov/realitycheck/faq#r1
7. "Obama: No reduced Medicare benefits in health care reform," CNN, July 28, 2009. http://www.moveon.org/r?r=51748
8. "Reality Check FAQs," WhiteHouse.gov, accessed August 10, 2009. http://www.whitehouse.gov/realitycheck/faq#s1
9. "Reality Check FAQs," WhiteHouse.gov, accessed August 10, 2009. http://www.whitehouse.gov/realitycheck/faq#c1
10. "Premiums Run Amok," Center for American Progress, July 24, 2009. http://www.moveon.org/r?r=51667
11. "Medical bills prompt more than 60 percent of U.S. bankruptcies," CNN, June 5, 2009. http://www.moveon.org/r?r=51735
12. "Reality Check FAQs," WhiteHouse.gov, accessed August 10, 2009. http://www.whitehouse.gov/realitycheck/faq#c1
Sources for the Five Lies:
#5: "Obama's 'Public' Health Plan Will Bankrupt the Nation," The National Review, May 13, 2009. http://www.moveon.org/r?r=51744
#1: "A euthanasia mandate," The Washington Times, July 29, 2009. http://www.moveon.org/r?r=51732
#2: "It's Not An Option," Investor's Business Daily, July 15, 2009. http://www.moveon.org/r?r=51743
#3: "Rationing Health Care," The Washington Times, April 21, 2009. http://www.moveon.org/r?r=51742
#4: "60 Plus Ad Is Chock Full Of Misinformation," Media Matters for America, August 8, 2009. http://www.moveon.org/r?r=51734
(Photo credit: matthileo on Flickr. Please note, image not used in MoveOn's original post.)
Hating Government Health Care (Except for the "Loving It" Part)
Published August 05, 2009 @ 11:02PM PT
I first saw this on Paul Krugman’s blog, but you’ve probably already seen a gazillion similar reports:
At a recent town-hall meeting in suburban Simpsonville, a man stood up and told Rep. Robert Inglis (R-S.C.) to “keep your government hands off my Medicare.”
“I had to politely explain that, ‘Actually, sir, your health care is being provided by the government,’ ” Inglis recalled. “But he wasn’t having any of it.”
But it's not just folks off the street. The award for “item I’ve been emailed the most this week” goes to a video of supply side economist Arthur Laffer on CNN. His unironic proclamation: “If you like the Post Office and the Department of Motor Vehicles and you think they're run well, just wait till you see Medicare, Medicaid, and health care done by the government.” Hm, clearly there is some confusion on this point.
Please consider this a public service announcement.
Medicare is a single-payer health care system, paid for and run entirely by the government. So we don’t need to wait to see it done by the government because it’s, well, already being done by the government. How does it stack up? Well, thanks to a survey by the Commonwealth fund, we can tell you. For starters, “Medicare beneficiaries are sicker and poorer but report fewer medical bill problems,” which, if you think about it, is quite the trick. They are much less likely to have their care denied, made unaffordable or, if you prefer, “rationed” (12% for Medicare vs. 26% for employer-based insurance). They have an easier time finding a doctor (10% report their physician didn’t accept their coverage vs. 17% for employer-based insurance). Indeed, part of the problem with Medicare’s fiscal outlook isn’t just that health care for all payers has gotten more expensive, it’s that Medicare makes it perhaps too easy for doctors and hospitals to make money hand over fist for specialist care. Still, the average annual rate of growth for Medicare (8.8%) is less than that for private insurance (9.9%).
But yeah, government-run, government-funded. We’d keep the government’s hands off of it but, well, they’ve kind of already been there for 44 years.
Oh, but it gets worse, I’m sorry to say.
There’s a health care system operating in the United States that for the past 7 years has beat both Medicare and private insurance in customer satisfaction surveys run by the American Customer Satisfaction Index; a system which the New England Journal of Medicine compared to Medicare on a broad range of health indicators, from preventative care to chronic care to inpatient care to outpatient care, and found it beat Medicare in 12 of 13 categories. When the American health care system cost $6,300 per person in 2006, this health care system cost only $5,000 per person. Indeed, when it was suggested that more of the patients using this payer be shifted to private insurance, with all of its supposed advantages, there were howls of protests, a frequent use of the word “betrayal,” and a bald declaration in a Wall Street Journal Op-Ed that, “This plan is as unfair as it is unnecessary.”
