Gary Stein: Health-care event light on facts, heavy on rhetoric

I recently attended a “town hall” event in Tampa sponsored by the Koch-brothers-funded “Americans for Prosperity.”  After the presentations, I came to the conclusion that their organization should more aptly be called, “Americans for their own prosperity, and the hell with anyone else.”

The first presenter was from the Foundation for Governmental Accountability, as well as the Pioneer Institute, whose presentation artfully used deceptive rhetoric, incorrect statistical analysis and emotional spin to malign the Affordable Care Act and Medicaid expansion.

The second presenter, a local insurance agent, was fairly pragmatic, centrist and mostly factual, which was refreshing. He did, however, state that too many doctors have left Florida and the practice of medicine because low Medicaid reimbursements. He didn’t cite any concrete examples or statistics, probably because he didn’t have any.

I’m not angry with the speakers. They did what they were paid to do, which was to confuse people about the Affordable Care Act and advance the agenda of the Koch Brothers and far-right opponents of health-care reform.

After the speeches, I got in line with other concerned Tampa Bay residents to ask questions. When it was my turn, I had a difficult decision to make. With all of the items that were just south of legitimate, what should I discuss first? I decided to tell my own personal story.

My lack of insurance due to unemployment for the last few years had put me into a share-of-cost catastrophic Medicaid plan, known as Medicaid for the medically needy.

If I didn’t make my share of cost, Medicaid would not pay any medical bills or prescription costs, which led me to a heart attack last November.

Medicaid expansion, which the speakers felt was folly, would not only have prevented my heart attack. But it would have saved the state from paying $220,000 for my subsequent surgeries and my $1,800 to $2,000 per month prescription costs.

So I asked the experts: “Please explain to me how Medicaid expansion wouldn’t have helped me or the state Medicaid budget?” The silence was palpable, their apology for my situation was seemingly sincere, but they had no solutions.

But the comment that hit me hardest was a question that revealed the true vitriol of their message.  During the question and answer session, the moderator asked, “Do you really want to have to pay for someone else’s insurance or health care? I don’t.”

Well, my first thought on this seemingly intelligent lady’s concern was to wonder if she really understands just how health insurance works. If she did, she would know that paying for someone else’s health care or insurance is just how insurance works in the first place.

You put your premiums into the pot. If you don’t use them, they pay for someone else’s health care. If that person didn’t pay enough premiums  to cover their medical bills, you have subsidized their insurance, as well. (It should be noted that because of the ACA, if an insurance company doesn’t use 85 percent of all premiums to cover the bills of subscribers, that money is reimbursed.)

But the most important point is that if the moderator had that insurance and did not pay enough in premiums to cover her costs, someone else paid for hers, too. If she had a $500 prescription bill and she was paying $200 a month in premiums, someone else helped pay for her meds. It works both ways. It has to.

If she had a Health Savings Account (HSA) instead (as many conservatives recommend), she wouldn’t have to be worry about paying for anyone else’s health care. However, if she used it all for just one major hospitalization or injury, she would be completely out-of-pocket self-pay (i.e. uninsured) for the balance. If she is not poor, she will owe any amount above and beyond what was in her HSA immediately or just not get any health care.

Living with a one-to-a-box attitude can lead to you being the one in the box in the ground.

It’s time to start caring. That is the basis of true health-care reform.

Gary Stein

Author: Gary Stein

Gary J Stein, MPH has a Master’s degree in Public Health from Johns Hopkins and spent 2 decades in the Centers for Disease Control and Prevention, tracking and educating on STD's, HIV and Tuberculosis. He also worked for several years in the Florida Department of Health, as Program Director for the Hillsborough Tobacco Control Program and Program Manager in the Office of Health Equity. He frequently contributes to the Huffington Post and advocates for Health Care Reform. Last legislative session, he testified in front of the Florida House and Senate committee on the Affordable Care Act. He currently is the Executive Director of Health Equity Connections and Accountable Care, Inc. (HECAC), a startup 501©3 non-profit organization dedicated to connecting people to wellness resources for better health, better healthcare and reduced costs.

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