Do we value health or insurance? Follow the money

Aug 22nd, 2009 | By | Category: Columns, Opinions

by Jason McGill

I recently read an article about a couple of kids who live near me, Sean and Cody Merrill.  They have Mucopolysaccharidosis (MPS), an exceptionally rare disease whose treatment costs $800,000 dollars a month.

Through an extraordinary turn of good fortune, their father, Eric, had insurance through work that covers all the expenses.  Most insurance policies, even “good” ones, top out at one million a year, which would cover less than a month for Sean and Cody.

But as the boys reach 18, they can no longer be covered as dependents, meaning they would either have to find their own insurance (yeah, right), or earn less than $600 a month to qualify for Medicaid.

Legislation is now before the House to help remedy this situation.  From the article:

“If the Ryan Dant Act passes in its current form, anyone whose medication costs more than $200,000 annually would be allowed to work and receive Medicaid benefits.

While that would include the fewer than 1,000 individuals with MPS in the United States, it would also cover thousands of others who suffer from diseases whose treatments are prohibitively expensive, such as hemophiliacs.”

Why does our mercy stop at $200,000?  Why not $180,000?  Why not $100,000?  Why not *gasp* everyone?

Sean and Cody are essentially in the same boat as millions of Americans without insurance.  For them, insurance is either prohibitively expensive or impossible to get because of pre-existing conditions.  The boys stand out because of the extreme cost of their treatment, but all uninsured Americans face the threat of crippling health care costs, poorer health, and shorter lives.

Are these kids any more or less deserving of medical care than the millions who are uninsured?  Although the news article frames their plight as a problem with Medicaid, it is also a failure of private insurance.  No insurance company would cover them with a pre-existing condition costing millions to treat each year.  If their father was uninsured, would they be less deserving of medical care?

The answer is yes.

We’ve collectively embraced an idea; our country is uniquely meritocrious, and the only difference between rich and poor is the ability to work hard.  Not only is this demonstrably untrue, but also carries with it a smug justification for the inequalities all around us.  Poverty, according to the American Mythos, is a moral failing on the part of the individual.

And so we do have rationing of care, right now.  Instead of recognizing health care and access to it as a human right (like nearly every other country in the world), we allow the insurance and drug lobbies to hold the health of the nation hostage to ever increasing extortion.  They decide who lives and who dies, and how much we pay for the privilege of their wisdom.  They are the “bureaucrats coming between you and your doctor” right now.  We have hospitals turning patients out into the street, a practice that should be a shame to any nation with a conscience.

But it’s not the fault of the hospital, it’s the natural outcome of a system that prioritizes dollars over health. For all the talk about personal responsibility, no one can seem to stomach an ounce of social responsibility.  Yes, we live in a society, meaning we have certain responsibilities to that society.  The uninsured are our people, fellow Americans, for better or worse. Our ideology has such a stranglehold on our discourse that advocates of a single payer system, which most other industrial countries have, are virtually absent in the mainstream media and such a program is ruled out from the start by our key legislators.

Does being an American have any meaning when your fellow Americans can so casually turn their backs on you in a time of need?  Perhaps the inscription at Liberty Island should read, “Give me your tired, your poor, your huddled masses yearning to breathe free, but after you get here, it’s every man for himself.”

Ultimately, you spend money on what you value.  We pay exorbinate amounts of money to health insurance companies to cover some people some of the time, while other countries spend much less to cover all the people all the time, and get better outcomes.  So when we spend all this money on health insurance, are we paying for our health, or the health of the insurance companies?

Right now, the Senate finance committee is considering allowing insurance companies to lower their payouts from 76 to 65 percent of medical bills, leaving their customers to pay the other 35 percent.  That’s after premiums, which are $3,900 for a family of four with employer sponsored coverage.

So the average hospital stay in 2006, which was $19,400, would require $2,100 more out of pocket.  It comes to a total out of pocket expense of around $6,800, for the insured, on top of premiums.  Considering the median household income in the US is around $50,000, it’s a devastating expense, sapping 21.4 percent of their gross income altogether.  Not to mention the impact on ability to work following an injury.

But we will break our backs to pay it, because we value our health and the health of our families.  What do the insurance companies value?

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  1. This is a great piece, Jason. Until we all look at healthcare as a human right and something other than a for-profit industry, there will never be any serious reform in this country.