Making a bad health system worse
Glendale resident David Cannizzaro has had asthma since he was 7. Prior to Obamacare, his healthcare strategy was to see the doctor as little as possible so his insurer wouldn’t notice his preexisting condition and decide to raise his rates or drop his coverage.
Now that Republican lawmakers are advancing a bill that would repeal the Affordable Care Act and potentially allow insurers to jack up premiums for people with preexisting conditions, Cannizzaro, 49, said he’s once again living in fear. “It’s very, very scary,” he told me.
The horror show that is the GOP healthcare bill became even gorier this week as the Congressional Budget Office released its highly anticipated analysis of the legislation.
It’s not pretty. Under the bill, the number of people without health insurance would grow by 14 million within just a year. By 2020, the number of uninsured as a result of the bill would reach 19 million, and by 2026 as many as 23 million people would be without coverage because of the legislation.
As if those numbers alone weren’t sufficient to make this one of the most consumer-unfriendly bills ever, the Republican legislation also would make it possible for states to opt out of requirements under the Affordable Care Act and for insurers once again to turn the screws on sick people.
Premiums for some would go down, but only because coverage would become skimpier and deductibles would be higher.
“For the richest nation on Earth, this scenario is simply unacceptable,” declared Sandra Hernandez, president of the California Health Care Foundation.
“Families will be forced to choose between paying for care or putting food on the table,” she said. “States, communities and families will struggle to provide necessary care for those who are most vulnerable — including children, seniors and people with severe physical or mental disabilities.”
What kind of politician would commit such a monstrous act? That’s easy, said Elizabeth G. Taylor, executive director of the National Health Law Program: Any politician more interested in cutting taxes for the rich
than providing affordable healthcare for ordinary people.
The bill “sacrifices the healthcare of millions of vulnerable people to pay for tax breaks for the wealthiest in this country,” she said.
The chances of the House bill as currently drafted becoming law are slim. First the U.S. Senate has to take a crack, and it appears that cooler (read: more reelection-minded) heads will prevail.
But the mere fact that such an odious piece of legislation could pass the House speaks volumes about the priorities of the ruling party and the lengths to which many Republican lawmakers will go to please rich benefactors.
None of this is to say there isn’t a need for further changes to the $3-trillion U.S. healthcare system. The Affordable Care Act did little to address insanely high treatment costs and was poorly structured in terms of ensuring that younger and healthier people joined the risk pool, thus bringing down costs for all.
Cannizzaro’s experience is instructive. He works as an art director for TV shows and video games. He’s selfemployed and has to buy his own insurance. He pays $385 a month for coverage from Blue Shield that includes a nearly $3,000 deductible.
On Super Bowl Sunday in February, Cannizzaro had a severe asthma attack. He said he called his doctor, who instructed him to visit an emergency room for immediate relief and then stop by the doctor’s office the next day.
Cannizzaro did as he was told. But, like any savvy consumer, he knew that just stepping through the door of an ER could entail big fees. So when he arrived at Providence Saint Joseph Medical Center in Burbank, the first thing he did was ask the receptionist for a cost estimate.
“She said she couldn’t tell me that information,” Cannizzaro recalled.
He asked about just the fee for visiting the ER. “She said she couldn’t tell me that information either.”
A Providence spokeswoman said hospitals are prevented by federal law from disclosing ER costs prior to treatment being administered. The idea is you don’t want patients going untreated just because they’re afraid of the price tag.
But that gag rule shouldn’t include disclosure of nonmedical fees, such as the hospital’s charge for entering the ER. Patients have a right to know.
Cannizzaro rolled the dice and sat down with a nurse practitioner, who hooked him up to a device called a nebulizer. It’s basically a portable air pump that allows people with asthma or other respiratory ailments to inhale medicine that clears the lungs.
Ten minutes later, Cannizzaro’s asthma attack was relieved and shortly thereafter he was on his way.
The bill arrived last month: Almost $3,700. That included $300 for use of the nebulizer and a hefty fee just for entering the ER.
Insult to injury: After leaving the hospital, Cannizzaro had figured that it would be smart to have his own nebulizer at home. He found one on Amazon for about $35.
Because of his high deductible, Cannizzaro’s insurer covered about $700 of the hospital bill. He was on the hook for the rest.
Cannizzaro said he called Providence and explained that he was only sporadically employed and had no shot at paying about $3,000 in medical bills. A hospital rep said he could appeal the charges. Cannizzaro did, supporting his case with pay statements and tax returns.
He received a response from Providence the other day. His appeal was denied.
So he called the hospital again and once again explained his financial situation to a rep.
“She told me to hold on,” Cannizzaro recalled. “Then she came back and said, ‘OK, we’ll let it go.’ ”
That’s right: They waived the entire bill. Just like that.
I’m happy for Cannizzaro, but this is seriously Looney Tunes and illustrates on multiple levels the craziness of our healthcare system — deliberately opaque pricing, ridiculous fees, knee-jerk denials and then seemingly arbitrary bill waivers.
Cannizzaro’s take? “It’s insulting,” he told me.
It’s worse than that. It’s a system that’s intentionally designed to disempower and exploit the sick, with possibly life-altering decisions being made almost on a whim.
And now the Republicans have a plan to make things even worse, and to strip health coverage from millions of people in the process.
The U.S. healthcare system — and the American people — need help. The status quo is both unacceptable and unsustainable.
U.S. citizens pay about twice on average what citizens of other developed countries pay for healthcare. And we’re getting less bang for our buck in terms of two key measurements of a medical efficacy: life expectancy and infant mortality. We lag behind most other developed nations on both counts.
My message to Republican lawmakers is a simple one, and it comes from that source of eternal wisdom and insight into the human condition, the movie “Die Hard.”
“If you’re not a part of the solution, you’re a part of the problem,” Bruce Willis said in typically sage fashion. “Quit being a part of the friggin’ problem.” Except he didn’t say friggin’.