It’s an inky very early morning on the way to the airport, just me and the cab driver on the empty highway.
Me: How’s business been lately?
Him: Not bad. I’d be doing okay if it weren’t for that damn Obamacare!
Me: How is Obamacare hurting you?
Him: My wife and I were forced to buy health insurance this year to avoid that stupid fine. The policy costs me almost two hundred bucks a month.
Me: That’s a lot of money.
Him: And I don’t have cash to spare! We have a ton of bills we haven’t paid and I can barely keep up as it is.
Me: Bills from what?
Him: The hospital. My wife got really sick last year. They charged me a fortune!
I fall silent as we continue to travel in darkness.
Author: Keith Humphreys
Keith Humphreys is the Esther Ting Memorial Professor of Psychiatry at Stanford University and an Honorary Professor of Psychiatry at Kings College London. His research, teaching and writing have focused on addictive disorders, self-help organizations (e.g., breast cancer support groups, Alcoholics Anonymous), evaluation research methods, and public policy related to health care, mental illness, veterans, drugs, crime and correctional systems. Professor Humphreys' over 300 scholarly articles, monographs and books have been cited over thirteen thousand times by scientific colleagues. He is a regular contributor to Washington Post and has also written for the New York Times, Wall Street Journal, Washington Monthly, San Francisco Chronicle, The Guardian (UK), The Telegraph (UK), Times Higher Education (UK), Crossbow (UK) and other media outlets.
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This reminds me of the story of the woman who wrote to the insurance company saying that she could no longer afford to pay the premiums on her husband's life insurance policy, so she'd have to cancel. Money had been tight, you see, ever since her husband died.
But, if your story is true, I hope that you didn't really fall silent.
To be fair to the cabby, his financial squeeze is real to him. Obamacare SFIK does nothing to help with financial stress from the past. There is no medical debt relief. Maybe there should. It would be cheap and largely once-off, outside the Medicaid refusenik states.
Hmmmm…. dunno…. Blue Cross Blue Shield is the first place you stiff. If you don't pay your electric bill or your cable bill or your landlord or your car, your life changes, big time. But your health insurance or ER bill just get sent to a collection agency after a year or so, and they send you some nasty-grams, but nobody actually does a bloody thing about it. I've been in a three- or four-year battle with a hospital or a health-insurer a couple of times, and nobody showed up at the door with a crowbar on the crook of their arm, nor did I even get a ding on my credit rating. I rather disbelieve the cabbie. If a hospital wants money, you simply refuse to pay them, and see how the chips fall. In the real world.
I'm not saying you're wrong exactly but the tone is a little off. It's not like we'd expect people to go hungry to buy health insurance… would we?
I know I'm missing the main point here, but: If the ACA hadn't also passed a bunch of new regulations on insurance companies, a guy buying a policy the year after his wife was in the hospital would be SOL. Because pretty much every item of care for both of them would be due to an uncovered pre-existing condition. (More seriously, it's going to take a generation or more to get rid of the meme that health insurance doesn't actually cover anything when you get sick.)
Nice post, Keith.