Senator George McGovern told Senator Sherrod Brown a story about a time, in 1980, that he was standing in line at a Sioux Falls supermarket. “…he saw two women standing in front of him paying for their groceries with food stamps, the program no one in Washington had done more to expand then McGovern. Not having noticed that their senior senator was standing nearby, they were discussing the upcoming Senate race between McGovern and his Republican challenger, James Abnor. With all of the major problems in our economy, one woman said as she handed the clerk the food stamps, ‘I can’t vote for McGovern. He’s for too many of those giveaway programs!” (From Desk 88 by Senator Sherrod Brown)
Today is the new normal. The past is just the past. The women in line were oblivious to the irony. They weren’t the recipients of government largesse or even a helping hand. Apparently they no longer remembered struggling to feed their families. Their food stamps were THEIR food stamps, as normal for them as their homes or their family pets. But please don’t spend my money on someone else. That would be a giveaway.
And that brings us to the Patient Protection and Affordable Care Act (Obamacare). Today is the new normal. The past is just the past. Cancer survivors come into my office during the annual open enrollment period (November 1st – December 15th) to purchase or change health insurance policies without the fear that their preexisting conditions will inhibit the transaction. Those clients come from across the political spectrum, from the far right to the equally far left. What they share, aside from preexisting conditions that would have made the purchase of insurance coverage nearly impossible in 2009, is little understanding or appreciation of how Obamacare has opened the door for them. Today is the new normal.
The expansion of Medicaid under the PPACA is also part of the new normal. Some of my most virulent anti-Obama / anti-Obamacare clients have taken advantage of this free health care. And thank G-d for it. Bringing Medicaid to the working poor, people making up to 138% of the federal poverty level, opens the door for routine care and necessary medication to individuals and families who might not have been able to afford such care. And, importantly, that door is the front door. Obamacare removed the stigma attached to Medicare.
In January 2020, Americans expect to have their preexisting conditions covered. They expect their children to be covered until they are 26 years old by a parent’s policy. And if their 27 year old can’t get a job, possibly Medicaid. American women expect maternity to be covered and men concern themselves with how to combat prostate cancer not whether or not their surgeries or radiation will be paid.
The American public has been lulled into complacency. The benefits of Obamacare have been disconnected from the law. It is as if Obamacare could be ruled unconstitutional and eliminated, but we get to keep all of the good stuff. Mitch McConnell was recently asked about his support of the Texas lawsuit to undo the PPACA’s protection for preexisting conditions. He said, “There’s nobody in the Senate that I’m familiar with who’s not in favor of coverage for preexisting conditions”.
A reader recently complained that this blog was too political. Really? Those were politicians who negotiated, argued, and crafted the compromises ten years ago that created the Patient Protection and Affordable Care Act. There have been politicians trying to destroy the law for the last ten years while other politicians have fought hard to save it. It is all about politics and it is my job to chronicle the fight. What it is not about is YOUR health. The debate is about how medical providers are compensated. Who pays and how much? What was once about hospitals and doctors now encompasses hospitals, doctors, pharmaceutical companies, medical testing equipment, therapists, and countless others attached to the business of health. Every one of them has an army of lobbyists in Washington and every state capitol. Hell yes this is political.
The new normal in 2020 isn’t perfect. Our premiums are too high. Prescription drug pricing is out of control. There is plenty of room for improvement. But denying the safety net of Obamacare is a lot like complaining about government giveaways while paying for one’s groceries with food stamps.
Picture – All Was Perfect In The Turtles’ World – David L Cunix
Bonus – Happy Together
The new normal is a far cry from what medical insurance was intended to cover. I have been in this industry 46 years. I started when I was 5. Back in the day “normal” coverage was a $250 to $500 deductible with 80% coinsurance. NOTHING was covered until you met the deductible. EVERYTHING was then subjected to coinsurance. You wanted a physical, you paid for it. You wanted birth control, you paid for it. You needed immunizations, you paid for it. There was nothing free and everything went toward the deductible and then you paid 20%. You can’t have free stuff and then complain that rates are too high.
Shari makes a good point. Of course, a $250 deductible in 1974, when Shari was 5, would now be a little over $1,300 now. That is based on general inflation. Medical inflation would be significantly higher.