I, too, was in that group of young adults who had no health insurance at work and never thought much about it until one day when I was hospitalized for minor surgery and couldn’t afford the bill. It was thousands of dollars for just an overnight stay. A bargain at today’s prices. But for me at that time it was overwhelming and what was worse, demeaning. I prided myself on being financially independent but now I had to call my father to ask him to pay my bill. Luckily, I had parents who could and would. I understand why so many in their 20s feel invulnerable and how dangerous that feeling can be. Fortunately for young people today, they can remain covered by their parents insurance until they are 26, thanks to the Patient Protection and Affordable Care Act.
One would think this act which provides health coverage to those who cannot afford private insurance and ensures that the most vulnerable with pre-existing conditions cannot be dumped by insurance companies would be welcome news. It also means people without insurance will not head to the emergency room for their routine health care — very expensive and inefficient. Instead, many of the people who have a health safety net (Medicare) and/or an insurance policy which protects them and they can afford are being selfish when they rally to undo Obamacare. Or maybe just hoodwinked by tea-party conservatives and go-along Republicans.
One would think with all the venom spouting forth that the state of health coverage in this country is excellent, or very good, or at least OK and does not need changing. But it turns out compared to other industrialized countries, it is not. We pay more but are less healthy than those countries which already have in place universal health care. That would include Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom. According to an international survey by the Commonwealth Fund, “ by virtually all measures of cost, access to care and ease of dealing with insurance problems, Americans fared poorly compared with people in other advanced countries” (New York Times editorial, Nov. 18, 2013). The United States spends more per capita and as a percentage of the national economy than do these other nations. “Some 37 percent of American adults went without recommended care, did not see a doctor when sick or failed to fill prescriptions in the past year because of costs. ... Nearly a quarter of American adults could not pay medical bills or had serious problems paying them. ... Americans who were insured for the entire year were more likely than adults abroad to forgo care because of costs, an indication of how skimpy some insurance policies are.” And “some 32 percent of consumers spent a lot of time on insurance paperwork or in disputes with their insurer over denials of payment for services they thought were covered.” Time magazine points out “there is a larger problem for the country if Obamacare’s ills metastasize. The glee of the law’s opponents masks the reality that failure would leave behind a country that pays too much and gets too little from its health care system, whose costs, at nearly 18 percent of GDP, limit America’s ability to grow and invest and compete globally.”
It’s been very tough to pass universal health care in our country because of the power of special interests. ACA is the result of political and financial compromise. It is a private enterprise solution to universal health care by giving insurance companies the major role. They expect to continue making big profits. In return for providing more care, insurers need healthy people in the pool. And more companies sharing the burden. A single payer system like Medicare, a government program, would have been easier to implement but there were not enough votes in Congress. As the Times concluded, “however imperfect, the Affordable Care Act is needed to bring the dysfunctional American health care system up to levels already achieved in other advanced nations.”
And by the way, U.S. Sen. Ted Cruz of Texas, a major opponent, does not need the Affordable Care Act. Neither does he need Congress’ excellent health insurance plan. He and his family are covered by his wife’s platinum health plan. Her employer is Goldman Sachs.
Sue Lempert is the former mayor of San Mateo. Her column runs every Monday. She can be reached at firstname.lastname@example.org.