I'm really not an expert on health care reform, but something clicked when I starting writing about it on Monday and I find myself with more to say.
This post is inspired by the graphic you see at the top, the image of the house on fire. The caption reads: PRE-EXISTING CONDITION--"Hello? My house is on fire and I'd like to buy a fire insurance policy. 911? Nah, the government says insurance companies must cover all pre-existing conditions now. It's not like I should have to pay for it."
This illustrates the problem with calling health care coverage "health insurance."
Insurance implies that there is a risk from which you need to be protected. So, you take out insurance to hedge your bets and guard against the bad thing from happening. That's why homeowners' buy fire insurance, motorists buy car insurance and people worried about providing for their families in the event of their death get life insurance. The insurance companies aren't stupid. They hire people to figure out the risks of offering such coverage to you with an eye on the costs and the goal of making a profit. So obviously, no one is going to sell you insurance if your house is already on fire, you just got into a car accident or your spouse just died.
I guess some people view health care the same way. For those who consider themselves healthy, "health insurance" is something they have "just in case" they get sick. So I can see someone with this point of view on health insurance putting together a poster like the one at the top of this post.
Then there are people like me. I admit that I really don't need "health insurance." I already have health problems, so insuring my health, i.e. gambling that I am going to stay healthy and not need medical care, is literally like closing the barn door after all the animals have escaped. What I need is ongoing access to health care. Without it, I have no support for all the things I need to do to manage my multiple chronic health problems.
If your house burns down, you have choices. You can walk away. You can rebuild. You can tear down what remains and leave an empty lot. You can sell what is left.
People are not like houses.
When we become ill or injured, we need medical care. The whole profession of medicine exists because of our societal commitment to the treatment of the sick and infirm. We do not abandon people when they are ill, like animals do when a member of the herd becomes sick or injured. We stand by them, help them and do what we can to help.
So why do we denied people with pre-existing medical conditions the ongoing access to the means to manage their health problems and ease their suffering? Why do we forget that some of people who utilize the health care system the most are people who live off disability checks and therefore not in a position to pay more to access health care?
Clearly there are multiple problems. There are also disturbing reports in the news that health insurers are already looking at ways to skirt the new provisions to end the denial of health insurance coverage to those with pre-existing conditions. This is why, in a nutshell, I think the emphasis on "health insurance" in the health care reform bill is not the smartest choice of words or concepts.
I know I am probably not qualified to solve these problems, but may I humbly suggest perhaps one small step towards fixing this problem?
Let's start by acknowledging that we all need to go to the doctor, even those of us who consider ourselves healthy. Let's agree that health care services need to be part of everyone's lives, from birth to death, in sickness and in health, to prevent and treat illness and disease. Let's stop selling "health insurance" and start asking everyone to pay for access to the health care system. Then let's talk about making it so that everyone can afford access to health care. Let's agree that health care for all is a goal our enlightened and compassionate society strives towards and is willing to pay for, together, as one united nation of people.
That said, I'm not sure what our health care solution should look like. Philosophically, we seem to be torn between "united we stand" and "pull yourself up by your boot straps" when it comes to solving our social problems. I feel if we could just get over the first hurdle and agree that health care for all is our goal and that we all need to be in this together, we can figure out our own uniquely American solution to this problem.
Agree? Disagree? I want to hear what you have to say so leave me a comment.