It Really Doesn’t Matter

Rodney Warner, JD
Rodney Warner, JD

I’ve got good news for those of you without health insurance.  The fact that you lack that insurance is not a big deal.  That according to Senate minority leader, Republican Mitch McConnell.  Senator McConnell has stated that addressing the fact that 45 to 50 million Americans have no health insurance is not a priority for the Republicans.  Translation: Republicans won’t be spending any time or energy on the issue because they don’t care.

The issue came up because of Republican criticism of the Affordable Care Act, the federal legislation aimed at reforming health insurance, which was especially sharp after the Supreme Court ruled it was Constitutional.  Given Republican criticism of the law, a fair question asked them was, what’s your alternative?  Their answer, we don’t have one, because it’s not worth bothering about.  It addresses an issue that we don’t feel is a problem worth our time.

This is a classic position to take when you can’t win an argument.  If you can’t solve a problem, you say it’s not a problem, thus no reason to come up with a solution.  Republicans are framing the issue as one of medical cost control, which they claim the Affordable Care Act doesn’t address.  If medical costs are controlled, they reason, insurance will become more affordable and more people will be able to get it.

What their plans are to lower costs, when and how effective they will be, I certainly don’t know.  I don’t think they know either.  Given their utter distaste for anything that even smells of regulation, or that would infringe on ‘states’ rights’ (like the states’ traditional roles of regulating insurance and medical malpractice cases), I don’t know how this would work.

Whether or not having health insurance is a problem depends on your perspective.  If you’re one of the estimated 45,000 Americans who die every year because they lacked access to health care, because they lacked health insurance, it’s a problem.  For 2009, that would’ve ranked it as the 10th leading cause of death in America.  Medical bills are the leading cause of personal bankruptcies, contributing to an estimated 62% of filings, according to a study by Harvard’s law and medical schools.  If you’re one of those folks facing financial oblivion because of medical bills, it’s a problem.

One study has estimated that between 2005 and 2007 (before the economy really hit the skids) that 79 million Americans were struggling to pay medical bills.  The study estimates that 28 million Americans used up all their savings, 21 million went deeply into credit card debt and 21 million were unable to pay for necessities, due to their medical debt.  The study pointed out that 61% of those in debt had some form of insurance, but it wasn’t good enough to cover all the medical costs incurred.

The Affordable Care Act addresses at least one driver of increasing health care costs.  The original plaintiff (the person filing the lawsuit) in the case that went to the Supreme Court was Florida resident Mary Brown.  She was an outspoken critic of the law and her family owned an auto repair business.  She felt that she shouldn’t be required to purchase health insurance, a provision of the law set to take effect in 2014.

As a business owner, she would have to pay for workers compensation insurance, unemployment insurance and she should’ve had some kind of umbrella liability policy.  If she owned a car, she would also have to buy auto insurance.  If she owned a house with a mortgage, she would have to have some kind of homeowner’s policy.  But health insurance?  By God, no!  That would infringe on her freedom and God given right to….not buy something!

Things didn’t go too well for the Browns after the lawsuit was filed.  Their business closed.  They declared bankruptcy.  Among the debts they couldn’t pay was $4,500 in medical bills.  Because of the Browns’ belief in their right not to buy health insurance, they stiffed their doctors and the local hospital.  Those costs don’t evaporate. Those doctors and the hospital will make up for the loss by raising their prices for those of us who do have health insurance or who are able to pay out of pocket.  Florida taxpayers might also pay the bill, if the hospital can get the state to pay for this uncompensated care.  Isn’t it great to be in a country with the Browns, where there are only freedoms, but no responsibilities?

The lack of health insurance by about one in six Americans is a problem and it deserves to be addressed.  Given how common cancer is, I’m guessing hundreds of thousands of Americans are dealing with cancer without the benefit of health insurance.  These people are not only facing a physical disaster, but a financial one as well.  I think a country wealthy enough to have taxpayers subsidize the care of Mitt Romney’s horse (to the tune of a $77,731 write off on his taxes) should be wealthy enough to help people dealing with a potentially deadly disease.

But some might say, forcing someone to buy medical insurance is too much of a government intrusion into individual freedom.  I think your freedom not to buy health insurance ends when it starts taking money out of my pocket.  If you walk away from your medical bills, I may end up paying for them through increased medical costs or taxes.  I’m more than willing to pay for my freedom, but not yours.

The real irony is that there are tens of millions of American tax payers who lack health insurance.  Part of their payments go to help pay for the health benefits of those in the House of Representatives and Senate.  However, Republicans in those houses, while enjoying these benefits, see others lacking them as not an issue worth their time (though they’ve managed to find the time to maintain tax breaks for companies sending jobs overseas).

If health coverage is so frivolous, shouldn’t Senator McConnell, and all those who agree with him, do without their benefits, and pay for all their medical expenses out of pocket?  They should lead by example and demonstrate how trivial medical insurance really is.

If you find yourself in need of treatment, but you lack health insurance, when you talk to that hospital or doctor’s office about payment, tell them it’s not a problem.  Tell them the minority leader of the Senate says this is a non-issue.  If they’re confused, or don’t agree, give them Sen. McConnell’s telephone number ((202) 224-2541) so he can straighten them out.  If the Senator is unavailable, I’m sure one his staff will be happy to explain how health insurance is truly unimportant.  Or, just ask Mary Brown!

Disclaimer: Views expressed are those of the author or other attributed individual and do not necessarily represent the official opinion of the OncoLink Staff, University of Pennsylvania Health System (Penn Medicine), or the University of Pennsylvania, unless explicitly stated with the authority to do so.