As many feared, putting band aids over our fragmented and totally broken healthcare system, would not magically make the problems any better.
And sure as night follows day, there's a new study entitled Medical Bankruptcy in Massachusetts: Has Health Reform Made a Difference? by David U. Himmelstein, MD, Deborah Thorne, PhD, and Steffie Woolhandler, MD, MPH, and the take home message is grim indeed.
1. Massachusetts’ health reform, enacted in 2006, served as the model for the 2010 nationwide reform that will not be fully implemented until 2014.
2. Although the Massachusetts reform has covered many of the uninsured, underinsurance remains widespread, and illness and medical bills still contribute to 52.9% of all bankruptcies in the state.The number of medical bankruptcies has not decreased.
3. The recently enacted national health reform is unlikely to adequately address the widespread problem of medical bankruptcy.
There's a reason why we call private, for-profit health insurance junk insurance, that's because, in order for the insurance corporations to maximize profits, they sell us bare bones coverage, which all too often is insurance in name only.
The Patient protection and Affordable Care Act is directly modeled on Massachusetts reform. In fact in Massachusetts, what reform has done is to take many of the previously uninsured, and make them UNDER-insured. That is, much of the new insurance is so skimpy that families can still be bankrupted when faced with a prolonged and expensive illness.
"People think they have reasonable insurance until they try and use it," Himmelstein said. "You are carrying an umbrella and it starts to rain and you put it up and it's full of holes. For most people, it just hasn’t rained yet."
Anyone who has ever faced even a minor health crisis, will be very familiar with what Dr. Himmelstein says. Those of us still able to afford the egregious price gouging, and who are still insured, think we will be covered if God forbid, we become ill. But then we discover huge gaps in our coverage--deductibles, co-pays, and all manner of medical services that we are expected to pay for on a first dollar basis. We discover after it's too late that our insurance has restricted our choice and, even worse, our coverage by using an elaborate system of co-payments and deductibles, exclusion clauses, and loopholes.
This uniquely American free market mentality for healthcare extends to prescription drugs. In the United States we pay prices that are nearly 60% higher than in Canada, and nearly 100% higher than in Europe. And I guess we still tolerate this crap and elect politicians who write laws that favor the drug and insurance industries.
This new study proves this reality. And since the Patient Protection and Affordable Care Act, is RomneyCare writ large, it's fair to draw the conclusion that medical bankruptcies are here to stay even after the implementation of the ACA. And this is a terrible tragedy and morally unjustifiable.
Woolhandler, Himmelstein and Thorne write, "These data suggest that reducing medical bankruptcy rates in the United States will require substantially improved -- not just expanded -- insurance,". And how do you improve health insurance? By removing the parasitic middleman, which is nothing but a skimming operation, and removes .30 cents of every precious healthcare dollar for administrative overhead, executive compensation, and Wall Street profits..
Here's another piece of the report.
What accounts for the seemingly paradoxical trends of
increasing coverage yet stable, or even increasing (on a per
capita basis), medical bankruptcy rates? Health costs in the
state have increased sharply since reform was enacted.9
Even before the changes in health care laws, most medical
bankruptcies in Massachusetts, as in other states, affected
middle-class families with health insurance. High premium
costs and gaps in coverage—copayments, deductibles, and
uncovered services— often left insured families liable for
substantial out-of-pocket costs. None of that changed. For
example, under Massachusetts’ reform, the least expensive
individual coverage available to a 56-year-old Bostonian
carries a premium of $5256 and a deductible of $2000, and
covers only 80% of the next $15,000 in costs for covered
services.10 Thus, an insured couple with medical problems
and an income greater than $44,000 (ie, 300% of poverty,
the eligibility threshold for insurance subsidies) might pay
$20,512 in annual medical expenses, a figure that far exceeds
the financial capacities of the average American family.
11 Uncovered services, such as physical therapy, drugs,
or home care, might push out-of-pocket costs even higher.
As you read this, please keep in mind in the rest of the industrialized world, there is no such thing as medical bankruptcy. This is a uniquely American depravity.
So what's the solution? There's only one way to solve the U.S. healthcare catastrophe, and you know (as do the politicians who protect the insurance corporations) what it is--single payer.
Vermont and California will lead the nation out of this abyss, but only if we all join together, and make single payer a reality in these two states.
1. You can sign this petition supporting California OneCare and the fight for single payer in California.
2. You can make a contribution to California OneCare. The fight for healthcare justice in California belongs to all of us.
Does everyone know that in Canada, single payer began at the provincial level in Saskatchewan and then eventually, as more provinces embraced universal health care, the federal government got on board. This is how it will happen in the United States, but it will take all of us.
Please note, I am on the Board of California OneCare