On health insurance reform

Well, I just watched President Obama sign the health insurance (not health care) reform bill into law. What is there to say about health insurance reform that hasn’t already been said, blogged, argued or screamed?

At the end of the day, we have a set of what amount to consumer protection regulations that all happen to relate to the health insurance industry (some of which, yes, still need to be funded by future action in Congress). On one hand, we have House Republican leadership calling the bill’s provisions “Armageddon,” and on the other you have Democratic leaders insisting that, without reform, the costs for both private insurance and public programs (like Medicare and Medicaid) would continue to spiral out of control.

At the moment, we’re wrapped up in debating what ex-Defense Secretary Donald Rumsfeld called “known unknowns” – things we all know still need to play out. I’m more interested in the “unknown unknowns” – the unintended consequences of this reform legislation, both good and bad, that we can’t even conceive of using our current frames of reference.

For instance: what will happen when it’s no longer a given that, if your child has a chronic condition (nothing life-threatening… let’s say, allergies), that your family will always have to struggle financially? What will it be like to be able to shop for insurance on the open market, even though you have, say, eczema? How much easier will it be to finally branch out on your own and start that small business, now that a) your old employer no longer holds your health care benefits hostage, and b) you can more easily afford to provide benefits to your own staff?

There aren’t very many of us who can divorce national policy from our own experiences. That’s true of the opponents of reform who are lucky enough never to have been bitten by an HMO, and it’s true of me, too. When I look at the bill that the president just signed into law, I see policy that I truly believe is worth its cost because of how it will benefit Americans in the long run.

And I believe that because, when I look at this bill, I see my family. I see a family that’s bigger than most – not Duggar-sized, but we do fill up Mom’s 14-foot dining room table – and where each generation is progressively better off because of the hard work of previous generations. I see a kid who’s allergic to everything that grows or has fur (that’s me), a kid who came out of the womb with full-body eczema (also me), and a kid who needs glasses to find her glasses (ok, that one’s me, too). The point is, we’re pretty blessed not to have had any major family illnesses – I’m talking leukemia or something here – but even the garden variety stuff would’ve bankrupted my parents if we hadn’t had insurance.

Speaking of me – I didn’t have insurance for just over two years, from the time I was 22 (and got booted off my parents’ policy) and when I was fortunate enough to get a job with full benefits at age 24. So, for two years: no prescription allergy meds (buying over-the-counter and not-nearly-as-effective out-of-pocket); no doctor visits (which meant treating everything I caught with NyQuil); paying for my required contact lens exam and contacts out-of-pocket; and no prescriptions for anything, ever. AND I WAS ONE OF THE LUCKY ONES. Looking back on that time, I thank God that my food allergies weren’t as severe as they are now. That screw-up at the cafeteria a few years ago that cost me an ambulance ride and ER co-pay probably would’ve bankrupted me.

So, a lot of people probably look at these new regulations and see a larger, more unwieldy federal government, or lower Medicare payments for doctors, or potential future budgeting problems. To be honest, I see those things, too.

But they’re dwarfed by the other things I see. Not to get too Big Rock Candy Mountain on you, but I see an America where no family – ever – has to choose between buying medicine or buying food. I can’t wait for an America where someone can go to the ER for an actual emergency and not have to wait behind the people who are there for a sinus infection, and where, consequently, hospitals don’t have to jack up their costs to cover those uninsured patients.

It’s about time that paying for the health care that keeps us alive became something we just didn’t have to stress over.