Reactions to Health Care Reform

From time to time, I’m not going to write about style. I might put you on the game to some real stuff. I can do what I want, it's my blog. So......

People love talking politics. And after yesterday’s Supreme Court decision on health care reform, I (as I’m sure many of you), had dozens of friends who were now suddenly experts on the subject. Well guess what? I majored in political science, which means somewhere a group of naive people thought I knew enough about politics to earn a degree in it. Here’s what I have to say:

The New

This health care reform act has a lot to it, and the finer implications it will have on the insurance industry, medical industry, and economy at large can only truly be known over time. Things change, people adapt. I don’t really care what you think will happen, because I generally don’t care what people have to say about politics. C’est la vie. 

One thing I like though, because of it’s dramatic personal touch, is that the law mandates that health plans cover a list of essential health benefits. “Essential health benefits must include items and services within at least the following 10 categories:

1. Ambulatory patient services

2. Emergency services

3. Hospitalization

4. Maternity and newborn care

5. Mental health and substance use disorder services, including behavioral health treatment

6. Prescription drugs

7. Rehabilitative and habilitative services and devices

8. Laboratory services

9. Preventive and wellness services and chronic disease management, and

10. Pediatric services, including oral and vision care”- source

Another thing I like? “Under the Affordable Care Act, insurance companies will no longer be allowed to set limits on the dollar amount of health benefits that they will cover in a single year or over the course of a person’s lifetime. This means that you won’t run out of coverage if you develop a health problem that is costly to treat.”- source

Now I’m a pretty healthy guy. I eat healthy food, I exercise regularly, I don’t smoke, and I don’t drink………...soda. In fact, I’m so healthy, I haven’t been to the doctor in years. I’m that healthy.

The Old

Years ago though, I had a pretty serious accident (not the incontinent kind). Subsequently I needed some reconstructive surgery. Not, “Hey my nose has a weird bump I’d like removed,” or, “I’d prefer if my ears didn’t stick out so much”. It was more like that scene from “American X.” You know, the one where the black guy gets his face curb-stomped to a pulp by Ed Norton and you can’t really watch the whole thing or else you’ll puke. Yeah, it was like that. 

So you can imagine my dismay, no, my fucking incredulous disbelief, when my then-current insurance provider claimed that replacing my teeth was an “elective surgery.” Let me make sure that sinks in. Replacing every single tooth was “elective.” Like I was supposed to gum down applesauce for the rest of my life. 

Not to mention, I was now “forced” to come up with a lot of money so I could “elect” to “chew” food and “talk” normally. 

Oh, and then the company, faced with some actual medical bills, decided to drop me. I had the same feeling you get when you watch this douchebag jump in a life-raft at the end of “Titanic.” 

The change

First, the ban on limiting dollar amounts means that, should you or I get in some serious shit, the insurance provider can’t cut you off. This affects a lot of people faced with life-threatening illnesses or costly medical treatments. It’s not fun to receive a letter saying, “Sorry, you stayed in the hospital too long, so we’re not paying,” if you genuinely needed to be there. A ride in an ambulance alone can cost around $5,000, so medical bills can and do quickly add up to amounts that can cripple a family financially. 

Second, although dental care is still considered a “nonessential” health benefit for most adults, as a law student I can tell you that mandating coverage of certain services goes a long way into helping an argument for why the provider should pay. Before, it seemed like insurance companies ruled with an iron fist, dictated by whims of fancy. What was an “emergency?” What is “essential?” Whatever’s cheap. Now there is a list of required coverage, and it’s easier to argue that replacing 32 teeth is a rehabilitative or habilitative service that has to be covered, rather than an “elective” surgery that isn’t strictly necessary. (In fact, you could also argue that replacing teeth is a preventative service that would cut down on health care costs in the long run for the provider, but that’s the lawyer in me talking). 

The End

Am I bitter? No, not really. Well maybe a little. But it really pisses me off when ignorant people claim “Obamacare” is ruining the best healthcare system in the world. Um, no, it’s fucking not. Health care in this country was like kind of the Titanic (again with the movies). If you could afford first-class, it was pretty good. If you couldn’t though, or if you ever had real problems, you were pretty much fucked when shit hit the fan. Because when the time came for my insurance company to come in and, you know, actually help pay for the cost of some medical care, they basically flipped me off. Frankly I would have preferred a post card that said, “Enjoy your apple sauce bitch!” because at least that would have been slightly amusing.

That’s my rant. Keep it real pimpin’,

MD