This would be the Veterans Health Administration or “the VA” – paid for and operated by the government.
Both of them are substantially more government-controlled and -influenced than any proposal currently in Congress or the White House, since those bills would preserve at least 160 million people in employer-based insurance plans. Medicare is a single-payer system, supported entirely by tax revenue in a way the public option will not be – a sore spot for progressives and single-payer advocates, but true nevertheless. The VA is true socialized medicine. We’re talking full-bore “doctors and hospital staff are government employees,” “track which treatments work and which don’t,” “actually bother to negotiate for bulk prices with Big Pharma without a perusal of Pfizer’s current stock price” socialized medicine. That’s the system that it would be "betrayal" to migrate folks from.
So we hate government-run insurance. We do. Unless we already have it, at which point you’ll have to pry it away from us with a crowbar.
(Photo credit: Chuckumentary on Flickr.)
How Many More Have to Die Before We Fix Health Care?, Part 2
Published August 03, 2009 @ 09:58PM PT
Between the work of the Institute of Medicine and the nonpartisan Urban Institute, we know that between 18,000 and 22,000 people die each year for no other reason than because they didn’t have health insurance. It’s a staggering number considering so many of those deaths could have been prevented. Each one of those numbers is a name. Each one of those names was a family member, a friend, a co-worker, a student, a person. For each of them, reforming health care so more people could afford to get the treatment they need when they needed wasn’t something politicians were rushing.
In fact, if we succeed this year, it will still come too late.
Angel “Inqy” Yates was an incredible artist with a stirring imagination (you can see her portfolio here). She created a whole mythology of a post-World War III world for her series of Web-based comics, entitled “Wicked Alchemy.” A small group of devoted fans knew she was gifted. What they probably didn’t know was how many balls she was juggling at once. As learned in a cartoon tribute by one of her instructors, “Even though she took a full course load, worked a full-time job, raised a family, and worked as a freelance artist, she always raised the bar and excelled in every course I had her in.”
This June -- less than 2 months ago -- she graduated, got her degree, and began working full-time doing what she loved. She was in a situation common to artists – without health insurance from her employer and without enough money to buy her own plan. In a note to her fans on her Web site – the last such note she would write – she revealed a new problem:
I'm also having odd health problems, which make me exhausted for no reason whatsoever. Hopefully.. hopefully.. we'll find a house soon, the health problems will go away on their own (since I have no health insurance at the moment to otherwise deal with them), and free time will return to me. It's going to be a long summer.
That was her public face. On her personal blog, she was confused and frightened by her health problems, but didn’t have the money or the insurance to see a doctor.
After a month and a half, it grew to the point of being winded by even smaller walking spurts. I could climb two flights of stairs, but my chest felt as if someone were crushing it from all sides, and I couldn't get enough air. Which was silly, because I'd be listening to myself breathe hard, and the air was coming and going, it's just as if my lungs weren't registering that. It's a very hard thing to describe... Not like chest pain, although my chest hurt unbearably. Not like heart problems, although my heart would be pounding in my ears. Not like asphyxiating, since the air was coming and going. But for some minutes after exerting myself over two lousy flights of stairs, I could do nothing but stand there and gasp and pant heavily….
I just don't know what to do. I really don't... Can it still be from stress? I still have plenty of it... I graduated, and got a job, and things are falling into place. But there's still so much to worry about... the lack of health insurance, for one thing, or that I'm away from my family for five days a week, or all the driving I do every day, or the crack in my windshield, or trying to find/buy a house...
She had a whole new life ahead of her. Things were falling into place. But the health problems did not go away, the answers didn’t come, and Inqy died on July 7.
One last story.
