Bueller?
For the past year I've been following the Massachusetts experiment in universal health care coverage with a great deal of attention. That state has taken on this issue and has shown remarkable success in making certain that most of its citizens have at least the minimum in coverage for those emergencies that happen when they are least welcome (although there is never a good time for a medical emergency). A broken ankle is one thing, however, but cancer treatment is an entirely different ballgame, and that was one area the Massachusetts plan didn't adequately plan for. An op-ed piece in yesterday's Boston Globe written by two officers of the American Cancer Society (John R. Seffrin and Donald J. Gudaitis) point out the gap, and have some suggestions for the Massachusetts legislature and for the nation.
IMAGINE you have been diagnosed with cancer and need chemotherapy or radiation treatments, but regardless of what your doctor prescribes, your insurance plan limits the overall expense or number of times you can receive the treatment.
This frightening and dangerous scenario is not hypothetical; it is now playing out in Massachusetts. The Massachusetts Connector Board is scheduled to vote tomorrow on potential changes to Minimum Creditable Coverage, which is the most basic coverage that an individual must have to satisfy the state's individual mandate. In regulations proposed earlier this summer, chemotherapy and radiation therapy are not considered "core services" and can be subject to limits by health insurers. The Connector Board should vote to reject any limits on these lifesaving treatments.
It really doesn't take much imagination to see how that scenario will play out in Massachusetts or the rest of the country. American families are being asked to choose between necessary treatment and eating and/or staying in their homes. The column does give the appropriate nod to the various parties invited to the table (legislators, employers, insurance companies, medical providers) when the initial plan moved through the state legislature, and one can "imagine" that this particular issue didn't come up explicitly, but surely this issue couldn't have been so hidden as to be invisible.
Massachusetts took a bold first step, one that I believe was necessary, but it was just a first step and not perfect by any means. Until this nation realizes that universal health care access is necessary, so necessary that the federal government should fund it as it funds Medicare which, contrary to the baloney peddled by the rotting right wing of the GOP, actually is more efficient than private insurance companies, our economy is going to be unnecessarily burdened by a cost of doing business. Ask the struggling automobile industry what health care costs for its current employees and retirees adds to the price of an American made car. Then ask the small businessman what portion of his overhead goes to providing minimal policies for his employees and what the absenteeism of those employees who passed on flu shots cost him/her.
I have a little personal experience on the issue. I'm 62 with a heart problem. My employer has had to shell out over $1100 a month for a reasonably decent plan that requires a hefty deductible and a co-pay by me. Right now, our business is down so much that the expenditure for my health care is a large burden, one my employers can't justify. And I can't get a private policy at all, at any price. The answer is for me to pay the money to stay in the group health plan.
And I'm relatively certain I'm not an anecdotal Lone Ranger. The op-piece cited above talks about what many would consider an extreme situation, but that situation is an example that is not really so extreme, especially when the realities of health care access is considered, as anyone who has had the experience of an emergency room visit will attest.
And now, when the economy is crumbling before us, the problem is even more acute, as Messrs Seffrin and Gudaitis point out:
Nearly 46 million Americans have no health insurance, and an estimated 25 million have inadequate insurance that won't cover critical treatments for life-threatening diseases such as cancer. As a result, people are being forced into crushing medical debt to bridge the gap between where their health insurance stops and where their recovery begins. It is a false choice between personal health and a family's financial survival.
The economic crisis gripping the nation only exacerbates the harsh financial circumstances faced every day by those with cancer and those at risk. Putting the country on firm economic footing will require that we improve access to care for everyone.
This is a problem with an obvious solution. Unfortunately, neither candidate for the presidency has shown the courage to address it.
Hopefully that will change in January.
IMAGINE you have been diagnosed with cancer and need chemotherapy or radiation treatments, but regardless of what your doctor prescribes, your insurance plan limits the overall expense or number of times you can receive the treatment.
This frightening and dangerous scenario is not hypothetical; it is now playing out in Massachusetts. The Massachusetts Connector Board is scheduled to vote tomorrow on potential changes to Minimum Creditable Coverage, which is the most basic coverage that an individual must have to satisfy the state's individual mandate. In regulations proposed earlier this summer, chemotherapy and radiation therapy are not considered "core services" and can be subject to limits by health insurers. The Connector Board should vote to reject any limits on these lifesaving treatments.
It really doesn't take much imagination to see how that scenario will play out in Massachusetts or the rest of the country. American families are being asked to choose between necessary treatment and eating and/or staying in their homes. The column does give the appropriate nod to the various parties invited to the table (legislators, employers, insurance companies, medical providers) when the initial plan moved through the state legislature, and one can "imagine" that this particular issue didn't come up explicitly, but surely this issue couldn't have been so hidden as to be invisible.
Massachusetts took a bold first step, one that I believe was necessary, but it was just a first step and not perfect by any means. Until this nation realizes that universal health care access is necessary, so necessary that the federal government should fund it as it funds Medicare which, contrary to the baloney peddled by the rotting right wing of the GOP, actually is more efficient than private insurance companies, our economy is going to be unnecessarily burdened by a cost of doing business. Ask the struggling automobile industry what health care costs for its current employees and retirees adds to the price of an American made car. Then ask the small businessman what portion of his overhead goes to providing minimal policies for his employees and what the absenteeism of those employees who passed on flu shots cost him/her.
I have a little personal experience on the issue. I'm 62 with a heart problem. My employer has had to shell out over $1100 a month for a reasonably decent plan that requires a hefty deductible and a co-pay by me. Right now, our business is down so much that the expenditure for my health care is a large burden, one my employers can't justify. And I can't get a private policy at all, at any price. The answer is for me to pay the money to stay in the group health plan.
And I'm relatively certain I'm not an anecdotal Lone Ranger. The op-piece cited above talks about what many would consider an extreme situation, but that situation is an example that is not really so extreme, especially when the realities of health care access is considered, as anyone who has had the experience of an emergency room visit will attest.
And now, when the economy is crumbling before us, the problem is even more acute, as Messrs Seffrin and Gudaitis point out:
Nearly 46 million Americans have no health insurance, and an estimated 25 million have inadequate insurance that won't cover critical treatments for life-threatening diseases such as cancer. As a result, people are being forced into crushing medical debt to bridge the gap between where their health insurance stops and where their recovery begins. It is a false choice between personal health and a family's financial survival.
The economic crisis gripping the nation only exacerbates the harsh financial circumstances faced every day by those with cancer and those at risk. Putting the country on firm economic footing will require that we improve access to care for everyone.
This is a problem with an obvious solution. Unfortunately, neither candidate for the presidency has shown the courage to address it.
Hopefully that will change in January.
Labels: Election 2008, Health Care, Insurance Companies
posted by Diane at 3:45 AM
1 Comments:
Ruth,
Our college is a county institution, and the whole county recently shifted our retirees from the same plan the employees have to another, worse plan. (No names, but I'm not glad I met ya.) They did this unilaterally and with two weeks notice, without checking to see whether or not the new plan would cover the same doctors and treatments. It didn't. One colleague noted to me that there were people who actually had to forgo cancer treatments because the new company didn't cover their oncologist, and they had to wait either for (a) the new company to negotiate with the doc, or (b) an appointment with another oncologist.
This system sucks.
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