Health Care

Bill and I listened to most of Bill Clinton's speech two days ago at the Democratic convention, and there is one thing that really jumped out at me. In one little line he mentioned that people have told him that in order to pay for medical costs they had to either quit a job or get a divorce in order to qualify for Medicaid. What kind of country do we live in where there is actually a disincentive for work? How does it make sense that a family has to actually quit work or get a divorce (two very un-American things) in order to get health coverage? Many of you know that Bill and I had to drastically reduce our income in order to get coverage for Molly. I had to leave my fellowship (temporarily, but it was a very significant chunk of our monthly income) because I was still getting a couple of paychecks from the university where I was teaching last semester, and Bill had to reduce his workload from 40 hours/week down to 10. We had insurance for Molly through my student coverage, but it was only for 30 days, and it had a $25,000 cap. That was approximately 3 days in the NICU, and our share would have been more than $450,000 (yes, that is 45 with four zeros). We also talked about the possibility of getting a divorce. Our situation is far from unique, and we are in a very temporary place because Molly (hopefully) only had acute medical problems, so after she left the hospital, she was a healthy girl with no long-term health concerns. We will eventually be able to buy insurance for her or include her in group coverage through employers. Of course, when she was born, she was absolutely uninsurable so we had to get Medicaid.

There are 45 million people in the U.S. without health coverage. 45 MILLION! That is crazy to me. I have done a lot of reading about this (it was the topic of one of the papers I wrote for my qualifying exam to advance to candidacy for my phd), and I am not hopeful that we will get this situation corrected any time soon. There are so many competing interests, and our system is an absolute mess!

There is the fairly common misperception that universal health care is the equivalent of socialized medicine. Socialized medicine would mean that the government employs doctors and other health care providers. Universal health care is a much more broad term that just implies a plan where everyone in the country has insurance or some other form of regular access to medical care. Ideally, employers in the U.S. provide insurance, and there are Medicaid and Medicare for the indigent and elderly, respectively, who are out of the work force. However, the number of part-time workers is increasing (they usually do not get insurance), and the number of employers who are providing any coverage or adequate coverage is decreasing so more and more American workers and their families are without adequate insurance. Thus, the incentive to NOT work becomes even more strong, and essentially becomes a mandate. Otherwise, how could they get health coverage? I really hope that our next president makes this a priority and at least gets the process moving forward.