Eric De La Cruz lived in Las Vegas, came from a loving family and had a good future. What he didn’t have was health insurance. At only 22, he was diagnosed with severe dilated cardiomyopathy, which is primarily a genetic condition – he didn’t ask for it, didn’t do anything to deserve it. The remedy was as severe as it gets – a heart transplant at a relatively young age. In addition to the intense preparation and the arduous nature of transplant surgery, it’s literally a life-changing experience. Transplant recipients need to be on medication to suppress the immune system to prevent their bodies from rejecting the foreign organ. The lifestyle changes are permanent and daunting. And because heart transplants are still relatively infrequent – only around 2,000 per year -- the frustration and uncertainty for families is stressful beyond measure. However, there is good news. As explained on About.com, “Today, almost 90% of heart transplant recipients survive for at least one year after transplant, and up to 75% survive for five years.”
Because of his relative youth, Eric had excellent prospects, as daunting as his health challenges would be. But what he didn’t have was health insurance through his employer, compounded by his being a student. The small business he worked for simply couldn’t afford it. So before he could fight for his life, he had to fight for the opportunity to fight for his life.
You can guess some of what followed – he could not buy insurance now because he had a pre-existing condition. Even if he had miraculously found a plan that would take him, he would have been charged a prohibitively expensive premium based on health status. By shedding his assets and giving up on working, he was able to qualify for Medicaid but, as we know all too well, Medicaid is a hybrid federal-state program. Normally that wouldn’t make a difference – but there are no transplant centers in Nevada. None. In order to be covered for transplant surgery in California, he needed to apply for Medicare coverage with his heart condition as a disability. Medicare is a program designed to give wonderful care to seniors over 65. It gives decent care for those with disabilities. But a heart condition in need of a transplant meant that Eric didn’t get the care he needed. Instead, he got more red tape than he could deal with as he was rejected for Medicare – twice. He appealed one more time – the appeal took over a year to be heard, a year during which his heart function continued to deteriorate.
Eric’s family did what any of us would hope our family would do for us – they fought. Hard. Eric’s sister Veronica, a CNN reporter who had specialized as an Internet correspondent, following the latest stories in social media, took his story public and turned to Twitter for support. You can still follow Eric’s Twitter Army using hashtags #Eric and #ETA, or at www.WeLoveEric.com and www.Tweet4Eric.com. Unlike your average transplant patient, the De La Cruz family had harnessed the Internet, and people they had never met created petitions, web sites and grassroots communities to rally support.
He got his Medicare coverage after all, but the hospital refused to accept Medicare only – they needed supplemental insurance. They wouldn’t admit him. Despite the well-known fact that no hospital can turn someone away, Eric was a state away and could not be taken off IVs. If the hospital didn’t send a transport for him, he could never get there. So they began to raise the money, attracting the attention of singer Trent Reznor and popular rock band Nine Inch Nails.
Eric had tremendous advantages not available to most in this country. He had a sister with connections who was willing to move heaven and earth to give her brother a new heart. He had a community of strangers who loved, supported and raised money for him on Twitter and on the Web. He had celebrities rally to his cause. He raised nearly $900,000 in two weeks. But it was all too late. Eric passed away on the 4th of July.
What the hell does it say about the state of health care in America that all of that wasn’t enough to get him the care he needed to stay alive when he needed it?
If we had HR 3200 10 years ago, Eric would never have had to even look at Medicare or Medicaid. He would have had quality health insurance, either public or private, either affordable (through a tax credit) for his small business employer to provide or affordable (through subsidies) for him to buy. He would have had guaranteed benefits that would never have been taken away and his catastrophic care would have been covered. Instead of raising a million dollars, he would have needed to raise 10% of his income for out-of-pocket expense.
If we had HR 3200 10 years ago, Inqy wouldn’t have had to worry about pinching pennies and worrying about how she would pay for car repairs or saving money for a house before seeing a doctor. Her primary care doctor’s visit would have had no co-pay. She would have had an insurance plan, public or private, that was affordable to her.
If we had single payer 30 years ago, neither one of them would have had to think of anything else except getting better. But we didn’t – we decided an industry’s profit and the libertarian impulse of individualism was worth more than thousands of human lives.
Remember their stories the next time someone tries to tell you an eight month long legislative process is moving too fast. Delay has consequences.
(Photo credit: stimpy89 on Flickr.)
