There was a time, back when I was in high school, when a boy asked a girl out for a date and paid for the evening. Movies, a dance, even dinner – he asked and he paid. A cheap date was a girl who didn’t insist on the fanciest restaurant for every date and didn’t search the menu for the most expensive meal. When we got into our twenties, a cheap date was someone who might only order one or two glasses of wine and didn’t view dating as a competitive drinking sport.
The young woman in my office last week has never been a cheap date, at least not from an insurance perspective. Millie (name changed) is an insulin-dependent diabetic, has been most of her twenty-four years. She has lots of claims every year. There was a time, about ten years ago, when her mother and I had real concerns about finding health insurance for her. Now it is no big deal.
I used to be a cheap (insurance) date. The only time I saw the doctor most years was for my annual physical. No Rx. No issues. This year has permanently changed my status. University Hospital and the doctors have submitted bills for over $550,000 for my care. Millie and I now have something in common. No Insurance company would take us if they had a choice.
We are not alone. Many of you have pre-existing conditions from an illness or injury. You used to be cheap dates. You paid your premiums and seldom filed a claim. An accident or ailment changed that. The most important benefits of The Patient Protection and Affordable Care Act (Obamacare) are the absence of medical underwriting and that all policies cover pre-existing conditions. Millie and I can apply for coverage with no fear of being turned away.
Are those benefits safe?
I get the calls at least once week:
- Are they going to repeal Obamacare?
- What happens if the Republicans win?
- Is my policy going to be cancelled?
My standard answers are:
- Probably not, but if it is we’ll find a new one.
We just watched the four day infomercial for the Republican Party and are moments away from the Democratic Party’s version. Did you hear a substantive discussion about healthcare, 20% of our economy? Of course not. Six years of Obamacare have yielded millions of dollars of negative political ads but not even one serious alternative proposal. Even if we wanted to, we can’t magically return to February 2010. We can’t just repeal the PPACA and then begin the difficult process of creating a new program. If there is to be an alternative, it must be designed with a seamless transition.
That is, of course, just my opinion. This blog has reviewed all of the Republican plans including Speaker Ryan’s latest last month. I have been trying to include coverage of the Libertarian Party’s proposal. In May I interviewed one of the candidates who had been running to be the standard bearer for the Libertarians. His suggestion was to eliminate the PPACA and to make charitable donations a dollar for dollar tax reduction. People would then donate to hospitals and everyone would receive the care they needed without any government involvement. I laughed until I realized that he was serious. Their official platform has no information or details.
But with no disrespect to either the Libertarian or the Green Parties, our next president will most likely be either a D or an R. But that doesn’t mean that there aren’t major issues with the PPACA. The insurers have not found a way to make money under this new system. They will continue to tinker with their networks and plan designs. Hospital and doctors are looking at different business models to reduce expenses and maximize payments from the government and insurers. A new president may be more successful working with a new Congress to make the needed changes to Obamacare. Perhaps, under new leadership, we can get a bipartisan buy-in once we change the name.
It is important to remember that we are talking about 20% of our economy. Our population is aging. Our cost of care is rising. Americans demand the very best of care. And we are never a cheap date.