Posted by Sir Four at 1:25pm Aug 24 '09We've had many threads on health care, including discussing the role of the free market and also the possible limits of providing health care (which stirred a lively debate as well as some snark). We are also familiar with the many talking points surrounding this issue. But let's try coming at it from a new angle.
Sophie is a young girl with serious respiratory problems. I tell you this not to tug your heart-strings, but to initiate a debate. At age two she came down with multiple bouts of pneumonia. Shortly thereafter her parents' insurance situation changed, and they shopped for a new policy (as self-employed individuals). Her mom tells what happened:
It was at this point that the family realized they could qualify for their state's Medicaid program, which would cover Sophie 100%. The rest of the story goes like this:
Now, my first statement is that the insurance company underwriters were spot-on. They knew this girl posed an unacceptable risk to their bottom line and did the only rational thing they could do: deny coverage.
The parents had to rely on government insurance for the poor. This government insurance acts as sort of a catch-all, taking in all the undesireables, leaving the private insurers to extract profit from the healthiest people (and we, as taxpayers, foot the bill for the unprofitable people). Perversely, Sophie's mom explains that she takes on work only to the extent that the family remains poor enough to continue being eligible for Medicaid. This, too, is the only rational choice.
We've heard the Palin wing of the Republican Party, apropos of nothing, attack the notion of denying care for the disabled. But how does Sophie get care, aside from a government-run program? If only we had Palinites here to explain. It is clear the free market has no solution for Sophie or anyone in a similar situation.
Does Sophie deserve medical care? Was she born with a right to it? Maybe a libertarian can answer. Republican Senator Jim DeMint said healthcare is a priviledge, not a right.
How does anyone win when Sophie's parents take only so much work as to ensure they remain poor enough to qualify for Sophie's government insurance? Clearly this is helping no one. Should Medicaid drop poverty requirements?
What's the answer here?
Sophie is a young girl with serious respiratory problems. I tell you this not to tug your heart-strings, but to initiate a debate. At age two she came down with multiple bouts of pneumonia. Shortly thereafter her parents' insurance situation changed, and they shopped for a new policy (as self-employed individuals). Her mom tells what happened:
We received a notice from [Blue Cross] stating that they considered Sophie to have a pre-existing pulmonary problem (due to the amount of doctor's visits for pneumonia), and that while they would cover her in general, they wouldn't cover any pulmonary/respiratory issues until she had gone two years without needing medication or problems. We spent the next couple of months researching every insurance company that we could, begging them to take Sophie. Nope, it wasn't going to happen.
And then our biggest fear came true: Sophie got very, very sick. And I'm ashamed to say that although we knew that she was incredibly ill, we actually considered keeping her home from the doctor's office, as we knew that this would be yet another strike against her getting insurance. Luckily we pulled our heads out of our asses and took her to the doctor anyway, and it's good that we did, because Sophie was so critically ill that she was sent straight from the doctor's office to ICU.
One night in ICU? $10,000, not covered by insurance.
It was at this point that the family realized they could qualify for their state's Medicaid program, which would cover Sophie 100%. The rest of the story goes like this:
Since that horrible October in 2005, Sophie has needed hundreds of thousands of dollars worth of treatments, hospitalizations, surgeries, medications, testing, and interventions in order to stay strong and healthy, and in some instances, to stay alive.
She has required three bronchoscopies, the middle section of her lung removed, extensive genetic testing, cardiology work ups, dozens of x-rays, CT scans, and a two week trip to a pulmonary hospital in Denver. When she's healthy, she requires three steroids, twice a day, and when she's sick she is usually on five steroids, twice daily. She's been diagnosed with right middle lobe syndrome (though not anymore, since she had it removed), a genetic mutation of cystic fibrosis, severe uncontrollable asthma, and severe sinus disease.
Now, my first statement is that the insurance company underwriters were spot-on. They knew this girl posed an unacceptable risk to their bottom line and did the only rational thing they could do: deny coverage.
The parents had to rely on government insurance for the poor. This government insurance acts as sort of a catch-all, taking in all the undesireables, leaving the private insurers to extract profit from the healthiest people (and we, as taxpayers, foot the bill for the unprofitable people). Perversely, Sophie's mom explains that she takes on work only to the extent that the family remains poor enough to continue being eligible for Medicaid. This, too, is the only rational choice.
We've heard the Palin wing of the Republican Party, apropos of nothing, attack the notion of denying care for the disabled. But how does Sophie get care, aside from a government-run program? If only we had Palinites here to explain. It is clear the free market has no solution for Sophie or anyone in a similar situation.
Does Sophie deserve medical care? Was she born with a right to it? Maybe a libertarian can answer. Republican Senator Jim DeMint said healthcare is a priviledge, not a right.
How does anyone win when Sophie's parents take only so much work as to ensure they remain poor enough to qualify for Sophie's government insurance? Clearly this is helping no one. Should Medicaid drop poverty requirements?
What's the answer here?
Should Sophie Get Health Insurance? - Sir Four