I first began noticing the many odd notions people have about health insurance last year, after I wrote a Los Angeles Times op-ed about my troubles with Blue Cross and my cancer treatments. A commenter on Kevin Drum’s liberal Washington Monthly blog observed: “I can’t help but notice that this woman is a writer for the National Review.”
The implication, I suppose, was that “this woman” is a mean old Republican who therefore doesn’t care about the millions of Americans who are uninsured or underinsured or just facing a lot of outrageous mistreatment from their insurance companies. (In my case, Blue Cross had retroactively denied an almost-approved lung-cancer treatment, even after two CT scans showed it had been working. I protested to the state of California, who sided with me and my doctor against Blue Cross.)
Yes, what is this terrible Republican woman doing complaining about an insurance company? Don’t all Republicans side with evil corporate entities against suffering human beings? Isn’t that…you know…a basic part of the platform or something?
But for some reason, the only politicians pushing expanded access to health care right now are Republicans: Gov. Arnold Schwarzenegger of California and former Gov. Mitt Romney of Massachusetts, who’s just left his post to become a (mean old) Republican presidential candidate in 2008.
Both Schwarzenegger and Romney believe in mandatory health insurance — as do I, because it spreads the risk among a wider pool and so makes insurance more affordable for everyone. That’s the basic idea behind insurance, although many people fail to understand it. I’ve had commenters on my blog, for instance, tell me that I should be grateful that my insurance company pays my medical bills at all.
But that’s the essential idea behind insurance. I never even reached my deductible before I was diagnosed in 2002, but didn’t feel I was getting a raw deal — although I’ve actually heard other people complain that every year they don’t reach their deductible they are for some reason unlucky and insurance is a bad investment.
Not surprisingly, this sort of thinking brings forth angry, Ayn Randian howls of fury from dedicated large “L” libertarians. “No different than socialism!,” I keep hearing from readers. Or: Who are you to tell me how to spend my money?
True-believer liberals don’t like it either, such as California-assembly speaker Fabian Nunez, who told the L.A. Times that he couldn’t support the governor’s mandatory health-insurance idea “until and unless we solve the problem of the costs of the premiums.”
But federal law means that everyone must get emergency medical care. So then the question becomes: Who are you to tell me (and other taxpayers) that we need to pick up your medical bills if you’re injured or sick because you refused to take responsibility for buying your own health insurance?
“It’s just too expensive,” is the refrain I often hear from young, healthy people in their 20s and 30s (or, this being Los Angeles, people who think they’re still in their 20s and 30s.) Well, yes, it is quite expensive. On the other hand, I see some of these same people managing to afford a car lease, or regular travel, or life without a roommate. There are ways to cut corners, even in a ridiculously pricey city like L.A. But health insurance isn’t a luxury.
Of course, sometimes people try their hardest to buy individual health-insurance policies and, in California at least, the insurance companies won’t let them — often for trivial reasons, such as taking medicine for heartburn or asthma. Blue Cross was recently fined $200,000 for improperly voiding members’ policies years after they’d been written, apparently just because they got sick and began making claims.
But here’s another thing: Federal law means that even the lowliest uninsured illegal immigrant must get medical care if it’s a matter of life and death. So then the question becomes: How much do you (or, actually, we) want to pay for this? What’s the point of denying the child of illegal immigrants a $10 dose of antibiotic, if that could prevent an extremely expensive hospital stay later?
I can understand why people are angry about Schwarzenegger’s plan to insure illegal immigrants — but children rarely suffer from expensive chronic diseases, so it makes a certain amount of business sense to add a broad healthy base to the risk pool. In any case, the real question is: Do you want to treat them cheaply now or expensively later?
In case you’re wondering what I mean by “extremely expensive,” here’s one example: The rack rate, so to speak, for my week at Cedars-Sinai last month was about $47,000; the Blue Cross negotiated rate was around $20,000. So that’s yet another reason to have health insurance: to avoid paying rates inflated to protect against all the people out there who can’t or won’t pay — including those who consider mandatory insurance socialism.
As someone who’s spent an unpleasant amount of time lately in emergency rooms, I’d also like to see these places stop being used as walk-in clinics for people with stomach viruses or the flu. In October, for instance, I sat in the Cedars ER waiting room for five and half hours before being admitted.
While there, I noticed a couple of robust guys next to me in the waiting room who had giant plates of hamburgers-and-fries from the cafeteria. Whatever was wrong with them, it certainly didn’t affect their appetites.