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Affordable Care Act Takes the Cruelty Out of American Health Care

The Affordable Care Act takes the cruelty out of health insurance coverage or the lack thereof for the uninsured.

The Affordable Care Act takes the cruelty out of American health care. Take, for example, my good friend in her fifties, a hard-working, ethical woman who lost her husband, her job, and her health insurance within six months last year. She couldn't buy health insurance because of a pre-existing position.

Now that the U.S. Supreme Court has upheld most of the Affordable Care Act, my friend may still not get health insurance right away, but she'll get health insurance in a couple of years.

Rekha Basu told a story in the 6/29/12 Des Moines Register about a woman who fell out of a kayak in the Boundary Waters and contracted a rare fungal infection in her lungs. Hospitalized on a ventilator for five weeks, she quickly reached the lifetime cap on her insurance of $1 million. Would you like to be maxed out on health insurance for the rest of your life at age 39?

The Congressional Budget Office predicted that the Affordable Care Act will save $100 billion on the national debt within 10 years. Whether you agree with this number or not, you can't just ignore a trend in the right direction. Medical bankruptcies are common when people get sick and have no health insurance or have inadequate health insurance. Hospitals and clinics pass the costs of those unpaid bills on to those of us who do have health insurance. 

Suppose you have health insurance but it's lousy. Does it get better? I'm not sure. Certainly now children with pre-existing conditions can't be barred from coverage. The lifetime cap on medical insurance is gone. In 2014 adults with pre-existing conditions will also be covered. Parents can keep their children on their health insurance up to the age of 26 years old. I'm very grateful for those provisions. We have a 23-year-old daughter. We want her and her friends to be covered.

Can health insurance companies still put annual caps for health insurance coverage, even if they can't put lifetime caps on insurance benefits? Retail chain stores usually have lousy health insurance if they have insurance benefits at all.

Would you pay $100 a month for $1,000 worth of coverage yearly? I wouldn't. Would I pay a small fine for not having insurance? Sure. But the fine goes up with time and starts to get really expensive, as it should, since poor people without health insurance would continue to check into hospitals and stick the rest of us with the bill. We're paying for poor people's health care now, either in Medicaid or when hospitals pass on the cost of unpaid care to patients who have health insurance. That won't change. Call it a tax if you want to, but it's a "tax" you're already paying if you have health insurance and pay your medical bills.

Presidential candidate Gov. Mitt Romney quickly stated that the only way to repeal "Obamacare" is to elect him. Ironically, Gov. Romney invented Obamacare, a liberal accomplishment he's been running away from ever since because the right wing doesn't like it and he's running as a Republican.

Remember a Romney aide's candid comment that as Romney moves closer to November 6th, he'll shake his"Etch-A-Sketch" and swing ideologically to the center?

John Avlon's line in "Mitt Romney's Empty Obamacare-Repeal Rhetoric" in the Daily Beast alludes to that "Etch-A-Sketch" moment at a time of Romney's choosing: ". . . if you're actually interested in governing as well as in winning, the impulse to scream 'repeal' has to be followed by a plan to 'replace.'"

Having invented Obamneycare, Gov. Romney would be able to replace Obomney care if he were elected president. The question is, would he? Or would he let 50 million uninsured Americans twist in the wind?

