I've been reading through various comment strings in various diaries today and have run across persistent comments related to the 36 million uninsured that really alarm me.
There seems to be a rather deep-seated belief that not supporting the Senate version of a health care insurance bill amounts to somehow callously endangering the lives and well-being of the 36 million or so uninsured; a belief that the legislation under consideration in the Senate, since it will at least offer "coverage" is somehow "better than nothing."
Please, think again.
Having run the gamut of insurance states-of-being available to Americans, I can't help but think that the persistent belief that "coverage" leads to care is naive at best and disastrous at worst. So from someone who has been there, and who was forced to drop their high-risk, state-based "coverage" for uninsurable Illinoisans in order to pay for doctor visits and medications (though, admittedly in this case my child's not mine) please do believe me when I say that coverage does not equal care, and can, in fact, force you to choose between paying those premiums and paying for care. When mandates are added to this mix, all I can assume is that there will be individuals - maybe many of them - who will soon be forced to choose between premiums, care, and fines.
I used to have great insurance. Within a single year I came within less than ten dollars of hitting the lifetime million-dollar maximum from that carrier in the course of cancer treatment. I fought to carry the COBRA for 18 months, while completely oblivious to the lifetime maximum limit. (Check your policies everyone, lots of people are completely oblivious to such facts.) Then, after I'd dished out 150% of the normal group premium to hang onto the stuff and it ran out, I entered my state's (Illinois) insurance pool for uninsurable citizens.
So I know how expensive that is, the answer is: more than the cost of COBRA, while simultaneously offering the junkiest of junk coverage. It covered no doctor visits, no medications, no tests, nothing but 50% of hospitalizations, capped at some ridiculously low (at least it seems ridiculously low to a cancer survivor) annual level like $50,000. And there was no subsidy available to me, because I was at the time divorced and without dependents and making enough to be living above the poverty level. As my insurance agent - who steered me to the program - put it, "all it amounts to is a get-into-the-hospital card it will never pay any benefits."
So, there I was, paying about 40% of my before-tax income for insurance that would never provide a benefit. Joke of all jokes was that the carrier was the same exact carrier I was less than ten dollars away from hitting the lifetime maximum for. Only I did not realize that there was a lifetime maximum at play at the time.
Sure, I get that the Senate bill gets rid of the lifetime maximum, but it does nothing to protect people from annual maximums, or from ridiculously high co-pays, or from sky-high premium increases.
And I've dealt with these people enough to know that the risk I represent to thse for-profit companies is going to be paid for. In advance. And if it comes time to cover care, well there will be a way out. For them.
The insurers I know and don't love are not going to settle for just getting a huge influx of healthy twenty-somethings paying for junk policies to stay one step ahead of fines. They are for-profit businesses and they do now, and will continue to, view well people as profitable, and risky people as, well, a risk, that must be controlled at all costs, so they will find a way to force people like me onto junk polcies as well.
The new well people mandated to become their customers are icing on the cake, people like me are ants at the picnic they have to keep away from their cake.
There are ample ways and means under this legislation to enable them to keep risks like me under control. Frankly, if I get sick enough that I am forced to go to the doctor and pay out of pocket (which is what will happen if I get sick enough to have to visit a doctor, with or without this legislation) I will be in a much better position to pay enough out of pocket to keep myself alive if I have not been spending half my income on junk insurance premiums for the past year or ten.
So please, do me a favor? Stop with the "you realize you are condemning 36 million people to live without coverage" comments in response to commenters and diarists who are concerned, as I am, about junk health insurance legislation. I trust that you believe you are fighing for people like me, but that only works if this legislation ensured that insurance companies will be forced to put some actual coverage in their coverage.
It just doesn't.
No one is unhappier about that than I am today, but there it is.