No Words

[babylonsister]

http://talkingpointsmemo.com/edblog/no-words--5

TPM edblog
Opinions, Context & Ideas from the TPM Editors

ByJosh Marshall
Published December 9, 2016, 8:05 PM EDT


I have nothing but silence to offer. This is TPM Reader TC.

I'm a longtime reader. Thank you for your wonderful reporting and analysis over so many years.

I am prompted write to you for the first time because I appreciate very much your attempt to closely track the GOP's efforts to repeal the Affordable Care Act.

So many times in these discussions words fail to capture the stakes of the issue. When we speak of 20 million, or 23 million people who may "lose their health insurance" if the ACA is repealed, I suspect most of your readers absorb that as a useful data point and then, quite naturally, move on. Their eyes slide to the sentence that follows.

I am writing in the hope that I can get your readers to pause for a moment and consider what this loss truly means, behind the abstractions.

My wife has advanced colo-rectal cancer. She was diagnosed in 2008 when our three children were 3, 2 and 9 months old.

At the time the only insurance available to her was California's Major Risk Insurance Program (MRIP). This was a program designed at the state level to address the insurance needs of people like my wife who have pre-existing conditions (she happens to have a genetic mutation that can lead to colo-rectal cancer). MRIP was better than nothing, but it was paltry: it had an annual cap of $75,000 per year. That first year, we blew through this cap by February. Same thing the second and third years, 2009 and 2010. All the rest of our medical bills -- for multiple surgeries, hospital stays, chemotherapy, radiation, CT-scans, etc. -- we had to pay entirely out of pocket. In 2011, to our huge relief, the ACA came into effect. Amid all the pain and the heartache and soothing our children and long days and nights and fears for the future, we at least knew that we had help with the expenses. We felt our country had our backs.

For many families, if the GOP repeals the ACA it means that they will be thrown back on state programs like MRIP again, at best. Politicians will be able to say proudly that everyone with a pre-existing condition can still get insurance! But without the structure of the ACA and its mandate they will know full well that these insurance programs will severely limit what they cover. Private insurance plans would simply not have large enough pools to do better. State programs would lack funding. People like us would be left in the lurch once again.

This doesn't just mean that "millions will lose their health insurance."

it means someone's mother coughing blood. Or a father groaning in pain and yelling behind a closed door. It means parents or other family members arguing because after one of them missed a promotion at work -- because of all the time spent taking care of a loved one. It means slammed doors. It means missed dinners. Most of all, it means a child somewhere, in some inconsequential town, crying, heaving sobs into his pillow, because his parent is going to die. Another child sitting in stunned silence in class, not listening to a word the teacher says.

I want TPM's readers to visualize this as concretely as possible whenever they consider millions losing their health insurance. Of course I would like members of the GOP leadership and the Trump transition team to visualize this too. Repealing a health insurance program that has been working for millions of people is worse than proposing something ineffective. It demonstrates outright a willingness to be cruel. To hurt people unnecessarily. There is no other word for it. It is heartless.

[BSdetect]

1. I came from Australia

where we had decent health cover for virtually everyone.

For years we read about millions of American families and individuals going bankrupt because of medical bills.

It seemed like a shocking way to deal with health and medicine. Science advances ought to be available for all.

Some examples. From Australia.

My brother has aneurysm deep in his brain. He had an operation that was only possible through recent advances in techniques. He came through without any loss of memory or motor function. A week later he underwent the same operation and came through again in perfect shape. They has found a tiny piece hidden from the first scans till after the first operation. The surgeon was one of the top surgeons in the country. This whole hospital stay cost almost nothing but would likely have bankrupted his family had it happened here. He is alive and well after 15 years.

The benefits included getting experience with this successful operation for other people.

This is the only so called developed country that has an aversion to helping people with health issues.

I am so sorry to hear about your wife and hope you can all get through this sham presidential nightmare.

The GOP is a party that totally disgusts me.

[ffr]

2. ACA member here. My rates will drop 20% for 2017 from 2016.

The reports of rates going up were for plans, like the one I had, that carriers upped rates on year to year. So what! I switched to an equivalent plan and my rates dropped substantially. Apples to apples. Well, I think I'll pay $35 - 40 for doctor visits, instead of $20, but my deductibles are lower, so pretty much apples to apples, plan for plan.

I don't want my ACA plan to go away, because my insurance carrier gave me their quote sheet for the "outside ACA" plans, which they said would be far cheaper. My 2017 plan was one on that list. $95/mo more outside ACA. Same exact plan.

Fcuk Republicans and their lying Insurance industry minions!

[Aviation Pro]

4. Fcuk Republicans and their lying Insurance industry minions!

Overlords.

There, fixed it for you.

[Tanuki]

3. I wish every lawmaker and every voter in America would read this. eom

[trc]

16. We have got to get over this belief

that if we just tell the truth the Republicans will see the error of their ways. They won't, they don't care. All that matters is that a person with an R after their name won the election. It is that simple. I have a Republican family member who has had an abortion, lives in a national forest and depends on social security for her support...no matter what I said, proved with facts, sources and documentation, she voted for Trump. I was not surprised, I knew she would do it...and then complain about the government. Wait till her SSI is gone, she has no health insurance, and her forest is sold for lumber and mining. Who will she vote for then? A Republican. Stupid is as stupid does.