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Tonto June 30, 2012 at 09:55 pm
Here we go again. Liberals site one terrific sob story out of 200 million and want to rip off more taxes from everybody. Did ya hear the one about the little ole lady that stubbed her toe and was so obease she fell and burned herself cause she is a chain smoker? Well vevrybody dig deep to buy her more food and cigarettes and a bandaid :(
Maria Houser Conzemius June 30, 2012 at 10:32 pm
Tonto, you're paying for the little ole lady now, buddy. She's on Medicare. As someone who paid into Social Security and Medicare for decades, I'm not looking forward to Medicare, but at least you and I will have it some day. You want to pay for health care your entire working life and then not get it when you retire?
Judy R July 1, 2012 at 11:50 am
Now we gotta get rid of the marriage penalty. My daughter got married because we encouraged that instead of just living together and she lost her health care coverage on our insurance.
David Leonard July 1, 2012 at 12:23 pm
What's riskier, just living together or living without health insurance? Perhaps you should have allowed your daughter to make her own decision.
Maria Houser Conzemius July 1, 2012 at 01:08 pm
David Leonard, I agree with your comment, but I can also see how a parent might forget all of what's involved in a grown child getting married.
Judy R, thanks for the reminder of a good reason for kids under 26 not to get married unless one of them has a job with family health insurance coverage available or neither has health insurance to begin with.
P. Observer July 1, 2012 at 06:04 pm
Nearly every state (except New Hampshire) "requires" motorists to carry some type of auto insurance. What, they can't do that according to the arguments surrounding healthcare.
According to the most recent data from the National Association of Insurance Commissioners Insured drivers pay a hefty price for fellow motorists who have no policies — $10.8 billion in 2007. Wow, so those motorists that choose to ignore purchasing insurance cost insured motorists that much money? So how much do you think those without healthcare insurance cost consumers? The Kaiser Commission provides some resources http://www.kff.org/uninsured/upload/the-cost-of-care-for-the-uninsured-what-do-we-spend-who-pays-and-what-would-full-coverage-add-to-medical-spending.pdf We wonder what's been going on in this country. I think Herbert Hoover sums it well when he said, "The trouble with capitalism is capitalists; they're too damn greedy."
Maria Houser Conzemius July 1, 2012 at 08:28 pm
+1, P. Observer! Great comment!
Rob Wilson July 3, 2012 at 12:43 pm
It is interesting how there seems to be a double standard. President Obama can run to the middle from his extreme liberal left position, but Mr. Romney can't. How do you think Tom Vilsack was elected governor of Iowa?
Enough about politics I think it is a bit of wishful thinking if we think ObamaCare or ObamneyCare, whatever you want to call it, is going to fix all our health care problems. Until people realize that they are part of the cause of higher health care then we don't have a chance to fix it. It is so easy to place the blame on health insurance companies and target how much their executives are paid, instead of grasping the nature of what an insurance company does. First of all, they are in business to make money If they don't make money then they can't hire people and they can't offer health insurance to their workers They have actuaries who compute potential risks (how many people will become seriously ill or die in a given year or decade and price their product accordingly) Other businesses have risks that they account for and price in their product accordingly as well. I think just because the health insurance industry by nature, deals with health challenges in peoples lives, and has made some mistakes in the past, like we all have I would like to point out, they have become the villian that many people quickly blame. In closing, I believe America is still the greatest country on this earth, however, too much government is going to ruin it.
Maria Houser Conzemius July 3, 2012 at 01:38 pm
Rob Wilson, my understanding of the Affordable Care Act is that doctors won't be paid according to how MUCH care they provide but based on results. We need to change the payment model for health care professionals to one based on results so that doctors are more willing to confront their patients regarding obesity and other preventable factors, elements that yes, people need to take more responsibility for.
I am lucky in that I had one parent who was an athlete all of his life and one parent who served as a role model for what NOT to do. Guess who died first, and almost two decades earlier, though they were the same age when she died? I've lost 25 pounds and have gone on RAGBRAI nearly every year since 1991. We all need to take responsibility for our health and fitness. Obesity is definitely a cultural issue. Minimizing and denying cultural influences is to misunderstand the problem.
Jennifer Zeis July 3, 2012 at 02:33 pm
