Monday, August 10, 2009

Why Washington Needs a Health Care Answer

In all of the disrupted town hall meetings, and all of the distortions from people like Sarah Palin discussing "death panels" or the 48 point GOP email full of more distortions or flat out lies, and even the policy wonk's focus on statistics, we often lose track of the real impact: The people. I want to share an illustration of one such person that is close to me.

A family member of mine, let's call him Robert (for his privacy), is a 35 year old professional who works for a good company and has for years. He makes just above the average income, has above average benefits, three children and a wife. He is an amazing guy who gives of his heart to people far beyond 98% of the people I know. He has one of the better medical insurance companies covering him with solid coverage. So why talk about Robert when he has such good coverage?

A few months ago, Robert hurt his back. He went to the doctor and the doctor noticed something that pointed to his brain. They did an MRI on his brain and found four spots in his brain in a very serious area. The doctors had to fight to get an MRI on his spine with the insurance company (talk about rationing of care?) and when they got one, they found a spot in his spine. The doctors don't believe that this is where these spots started, but they can't get the insurance company to cover an MRI on the rest of the body to find out where it originated. At this point, we still don't have a diagnosis three or so months later.

The location of the spots means that they can't simply do a biopsy to find out what the spots are because they are in the center of the brain and in the spine. What makes the rationing of care even more unnerving is that Robert had a benign tumor removed in the lower part of his body less than a decade ago, but the insurance company won't cover any scans to look for more. Now, there are other details but the point is the care is rationed in the private sector without any real recourse.

Now, to take this a step further, while there is no diagnosis at this point, let's assume a very bad case scenario, that this is a tumor that has spread to his brain and his spine. Robert is the breadwinner for his family and while his wife does work, she was planning to start school to become an RN, a multi-year endeavor that may or may not be on the back burner. They own their own house and have two car payments and the kids. So the question becomes, what happens to Jamie's health care when things get worse?

It won't be surprising if Robert can't work at some point, which would mean his employer may have to lay him off when his leave time runs out. That leaves Jamie with two choices: COBRA insurance or no insurance. COBRA only lasts for a relatively short time and leaves the individual paying both their part of the premium and most of the company's part. That means they will lose their primary income AND increase their bills just to make sure he has care.

Not counting their clear economic problems, this is a scenario that the GOP doesn't have a health care answer to. Some of it may be covered by disability and coverage, but still will leave them falling short. It also doesn't answer the question: What about medical insurance for the children and the mother now that his job coverage is gone?

This is the average family that has paid for their health insurance for years and now when there is a major problem, it looks like their health care is both rationed and potentially unable to cover the whole family over the time of the crisis. If you want to know why I am so hard on the Republican Party over health care at this point in time, the answer is simple: They offer nothing for the problem of Robert and his family other than to suck it up and beg the church for money.

It is up to President Obama and the Democrats to create the leadership that will help Robert and his family. Without their leadership, this is one family that may fall by the wayside, and one of the most giving people I have ever met that may have to suffer and watch his family suffer. That should never be allowed to happen.

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