Monday, January 09, 2012

A Little More on the Iowa Caucuses | I'm Sorry You Lost Your Health Coverage

Someone I don't know took exception to my brief post about Mr. Obama's final message to Iowans the night before the caucuses in 2008. My correspondent is understandably distressed and frustrated by the series of personal catastrophes he's endured in the last couple of years. I wish him well and, more, I want to do all I can to ensure that we as a people do right by him and his family — that we do right by each other.
Dear Anonymous,
I'm sorry you lost your job and home and health coverage. I can't think of a single way in which that doesn't suck. I'm sure you're aware that Republicans in Congress, and a few Democrats, have fought tooth and nail to block the President from extending and expanding loan modification programs. Or maybe you're not aware of that, but it's in the public record. And your family is paying the price very directly. Again: Sorry. 
I don't have a job. I quit my last day job a dozen years ago to operate a one-person company. I've been on my own for health coverage since June 2000. If you think things are bad now -- and they still are -- you would have soiled your trousers over the last decade. When my COBRA coverage timed-out, the insurer I'd been with for most of a decade said they would be happy to extend the same plan to me for $6,000 a month. In case you think that's a typo, let me say it differently: My insurance company said they would cover me going forward for a premium of $72,000 a year. I was so shocked by that number that I just laughed at the young woman on the phone -- so loud that I felt like I needed to apologize. She didn't make up that number.
 Someone making a whole lot more money than either of us did. Allow me to make a partial list of benefits extended under the Patient Protection and Affordable Care Act of 2010 -- which is, frustratingly, phased in between 2010 and 2018. You can read the list and then tell me if you think it represents significant reform. The Act: - sets a cap on our total out-of-pocket expenses - ends lifetime coverage limits - ends annual coverage limits - extends coverage under family insurance to our children until their 26th birthday - sets minimum standards for health plans - prohibits insurers from declining coverage due to preexisting conditions - ends copayment for preventive care and screenings - establishes clear apples-to-apples comparisons of plan costs and benefits - prohibits insurers from dropping us if we get sick - requires a minimum of 80% of premiums go to medical services or we get a rebate - extends medicare to small and rural medical facilities - prohibits insurers from charging us higher premiums based on health risk - expands Medicaid eligibility to more low-income citizens - subsidizes premium coverages for low- and middle-income citizens - all but ensures an end to U.S. families losing their homes because of medical misfortune Is it perfect? Of course not. But the law already beats the heck out of what we had and what we were going to get without it, and it's being refined and improved as the elements are activated and tested in real world applications. There's more on all this at HealthCare.gov and other nonpartisan sources. Every potential opponent in the 2012 presidential election wants to take all that back and leave us hanging out to dry. As for Iraq, without going into the bigger story, I'm sure you know that the general terms of the withdrawal were set by the Bush Administration in 2008.
 No one doubts the capacity of of the U.S. military to project power in such a way as to change the terms of that departure -- and a lesser Commander in Chief might had been baited into such a move. But by what authority, at what cost, and to what end? I think this withdrawal was about as dignified as it could have been under the circumstances. Please don't get me wrong: I don't place my hope in the U.S. government. I merely have expectations about what we should be able to expect from each other and for each other, and how government should operate to deliver those results as nearly as possible for our mutual benefit. I don't see anyone in the presidential race whose vision about that overlaps with mine nearly as much as President Obama. I really am sorry for your pain. I hope you find great healing and restoration for your family very soon. respectfully, jh

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