The whole "auto insurance is mandatory" argument doesn't hold water when it comes to talking about health insurance. You're not required to own a vehicle. If you don't own a vehicle, you don't have to carry auto insurance.
Jeff Klinzman July 3, 2012 at 02:52 pm
What I conclude, Maria, is that health care must be removed from the profit sector of the economy. Consider: health care is not a service that I can contract for when I choose, but a necessity when I become sick or injured. Health care is not a commodity, like petroleum or ag products, which can be sold on an open market.
Look at education: ensuring our children are literate and numerate is so important we cannot entrust that duty to for-profit entities. The irony here are the for-profit colleges, which spend more on marketing than they do on instruction, and which would wither and die if not for access to federally-guaranteed student loans. The for-profit colleges have a dismal record of preparing their graduates for careers, but are great at loading their students with unsustainable debt. And for-profit colleges cost MORE than your typical Ivy League school! So much for the "efficiency" of the capitalist market! Like housing, health care is a fundamental human need. When the Constitution was written, medicine was hardly a "science," surgeons used burly assitants and alcohol to control and subdue their patients, while doctors routinely bled and cupped their patients. The Founders could not be expected to foresee how vital medical care would become. You are right on when you note that the GOP has offered nothing but veiled cruelty and deprivation as its preferred healthcare policy solution.
Maria Houser Conzemius July 3, 2012 at 05:44 pm
Jeff Klinzman, thanks for your support and your explanations of how most Americans are getting screwed by our capitalists-in-bed-with-politicians (of both parties) oligarchy. Republicans are the worst, as you say. The Paul Ryan budget and Mitt Romney's agenda are both heartless and hurt the most vulnerable.
Take Republican Gov. Terry Branstad's decision to refuse federal money to cover 100% of an expanded Medicaid system that would include the working poor who are single and childless currently on IowaCare or Iowa Cares (not sure of the name). Medicaid has better coverage than IowaCare. Why would you want to punish the working poor by depriving them of benefits refused to them by their employers? Just one more reason to NOT reelect Terry Branstad when he's up for reelection.
Maria Houser Conzemius July 3, 2012 at 05:50 pm
Jennifer Zeis, people don't need to own a vehicle to get around, you're right. My grown kids don't own cars, and they get around by bicycle and by walking. They've been doing that almost their entire lives. There's also bus service in Iowa City, which is nice.
However, all humans need health care at some time or another. Uninsured people who don't get health care until they're in extremis cost the system more by going to Emergency Rooms and running up a bill they can't pay. Forcing people to buy health insurance will mean they pay for health insurance instead of hospitals and doctors passing on the costs of uninsured patients without health insurance, people who don't or can't pay their bills, on to the rest of us. The Congressional Budget Office estimates that the Affordable Care Act will save $100 billion over the next 10 years. Preventive care alone, which will be free, saves money because you address medical issues earlier before they become serious.
Jeff Klinzman July 3, 2012 at 06:14 pm
Here's a link to today's NYTimes story about the $3 billion fine levied against GlaxoSmithKline, which was offering cash incentives to doctors to presribe on the GSK's anti-depressants for non-FDA recommended uses.
The FDA is a prime example of the need for federal regulation of the marketplace. Let's remember the reality which led to the formation of the FDA: adulterated food and meat produced in filthy conditions, and an unregulated pharmaceuticla industry which sold addictive drugs such as morphine in patent medicines. Would the Founders have anticipated the rise of the modern pharmaceuticals industry? Would they have foreseen the industrialization of food production? I doubt it. http://www.nytimes.com/2012/07/03/business/glaxosmithkline-agrees-to-pay-3-billion-in-fraud-settlement.html?_r=1&nl=todaysheadlines&emc=edit_th_20120703
Maria Houser Conzemius July 3, 2012 at 07:35 pm
Jeff Klinzman, in my opinion the government should nationalize all pharmaceutical companies, especially when they create an artificial shortage of cancer-fighting drugs. Bayer sells a product for farmers that kills all bugs, including honeybees. You just wonder what Big Pharm is NOT willing to do to make a profit.
Matthew Georges July 4, 2012 at 07:25 am
So all of the good chemists will leave and do something else? This is one of the stupidest things I have ever heard you say Maria, and I've heard you say a lot. Luckily this will never happen. What happens when these government run pharmaceutical companies release a bad drug that causes harm? Who are the people going to look to for compensation? Why would these companies continue to exist absent the motivation to create and sell their medications? Why would they bother developing any more drugs? What planet do you live on? Also, drop the whole holier than thou attitude already, nobody cares if you do Ragbrai, nobody.
