What the Health Care Decision Means to Us

07/03/2012 08:27 am ET | Updated Sep 02, 2012

by guest blogger Diana Zuckerman, PhD, president of the National Research Center for Women & Families

The term "Obamacare" began as an insult, but now it's the name almost everyone uses to describe the healthcare reform law. Earlier this year, some of Mitt Romney's critics called it RomneyCare, because it was, after all, a descendent of the healthcare program that Mitt Romney developed for Massachusetts.  (An excellent program that Romney now says he opposes.)

But let's forget the politics and call it what it is: the health care law that survived the Supreme Court. I like it because:

  1. Children up to age 26 can be added to their parents' health insurance policy for the same price as younger children. (That part of the bill is already in place.)
  2. Insurance companies can no longer put limits or a lifetime "cap" on how much they will pay for your essential health benefits.
  3. Insurance companies can't cancel your insurance coverage because you get sick or make an honest mistake on your insurance application form.
  4. Insurance companies cannot increase (by 10 percent or more) how much they charge you without justifying it first to your state or federal Rate Review program.
  5. Insurance must pay for screening tests such as mammograms, Pap smears, and colonoscopies.
  6. Women can go to an OB/GYN without needing a referral.
  7. And soon, people with health problems will be able to buy health insurance and be covered for illnesses they already have.
If implemented as it's supposed to be, the health law will reduce medical costs. Why? Because every year, thousands (perhaps millions) of people who don't buy health insurance get sick or get hurt in accidents. Many of those people don't have the money to pay their medical bills. We don't live in a country where we like to see people dying of cancer or gunshot wounds or in car accidents on the streets, so we rush them to the hospital and provide medical care even if they don't have health insurance.

But somebody has to pay those medical bills, and guess who does? It's you and me and everyone else who goes to that same hospital and pays for care through insurance or with our own money. We aren't asked to donate or pay for medical care for total strangers, we just do it automatically without realizing it because our medical bills secretly include a portion of the costs of those unpaid medical bills of the uninsured.

It's like magic: The fewer uninsured people who get medical care, the lower our healthcare bills will be. There are two solutions: We can lower those bills by 1) having fewer uninsured people or 2) by denying medical care to anyone who won't pay.

Outside the Supreme Court, some Tea Party demonstrators said, "I will NEVER buy health insurance, and nobody can make me." Perhaps we should just say to them, "OK, but please realize that if you or any uninsured family members need medical care because of illness or an accident--even an accident that is not your fault--you can't expect anyone else to pay for your medical care.  I'm sorry, but you or your loved one might die because you defended your right to NOT buy health insurance instead of taking advantage of your right to buy affordable health insurance."

In truth, I wouldn't want to have to say that, and I don't think Americans would find that situation acceptable if asked. However, some hospitals do that quietly, by sending patients to other hospitals or sending them back home when they actually are too ill to go home.

The Supreme Court upheld the law, but some states have done almost nothing to implement it. People in those states may end up with few options when they need health coverage. In contrast, states like California, Connecticut, and Maryland are going full-speed ahead to implement the new law in ways that will provide essential health benefits to everyone, with a benchmark plan that's much better than what many Americans currently have.

I won't be insulted if you want to call it Dianacare.  I'd be proud to have it named after me because I think the law is good for families across the country. Or perhaps we should call it USACare because finally, our government shows it cares by providing something almost every other country provides, affordable healthcare.

I'm tired of the angry politicians making ridiculous statements about government interference.  If they want to abolish the health bill but want to keep Medicare, then they are hypocrites (or worse--perhaps they don't actually understand Medicare).  Instead of listening to the political food fights, let's just look at the health care that the law provides and think about how it might help you, a friend or neighbor, or an unemployed 55-year-old who is too young for Medicare but too old to be able to get an affordable health insurance policy.

The bottom line: This law will end some of the worst insurance company practices that have unfairly hurt so many Americans.  It will improve healthcare options for women, children, and people with preexisting conditions or disabilities.  (Perhaps this is why so many insurance companies and their lobbyists opposed it, through quiet contributions behind the scenes.) It will pay for cancer screening, prenatal care, and other preventive services that could save your life.  That sounds pretty good, doesn't it?  Let's think about it with an open mind.



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