“I mean, people have access to health care in America. After all, you just go to an emergency room.” President George W. Bush, July 11, 2007
Imagine you are John Doe, married with two children, earning $30,000 a year. Your employer doesn’t offer health insurance and you can’t afford to buy it privately. You’re worried about some heart issues, so you go to the local emergency room. You wait your turn, and then tell the doctor, “I’m here for my annual check-up.” What will the doctor say?
After the doctor stops laughing, he or she will gently remind you that emergency rooms do not provide primary care or preventive care or continuous care for chronic conditions such as heart disease or cancer. Emergency rooms are for emergencies, immediate and acute situations. If emergency rooms tried to provide primary, preventive and ongoing care, they wouldn’t have the resources to provide the emergency care for which they were built.
During a Sept. 23, 2012, interview on 60 Minutes, Republican presidential candidate Mitt Romney said America already has adequate health care for everyone. “Well, we do provide care for people who don’t have insurance, people — we– if someone has a heart attack, they don’t sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care.”
Neither Bush nor Romney seemed to understand that waiting until you have a heart attack is not the best way to stay healthy. Bush had his regular physical on Aug. 5, 2013. His doctors found a blockage in an artery. On Aug. 6, Bush had surgery to place a stent in the artery. If Bush was getting his health care from the emergency room, would that have happened? Of course not. If Bush was John Doe, he would have had to have a heart attack first, possibly dying, and definitely placing his and his family’s welfare in jeopardy. It was for this very reason that the Affordable Care Act (ACA) was created, modeled on the plan Gov. Romney implemented in Massachusetts.
The basic foundation of the ACA is the state health exchanges. Consumers can go to these exchanges, look up insurance plans, compare features and prices, and pick the plan that best fits their needs. Each state will have several plans available, averaging 53 plans per state. These exchanges embody what Republicans claim are two of their basic principles — freedom and competition. No one is forced to buy from an exchange. If you can get cheaper insurance privately, great; however, most people who have to buy their own insurance will find the exchanges much cheaper.
If John goes to the Nevada exchange, nevadahealthlink.com, he will find that with a family of four and a salary of $30,000, he is eligible for Medicaid. The actual insurance will cost him nothing and will cover 70 percent of his medical costs.
If John gets a new job paying $50,000 a year but without benefits, he can still apply on Nevada Health Link. With the Silver plan, he will pay a premium of $280.46 a month. That’s not free, but it is affordable, and John’s entire family will be fully covered.
Republicans shut down the government to prevent people like John from getting health coverage. Sen. Ted Cruz, R-Texas, the leader of the shutdown, is covered by a $40,000 per year policy paid for by his wife’s employer. I don’t begrudge him that. I do begrudge him thinking that regular people don’t deserve health coverage. Cruz said Obama wouldn’t negotiate. Here is what Obama should have said.
“We will delay the ACA for one year. In return, Congress will pass a law requiring background checks on every gun purchase and registration of every gun in America.” Would Cruz have negotiated then?
When the healthcare.gov website opened, it had 8.6 million visitors the first four days. There were many glitches. When Medicare Part D launched in 2006, it was very unpopular and had a multitude of problems. Romneycare in Massachusetts, now very successful, also had a rocky start. The difference was that Democrats weren’t trying to scuttle those programs. People found the problems and fixed them. Unfortunately, Republicans don’t care about fixing the ACA. They would rather see it fail and make Obama look bad than make sure tens of millions of Americans have affordable health insurance. I guess when you have a $40,000 a year policy protecting you, it’s easy to forget that everyone is not so fortunate.
Jeanette Strong’s column appears every other Wednesday.