[iluvtennis]

5. What Don the Con/Paul Ryan/et al want to do with Obamacare is DISGUSTING...

...they are all wealthy or never had a health condition where they were denied them medical care, so they have no empathy.

I'm with you, just speechless if Don the Con overturns Obamacare.

I don't care if Don the Con wants his own legacy for healthcare, he can do that, just please provide folks who need healthcare with healthcare options they can afford to pay for and provide coverage for folks (like me) with pre-exisiting conditions.

[PoindexterOglethorpe]

6. If the person who told that story in the OP

went through the $75k cap by February, how in the name of whatever did they pay what must have been hundreds of thousands of dollars for the rest of the year?

I can't begin to imagine.

I've always had the good fortune to have excellent health, and decent medical coverage for what little bit of medical stuff I've ever needed. For years I've wondered why anyone would ever move to this country from one that has genuine medical coverage for its citizens.

I sometimes write science fiction, and I've been toying with the idea of a story set in a very dystopian U.S. in which medical care and medical insurance has gotten so out of hand that the most popular low-cost plan is one in which if you have a disease or condition that's too expensive, you get taken out to the north 40 and shot.

I did say very dystopian.

[OldRedneck]

7. How did they pay for it?

Take out a second mortgage.

Borrow from family and friends.

Blow through all their savings and investments (forget college for the kids).

Don't pay the bills. The hospital and docs will take them to court, get a judgment against them, their estate, and their heirs.

I'm an Advanced Life Support EMT in rural Virginia. VA did not adopt Medicaid expansion. We were called to a residence two months ago -- 55 yr old woman with multiple chronic illnesses, 56 yr old husband, no medical insurance, huge medical bills. His job had no benefits but pay was too much for them to qualify for Medicaid. They had gone through their small savings; family was not able to help; they had used all the equity in their home. He went grocery shopping, came back, found her with a plastic bag around her head, dead. She left a note: "We can't afford for me to be sick. Goodbye. I'm no longer a burden on you."

I hate Republicans. I really, really do hate Republicans.

And about your proposed story line? It's not that far removed from the reality that's coming.

This nation is headed into a very long, very dark tunnel with no hope of a light at the end.

[PoindexterOglethorpe]

9. Thank you.

The states who did not expand Medicaid, more precisely the elected officials who blocked such expansion are pure evil. They will never suffer enough themselves.

[progressoid]

11. Good lord.

Sadly, there are more stories out there like that.

[LittleGirl]

13. have a similar story

my niece's husband's father committed suicide by gun a few years ago. He was sick and couldn't afford the medical (pre-ACA). He was about my age- mid-50s.

[smirkymonkey]

17. God, that is just such a tragic, awful story.

And I am only afraid that we are going to hear a lot more of these as time goes on. I just cannot believe how incredibly cruel and heartless republicans can be. I never imagined such evil really existed.

[napi21]

8. The ACA iswonderful for some, and awful for some others.

I helped my cousin to enroll in the ACA when it first was available. She had a Pa. State plan that allowed 4 dr. visits per year, no drug coverage, and a cap of $25,000/yr., and cost $165/mo. She's thrilled with the ACA plan she has. It cist's $112,/mo. but has drug coverage, a deductible of $100, and no cap. Yes, he cost went up a bit both last year and this one, it still iss at a reasonable $ 160/mo.

OTOH, my son lost a job he had for 11 years, working in Sicily under a contract. The contract was issued to someone else and he came back to the US. He applied for ACA ins. and his monthly payment for 2 people was $320. He found a job later that year that didn't offer ins. He contacted the ins. he had, and they said the premium was going to go up to $1600/mo. How the heck was he supposed to pay THAT? He had rent to pay, all the other expenses of living and they wanted THAT MUCH. He decided they were going to take a chance and not have any ins. He finally found a carrier to sell his a policy that wasn't ACA compatible, but it was $300/mo. Thank goodness, he now has a job that has benefits so he no longer needs to worry about the ACA.

Just with those two examples, you can see why there are very different opinions about whether the ACA goes or stays. It's terrific for the very poor, butt slip into the middle class and you get screwed.

[SHRED]

10. ACA has changed insurance for the better in many ways

No discrimination for preexisting conditions.
Women pay the same rates as men, not more as before.
Up to 26 years old can be on parents plan.
Caps on treatment cost has been removed so your insurance company must pay ongoing expensive care.

That said...we need it fixed.
Still way too expensive for those in my age group 55-65.

[flamingdem]

12. These personal stories are so critical to hear

I am personally being saved financially by ACA. My previous insurance was so poor I never used it. The idea of going back to that and essentially not taking care of myself is unthinkable.

[McKim]

14. Our Niece Died Because ACA in Georgia Was Too Expensive

Our 54 year old niece died last year. She lived in George and the deductible for her ACA was very high. She put off going to the doctor for that nasty cough and her lung cancer was very advanced by the time she did go to the ER. We tried to get her to go earlier, but the copay was a deterant.
This is one tragedy out of many.

[Lifelong Protester]

15. I am so heartbroken.

This is appalling. What is GREAT about this?