Saturday, April 3, 2010

Healthcare Example

This got me fired up this morning. For those that don't see what I may infrequently post on facebook, I've put the article here and my response. This was posted by a former high school classmate with the following comment. My response is at the bottom.

Former classmate: "Oh Tea Partiers and other healthcare reform opponents, what do you have to say about this? "

http://cbs11tv.com/local/Baby.denied.coverage.2.1587978.html

10-Day-Old Baby Denied Health Care CoverageBy Melissa Newton FORT WORTH (CBS 11 / TXA 21) ―

Houston Tracy is just 10 days old, but the little boy has already lived through trying times."He was born with what's called transposition of the great arteries." his father, Doug Tracy said. "It's heart wrenching; I hated it."The congenital heart defect causes the two major vessels that carry blood away from the heart to become switched.It's a condition rarely detected before birth."My whole pregnancy was simple, it was easy, no complications, doctor visits were great," Houston's mother, Kim Tracy said. "Perfect sonograms, great little pictures and then, he wasn't perfect."The baby was rushed to Cook Children's Medical Center in Fort Worth where he had life-saving surgery."He's doing really good," his mother said with a smile, "he's a little tough guy."While baby Houston is fighting for recovery, his parents found themselves in another battle: Fighting the insurance company, Blue Cross and Blue Shield of Texas.The Tracy's are both small business owners and do not carry health insurance for themselves. They do carry insurance on their two other children and tried to get insurance for Houston, but they found out Wednesday his coverage was denied."They kept saying it's preexisting, it's preexisting, but I don't know how it can be preexisting on a baby that was just born." his father said. "If it's mandated that everyone have health insurance, than how can one be denied?"Blue Cross and Blue Shield can't comment on the family's situation, but did comment about the health care reform law, and how it may affect coverage."We will work closely with our customers to keep them informed of any changes that may result from the new law," said Margaret Jarvis, the company's Senior Manager of Media Relations. "We will continue to review the bill's requirements on our business and their respective time frames to ensure full compliance."While the Tracys said they'll do whatever it takes for their baby, they have no idea at what cost.A "Houston Samuel Tracy" fund is set up at Bank of America to help the family cover medical costs.

My response:
What do you want to hear? Most private individual insurance policies offer de-facto coverage to babies born from an insured mother. The baby's mother CHOSE to NOT have her own insurance, which meant her baby wasn't automatically covered at birth. Sounds like the mother's fault. By choosing to not have coverage for themselves, they denied their ... See Morebaby automatic coverage, and took the risk that if their baby were born with a health issue, it wouldn't be eligible for its own new coverage. The article, and you, of course, fail to mention this very important fact. Health insurance (not health CARE) is a risk-based service provided by companies that have to run sustainable businesses. If insurance companies are forced to cover everyone that asks for coverage, their costs would overwhelm their income and they'll go bankrupt, which of course denies coverage for EVERYONE. It is immensely sad that this baby was born with a defect, but in this world things happen that are expensive, many that are out of our control. When those things happen, it is the person's responsibility, along with the beneficence of fellow citizens, to bear these costs. (Use this publicity to set up a fund where the public can donate to cover the costs of care for this child). It is not the role of the government to FORCE everyone to bear the costs of the private matters of others.



A final note. At the end of the article is information about a fund that indeed has been set up to help the family pay for the medical expenses. This is how it ought to work. We live in a free country where we ought to be free to help (or not help) when situations like this happen.

3 comments:

Justin said...

Interesting point to just blame the mother, but it seems like we could do better. Here's a similar example. Suppose we lived in a country without mandatory vaccination programs. Imagine this mother decided to not vaccinate her child against polio, and, later, the child becomes permanently disabled by a severe case of polio. This is a similarly sad story about a child who is left with life-long medical problems because her mother did not make the most responsible choice possible. Here the solution is clear and (setting aside the recent Jenny McCarthy movement) non-controversial--institute a mandatory vaccination program, including free vaccinations for those that cannot afford them. The justification for an insurance mandate and a vaccination mandate are fairly similar: (1) even in a free country, an individual should not be free to make unreasonably self destructive decisions or decisions destructive to one's children, (2) mandating individually responsible behavior in the short term has a dramatically positive effect on society in the long term.

Over one hundred years ago the Supreme Court rejected challenges to a mandatory vaccination program and stated:

"the liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is necessarily subject for the common good. On any other basis, organized society could not exist with safety to its members. Society based on the rule that each one is a law unto himself would soon be confronted with disorder and anarchy. Real liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own, whether in respect of his person or his property, regardless of the injury that may be done to others. " Jacobson v. Massachusetts, 197 US 11 (1905)

That sentiment makes just as much sense today.

Justin said...

another point, I am not sure I follow this argument where you say: "If insurance companies are forced to cover everyone that asks for coverage, their costs would overwhelm their income and they'll go bankrupt, which of course denies coverage for EVERYONE."

That may be true if, for example, only sick people ask for coverage. But that is why we need a mandate. If EVERYONE is forced to carry health insurance, then the risk will be spread across the largest possible pool and overall insurance costs will go down. Insurance companies are not worried about going bankrupt because of the new reform, rather they are likely to increase profits because there will be millions of more customers.

Randy said...

You make a good argument, but the forcefield umbrella of "even in a free country, an individual should not be free to make unreasonably self destructive decisions or decisions destructive to one's children" opens the door to umlimited limitations of liberty based upon the idea of a government knowing better than the citizens (1) what are unreasonably self destructive decisions and (2) when and how to counteract them. This is the danger of legislating morality, and why it was the founder's intention to limit the government's role to the securing of rights by protection from injury. I'll continue later.