There has been a lot of talk in the media about HealthCare.gov, the website that was designed to help ease the implementation of the Affordable Care Act, otherwise known as Obamacare. Amidst all the fuss about the malfunctioning site, commentators seem to have overlooked the fundamental problem that spurred the creation of the Affordable Care Act in the first place: millions of Americans are still without health care coverage, and many of them cannot afford access to proper treatment as a result. Who cares if HealthCare.gov isn’t working properly if our whole healthcare system isn’t working properly? I can speak from personal experience when I say that having access to health insurance can save lives, and that’s why I want to call attention to the ways in which health care in the United States is due for serious reform.
As college students, many of us are already agonizing about how to pay our bills after we graduate. Plenty of us will need to rely on some sort of parental support until we get on our own feet, and most of us have had our parents pay for family access to utilities, phone service, television and internet provider services, and, of course, health care plans. Having access to health care is a huge issue for recent college graduates entering a formidable job market, right up there with paying the rent and paying the bills in terms of importance.
As someone who has had to make use of health insurance and who qualifies as poor according to the U.S. Census, I know that simple measures like routine blood work and a consultation with a physician can cost hundreds of dollars, and an in-patient hospital stay (for testing purposes, non-emergency) can cost the equivalent of tuition at a state university. Almost none of us, save those who did really well on our job interviews with Deloitte, can afford to pay out of pocket for physician visits and related tests; most of us cannot even afford the average annual cost for an individual private insurance plan. Our need to provide for ourselves is made all the more difficult by the obstacles that the adult world has set before us.
The option of opting into a University-sponsored plan affords students some of the benefits of private health insurance and lasts until we graduate. Students are lucky in that regard. For a long time, low-income families have suffered from the high costs of gaining access to health care. Long before President Obama made a speech in 2008 promising to promote single-payer health care, leaders among poor and minority communities recognized a huge crisis that resulted in major disparities in access to health care.
An average premium for a private health insurance plan is almost twice what a poor family can afford. Systematic abuses of privilege, such as forced sterilizations of minority women, bias in physical exams and quality of healthcare, and problems with lack of proximity of service providers to low-income and minority communities, have long plagued the U.S. They continue to dictate a significant gap in quality of health and health care between wealthier, predominantly white communities and families and low-income and minority communities and families.
Several groups over the past few decades have attempted to provide access to low-cost or free health care in the form of portable, accessible, mobile clinics, community health care centers that provide free health care, and free programs and initiatives that help families navigate the health care system and seek affordable means of coverage. Government intervention, however, along with lack of funding and support and even simple issues of bureaucracy, have limited the effectiveness of these programs, despite their clearly positive impact on local communities.
For a long time, Medicaid has provided low-cost health care insurance to people whose low incomes qualify them for charity care (in addition to state-run Medicaid branches, many states also have their own charity care programs that target a similar low-income population). However, the application processes are difficult and lengthy, information about the processes is not always available, and demand for these programs far exceeds supply. Many among those who qualify and apply properly for low-cost health care insurance programs are turned away because cuts to funding have limited the amount of overall assistance that each state can provide.
That is a lot to digest, I know, but for many of us it’s a simple reality. Health care is hugely expensive, and for some reason a lot of people on Capitol Hill and around the U.S. seem dead set against the principle of providing affordable health care coverage to anyone who needs it. I think that we are asking the wrong question by scrutinizing Obamacare or the principles of the Affordable Care Act. What we need in this country is free health care for everyone, subsidized by the government. We need a system in which each local community contributes to its own resources, and every medical school emphasizes a service component in its graduate and residency programs. We should make health care an essential, basic right afforded to all people automatically, regardless of their ability to pay. We should pay doctors for the quality of the care provided, and no health insurance company should be permitted to penalize doctors and patients for seeking treatment methods.
Let’s eliminate the absurd idea that a basic physical or eye exam should be billable for hundreds of dollars, and let’s do away with the notion that people who lack significant income don’t deserve the best access to care because they can’t pay. Let’s stop forcing families to choose between health insurance and rent, and let’s fix the reality of an emergency room visit sometimes being more affordable than a routine medical exam. Let’s not force anyone to forego quality of life because cancer and diabetes are preexisting conditions, and let’s devote every spare cent we have to make sure that children grow up healthy, regardless of their family’s circumstances.
Alperstein is a member of the class of 2014.