Jeff Klinzman July 4, 2012 at 02:05 pm
Nice. In lieu of a thoughtful response, you attack Maria personally, Matthew, and all I see here is more of the same ol' same ol' conservative prejudice, especially in how you imply that public employees are bottom of the barrel in terms of talent. Following your lead, I have to ask if you're one of those "holier than thou" motorists who flip off bicyclists as you drive by?
In a more serious vein, where would we be without federal regulatory bodies like the FAA, NTSB, NOAA, or CDC? Do you REALLY trust the food industry to regulate itself for product safety absent the FDA? As I've mentioned before, shall we discuss patent medicines like laudanum (Wyatt Earp's first wife was addicted to it), which were sold, unregulated, over the counter?
Maria Houser Conzemius July 4, 2012 at 02:56 pm
Thanks, Jeff. Matthew's comment looked like a personal attack to me, too, and I reported it.
Maria Houser Conzemius July 4, 2012 at 03:05 pm
I am one of those Americans who have lost faith in our institutions. I'm currently reading Charles H. Ferguson's "Predator Nation: Corporate Criminals, Political Corruption, and the Hijacking of America," which certainly doesn't improve my faith any. The book is a revelation even after reading Bethany McLean and Joe Nocera's book about Wall Street's gambling away our economy, "All the Devils Are Here: The Hidden History of the Financial Crisis."
Matthew Georges July 4, 2012 at 04:55 pm
Where do the top scientists hope to go? Into Gov jobs or to go make money and have their research actually funded?
As to your assumptions, I am not a conservative, nor am I a driver. I am a year around cyclist who volunteered my time and resources at bike to work week events. I am not saying we don't have government agencies overseeing and testing these drugs, but to have government agencies responsible for creating new drugs is perhaps the dumbest thing I have heard of. It's not so much of a personal attack on Maria, as much of an attack on the stupidity of such an idea. Government has no business creating these new medicines. As Maria even admits below, she has lost faith in our institutions, but wants those same institutions coming up with the next generation of pharmaceuticals.
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Maria Houser Conzemius June 13, 2013 at 10:27 am
Penn State had much the same creed, and you see what that kind of mindless hero worship led to.
Stephen Schmidt (Editor) June 4, 2013 at 10:41 pm
Anything in particular vexing you Maxine? I can't do much about the look but I could help in otherRead More areas.
maxine wiemer June 5, 2013 at 07:53 am
I have been off the blog since the change. For some reason I couldn't get on. When I would sign in,Read More everything would start flashing and wouldn't stop. Anyway I can't seem to find the regular group and its just confusing. I guess I will get used to it eventually or get so frustrated I give it up.
Stephen Schmidt (Editor) June 5, 2013 at 07:59 am
I can see what you're saying, it's been a bit of a culture shock for the editors as well. We'reRead More working to try to make things easier and more understandable for both regulars and newcomers. The article people seem to be arguing on at the moment is this one: http://iowacity.patch.com/groups/editors-picks/p/iowa-patch-poll-will-iowa-gop-be-able-to-recruit-a-highprofile-candidate-to-challenge-bruce-braley
Mr. Clean June 4, 2013 at 08:51 pm
While i don't support ANYTHING this group does, this isn't right. There is a cancer in the IRS. TheRead More whole organization needs to cleaned out and raise the unemployment rate.
Joe Stutler June 4, 2013 at 09:26 pm
I wouldn't mind seeing *every* group requesting not-for-profit status to be examined. That certainRead More groups are being singled out is inappropriate, whether they be anti-abortion (that's the proper term...we're all "pro-life") or pro-choice or whatever. Examine them all, to the same standards.
Maria Houser Conzemius June 4, 2013 at 01:51 pm
No. Didn't work. Okay, now I need to find the article format.
Maria Houser Conzemius June 4, 2013 at 01:55 pm
Can't find the article format. I tried.
maxine wiemer June 5, 2013 at 08:10 am
I totally agree that "growing old isn't for sissies...its for the strong." I will be 60Read More on my next birthday and although I am not looking forward to leaving my 50's, I must admitt that each year comes with a more calming sensibility to it. I see things more clearly now even though forgetfulness is a daily occurance. The laughter of the children is much prettier and the birds chirping is welcoming instead of a nuisence at 5AM.
Stephen Schmidt (Editor) May 31, 2013 at 08:57 am
For tomorrow? I'll ask them and get back to you.
Stephen Schmidt (Editor) May 31, 2013 at 07:08 pm
As far as I know still going.