WASHINGTON — My mother has always been obsessive about making certain that her grown children have health insurance. Her Depression-era childhood in the rural, segregated South taught her the hazard and heartbreak that can engulf those without the financial resources to get medical care.
But she’s by no means the only parent to worry about health insurance for adult children. The labor-force-entry period right after college has frequently been a time of low earnings and no benefits for young workers, who are routinely kicked off their parents’ health insurance plans once they finish college (or before that, if they hit a defined age limit, usually 23). Parents of young adults have scrounged about for an affordable health insurance plan to cover them.
One of the many benefits which will likely be enshrined in health insurance reform is a provision which would allow an adult child to stay on a parent’s policy until his/her 27th birthday; that simple change would grant coverage through graduate school for students, as well as covering the period when many 20-somethings find themselves in a low-paying job with no health care coverage. Despite the constant drumbeat from Rush Limbaugh’s microphone about a U.S. health care system that’s “the best in the world,” ours is not. It is the most expensive in the world — a dysfunctional hodge-podge of fee-for-service care that de-emphasizes preventive medicine and encourages expensive procedures and pills.
You’d think that, with those facts on their side, President Obama and Congressional leaders would be able to construct a simple, compelling narrative to compete with Limbaugh’s line. But they’re Democrats. So they’re losing the rhetorical war over health care reform.
Yet, both the House and Senate versions contain measures that will improve the marketplace for health care consumers, including those who already have insurance. Both bills, for example, would curb the infuriating practice of denying coverage for “pre-existing conditions.” That’s a significant improvement.
Critics have rightly noted that some of the harsher measures in the legislation — such as penalties for small businesses that don’t provide insurance for their employees — would go into effect in the coming months, while the major benefits for consumers will be phased in through 2014. But Obama recently outlined benefits that he expects to become effective immediately, including tax credits for small business to purchase health insurance. The immediate provisions would also include curbs on the practice of using “pre-existing conditions” to deny coverage, he said.
Neither the House nor the Senate bill is perfect. The House bill was passed with an amendment whose sole purpose is to restrict women’s reproductive rights. The Senate bill has been criticized for the porkbarrel measures and special provisions with which it was larded — simply because 60 senators could not be persuaded to pass health insurance reform for its own sake. Nevertheless, at the core of both bills is a consensus about reforms that would improve health care for most Americans.
When my mother was young, she stayed several days in a small, rural hospital to help her own mother, hospitalized after surgery. While she was there, my mother heard the anguished screams of a man whose family couldn’t pay for the amputation he needed. He died of gangrene because emergency care wasn’t considered a basic right back then.
Today, we take emergency care for granted. We simply can’t conceive of a nation in which a man dies of gangrene because he can’t afford an amputation. I’m betting that getting rid of insurance-company-baloney such as “pre-existing conditions” will prove equally popular — an obvious improvement — when health insurance reform becomes law.