Blair Horner: Fact checking the health care debate

Oct 23, 2012

As we all know, the fate of the federal health care reform law is to be decided by voters this November.  There are those running against the law that argue that they want to “repeal and replace” the law. 

However, there has been no alternative offered by opponents – just vague promises, partial pledges and grotesque distortions of the federal law itself.

In the heat of the political season, it’s important to take a closer look at opponents’ promises.

The first is the charge made that “nobody in America dies because he or she is uninsured.”  Supporters of this argument point to the fact that health care providers are barred from denying care to those who show up for emergency care.

That is true.  If someone without health insurance shows up in a hospital emergency room, they get care.  But they then get billed for that care.  If someone with adequate health insurance goes to an emergency room seeking care they get it, their insurer gets the bill.

As a result, many of the uninsured don’t go to the emergency room for care.  If they could afford the bills for serious illnesses, they would probably have insurance in the first place.  In addition, those without health insurance often fail to obtain preventive care because they don’t have the money to pay for it.  Not getting regular preventive care can lead to dire health consequences.

In the area of cancer, uninsured patients are less likely to get recommended cancer screenings and are more likely to be diagnosed with cancer at later stages.  As a result, the uninsured are also much more likely to get a cancer diagnosis at a later stage, on average, than an individual with health insurance.  For example, uninsured women diagnosed with breast cancer are 2.5 times more likely to have a late stage diagnosis than women enrolled in private health insurance.  In many cases, an early diagnosis is the difference between life and death.

So when you hear the argument that “nobody in America dies because he or she is uninsured,” know that the argument is false. 

Secondly, some opponents of the federal law say that they support aspects of it.  They argue that they wish to repeal the law and then reinstitute some aspects of the plan.  During one of the recent Presidential debates, Mr. Romney stated that he supports requiring insurers to cover pre-existing conditions. 

Sounds like the current federal law, but when you look deeper at the details, it’s far weaker. 

People who have pre-existing conditions — and are not already covered by insurance — are often refused coverage or charged exorbitant rates by private insurers. Starting in 2014, the current federal health care law will require insurers to accept all applicants and charge them without regard to health status.  By contrast, Mr. Romney has simply pledged to protect people who had insurance but then lost it, provided they take out a new policy within a short time.  But this protection is already required by law and offers absolutely nothing for millions of people who can’t get or can’t afford private insurance.

But let’s get away from policy arguments and look at how repealing federal health care reform impacts real people.  A professional acquaintance of mine told me of her son who was born with no aorta and a too small windpipe.  Her son has had many surgeries and there are more surgeries ahead for him.  

Despite those difficulties, one thing her son has going for him is that the family has excellent health insurance.  Unless life makes some seriously unexpected turns, she expects to be insured. But if the federal law is repealed, her family may very well reach an established annual or lifetime caps on his coverage.  Before he was one year old, her son’s medical bills exceeded $2 million.

Without the federal health care law, once he ages out of her coverage at the age of 26 (the current legal requirement under the federal health care law), her son must maintain his insurance status because his pre-existing heart condition would allow insurers to deny him coverage.

As you see, however imperfect the federal health care law, without it we could all face devastating consequences.

Blair Horner is the Vice President for Advocacy for the American Cancer Society, Eastern Division.  His commentary does not necessarily reflect the views of the American Cancer Society.

The views expressed by commentators are solely those of the authors, and do not necessarily reflect the views of this station or its management.