The Zoo That is our Health Care System

What kind of health insurance policy is there for a divorced mother of three, working for a small business, receiving no support from her unemployed ex-husband, with a child who has a chronic illness? If you said none, you are correct.  There is no reasonable health care plan for this family and for millions of others like it.

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For now, the Affordable Care Act (ACA or Obamacare) protects her child with cystic fibrosis from being excluded from coverage because of her “pre-existing condition.” And the mother is prepared to pay a hefty amount for a good policy. But there is no policy to be had that covers the specialized care her child needs.

I have written several posts about the mess that is health care in America, HERE and HERE and HERE. Readers have shared heartbreaking stories after every post. Folks are really suffering and dying out there. Blame whomever you want, but the fact is that as long as there are profits to be made by insurance companies, drug companies, and hospitals, all of us suffer. Yes, we have the best medical care in the world, but only those with access to this excellent coverage can have it.

President-Elect Trump and the Republican Congress have vowed to repeal and replace the Affordable Care Act, but I have yet to see what their vision is. I am hoping, as Trump has promised, they keep the few things that work like maintaining coverage for people with pre-existing conditions, allowing young adults to stay on their parents’ policies until age 26, and providing coverage for the poor. And please leave my Medicare alone, as that system works very well, thank you. But as long as the lobbyists connected with the health care industry are more important to our elected representatives than their actual constituents, I can’t imagine how anything will improve.

If I ran the zoo, like young Gerald McGrew of Dr. Seuss fame, “I’d make a few changes. That’s just what I’d do…I want something new! So I’d open each cage, I’ll unlock every pen, Let the animals go and start over again.”

  • Uncouple health care from where folks work. Millions of us work for companies with fewer than 50 employees that are not obligated to provide access to health insurance. Millions more can’t afford the plans being offered through their workplaces. There must be a better way to do this.
  • Everyone into the pool. For every person with a chronic illness there are many more very lucky folks who are blessed with good health. Sharing that blessing with those who need more specialized care is a value our country should support.
  • People’s health should not be a for-profit industry. No one should make a profit by denying a child with cystic fibrosis access to her specialized doctor and hospital. The Declaration of Independence guarantees us “life, liberty, and the pursuit of happiness.” The way I see it, access to healthcare is a basic American right.
  • It should not be so complicated to obtain reasonable health care. After a presentation to a group of his fellow professors with math and science backgrounds explaining the options offered by the university, my son made a spreadsheet with all of his choices. What he learned was that it was virtually impossible to compare this "apples and oranges" information and make the best selection for his family based on the data.

Donald Trump campaigned on the promise to repeal and replace the ACA with something much better, a plan that would cover everyone, offer more choices, and cost less. In an interview with Dr. Oz on September 16, 2016, he promised "plans that you don't even know about. It's going to be great." Right now, reasonable choices are few and far between. Trump says he favors competition in the insurance market, especially across state lines. At various times, he had recommended that Congress to allow Americans to import prescription drugs from countries where they are sold at lower prices. Above all, he has told us he is great at making deals, so perhaps that skill will enable him to fix the health care mess? If not, many who voted for him will be left behind once again.

By the way, this is a very personal issue for my family as well as countless others in this country. For many of us, it is a life-or-death issue. The family described in the first paragraph is my daughter’s. Right now, an advocate for the Cystic Fibrosis Foundation is helping her to navigate what appear to be no good choices that meet her needs on the Marketplace.

Although the sticker shock people experienced when they saw their health insurance costs would skyrocket for 2017 was probably a factor in getting him elected, I have no illusion that anything will change for the better under President Trump. In this zoo, there is little appetite to “start over again” and no Gerald McGrew with a vision of how that could work.

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