A letter to the editor from Alan Cipriani.
I tried to put a comment up on the Daily Camera’s website, but apparently my post is too long and it’s just a PITA. It’s the typical healthcare tale of woe with just enough truth in it to pull all the heart strings. Of course, let’s not forget that the whole letter appears to be a fabrication.
The hypothetical conditions are a wife with multiple sclerosis and the husband who just lost his job with either past or current treatment for prostate cancer and two children.
Next month you lose your job and health care benefits. You are now one of the 14,000 Americans who lose their health insurance every day. You investigate COBRA insurance, but discover the premiums are much more than you can afford. You try to buy insurance on the open market, but are denied due to your pre-existing condition. Now you gamble and do without health insurance, even though 18,000 Americans die each year due to a lack of medical coverage.
Well, there ARE options:
- First, COBRA insurance is simply continuation of the group plan you are on with your employer. The cost is much higher as you have to pay the total premium, which includes your employers share. At most, the cost you pay is 2% higher then what the combined cost was when you were an employee.
- Secondly, each person in the family can elect or decline COBRA.
- Third, yes multiple sclerosis is an automatic decline with individual insurance companies. Prostate cancer in the past is one of the conditions that is more likely to be covered but no guarantee.
- And finally, just because an individual insurance plan is not available from a private carrier, the option of a State risk pool, in this case Cover Colorado, is available. Cover Colorado premiums are based on age, tobacco use and interestingly enough, gender, which the individual companies cannot do. They are not based on your medical history.
SO THERE ARE OPTIONS available to this hypothetical family. Are they expensive? Most likely but it depends on age. That said, they ARE available and people that have had these diseases certainly should have an appreciation for the benefits health coverage could provide for them.
After lamenting about all the day to day bills, the son has a hypothetical accident:
Then your son is in an auto accident and hospitalized for an extended period requiring multiple surgeries. Medical bills are quickly mounting.
So why aren’t the children covered? If this was a real case that Mr. Cipriani was actually familiar with, he certainly would have taken a moment to lament on the difficulty of obtaining child only insurance. Since he didn’t do that, this adds evidence that this is either a manufactured situation or something that happened more than a few year back.
Getting back to the lack of coverage for the children (or at least the son) there are a few easily exercisable options:
- The children alone could have been put on COBRA
- If a child only open enrollment period lined up the children could have gotten there own individual policies. Individual policies are guaranteed issue for children (not guaranteed price) with no pre-existing waiting period. The fly in the ointment is aligning the need with the open enrollment periods. If a parent is eligible for coverage, the child is guaranteed issue and the open enrollment period restriction does not apply
- If it wasn’t a child only open enrollment period, the children could have either been put on COBRA or gotten a short term major medical policy and then gotten a child only policy
- Another option is Cover Colorado if it wasn’t a child only open enrollment period
- and another option would be to get an accident plan. Obviously this strategy has multiple weaknesses but for the cost it provides a measurable amount of protection
- If the child hasn’t had coverage for 6 months, he can get on the Federal risk pool and pre-existing conditions will be covered with no waiting period.
Mr. Cipriani concludes:
Affordable health care for all Americans now looks pretty good.
Talk about Mom and Apple pie, of course that would be good. However, Obamacare is far from addressing the cost of healthcare. What Mr. Cipriani actually means is won’t it be great to have someone else pay the hypothetical families premiums. Damn, I’d like that to happen at my house too.
It’s true many people cannot afford health coverage.
But many many people ELECT NOT to be able to afford health coverage. It’s quite obvious this is happening because the Federal Risk pool in Colorado, that is run by the State, is hemorrhaging money. Why? Because if you haven’t had coverage for the last 6 months and you develop an uninsurable medical condition they will accept you with NO Pre-existing waiting period. If people truly couldn’t afford health insurance this program wouldn’t be hemorrhaging money. Of course, once they have a major medical condition and insurance is suddenly important to them, many of the applicants can suddenly afford the coverage. Hence it’s a matter of priorities.
Having had major insurance claims in my family, I can tell you that our health insurance would be the last expense that I dropped. I would think that someone that had a family with MS and prostate cancer would feel the same way.
