Science Blogger Kevin Zelnio writes about his six year-old son's bout with pneumonia:
My family includes four of the 49.1 million uninsured people in the United States. I’ve comforted myself that we couldn’t afford private insurance, which we can’t, but at least we were all relatively healthy and never seemed to have problems. [...]
But recently my mindset has become affected by our position. I tell my kids not to do things that I certainly enjoyed doing as a kid, like don’t climb high on trees, run a little slower on the trail, watch out for roots and stones! It’s not just the usual parental concern either. I’m consciously thinking “oh my god, I cannot afford to fix them if they get broke!”.
This is the luxury gap between the between the 20% of nonelderly americans who are uninsured and the rest. The luxury is, of course, being able to just walk into a doctor’s office and see them at the appropriate times. It is easy to discount this minority since most are at or near the poverty line. But many of the uninsured are like myself and just can’t seem to make the numbers work for a family of four each month by adding on private individual (i.e. non-group discounted) health insurance. [...]
By Tuesday we weren’t left with any choice. My son had just gotten out of a bath and though he wasn’t cold, his hand and his feet were blue. I’d never seen it like that before. My wife laid it down and we were going to the Urgent Care. We all got dressed and heading over there early. He was miserable, crying in pain cause he couldn’t get enough oxygen. We were scared that we might have waited too long. [...]
Most of the uninsured in this country aren’t lazy, freeloading hobos who don’t wanna work. They span a wide variety of demographics. As a 30 something, white male with advanced college degree who works full time as a self-employed consultant and writer are you surprised that I cannot afford health insurance for my family? In fact, the majority of uninsured are in my age range and are full or part time workers earning incomes above 100% the federal poverty level.The good news is that his son got better. The bad news is that his care was a couple of orders of magnitude more expensive than it might have been if they'd had better access to care, and that his son's life was put into jeopardy by their necessary reluctance to seek out care. Adding insult to injury is that this family will probably have any financial reserve they possess wiped out by what should have been a minor illness.
And these aren't dirty cigarette-smoking, cell-phone buying scumbag poor people who deserve their fate (the caricature of the uninsured found most typically on libertarian blogs). This guy holds an advanced science degree and this family is firmly in the middle class. They're just unlucky enough to have to buy non-group plan insurance in the pre-ACA marketplace.
And this shouldn't be surprising, but it is: 12% of families making more than $90,000 a year (that's 4x the federal poverty level for family of four) went uninsured for at least some of the time in a given year, and that number is much higher the closer to the FPL you get, with 15-40% of those affected remaining uninsured for an entire year or longer. And when they are uninsured, they skip screenings and preventative care and also skip necessary care when they get ill. All of which adds up to increased cost, sickness, and death.
The ACA — if it goes into effect — will mitigate this. The health insurance exchanges will regulate individual health insurance plans, guarantee that no person or family will be rejected due to prior history, and make it easier for families to shop for and purchase insurance. The subsidies will make insurance more affordable on a sliding-scale basis. Bringing everybody (or nearly so) into the system will make insurance cheaper for all of us.
The ACA isn't perfect. At best it's a start. There may not be death panels, but there's plenty there not to like. You've got the mandate (for the record, I'd be fine with ditching the mandate if there were another effective method to encourage healthy people to buy in — lock-out periods or late-entry penalties or what have you). There's no public option to force insurers to compete honestly. ACOs may not do anything to bring down costs. But for Kevin Zelnio and his family and the many other families in similar situations, who desperately want insurance but cannot afford it, ObamaCare provides them with a ticket to enter into the system. It's a pity that it's gotten so polarized that we can't move on and get to work on fixing deficiencies, improving what we've got, rather than refighting the scorched earth campaigns of 2009.