Ezra Klein, “Why libertarianism fails in health care.” Ezra points out that a former campaign manager of Ron Paul’s died of pneumonia without health insurance because he had a pre-existing condition and couldn’t get insurance. Ezra also makes the point that many people who receive health care are not in a position to refuse it. For example, if you are hit by a bus you may wake up six months later with a $600,000 hospital bill. I also think someone should ask Paul if he’d let a two-year-old die because his parents don’t have insurance.
Paul Krugman on the squeezed middle class.
More on the Brooklyn special election — “Jewish voters switched to GOP over NY same-sex marriage, Israel.” It wasn’t about President Obama. Everybody stop panicking.
Michael Klare, “America’s Oil Fueled Collapse.”
Another court decision about religious indoctrination in public school classrooms has the Religious Right throwing itself a pity party. I explain on the other blog.
This story about Ron Paul’s campaign manager rankles me no end. He may not have had health insurance and he may have died from pnuenmonia but he did not die without lots of medical care — $400,000 and two months worth of it. What could have been done for him, appears to have been done. Contrast that with the man in my town who died from an infected tooth last month.
And this bit about how he couldn’t get health insurance because of a pre-existing condition? He managed a very demanding, high-powered job, campaign manager, and he managed it very successfully. Are we to believe he couldn’t have used those smarts and connections (you don’t raise that much money without a LOT of connections) to get a job with health insurance? Even if it wasn’t as glamorous a job as the one he had? I mean, if you have a pre-existing condition, you know you need health care!
When Ezra lists all the jobs with insurance Snyder tried for and was turned down from, I’ll reconsider. Until then I have to assume he enjoyed his “freedom” not to be insured. He’s a perfectly awful poster boy for those of us who pine for single-payer.
Ohio Mom
“Are we to believe he couldn’t have used those smarts and connections (you don’t raise that much money without a LOT of connections) to get a job with health insurance?”
In Texas and several other states, even if you have a job with health insurance your employer’s insurance provider can still refuse to insure you if you have a pre-existing condition, so Snyder’s employment history is irrelevant. Texas is especially bad about this; insurers can refuse to insure you for any amount of money for extremely trivial reasons. This is one of the reasons more than a quarter of Texas citizens have no health insurance.
Thanks for the quick reply. It appears though that he lived in northern Virginia for the last ten years of his life. (http://www.washingtonpost.com/wp-dyn/content/article/2008/07/10/AR2008071002937.html)
I’ve never heard of a group plan provided by an employer that can refuse to insure you (I’ve never heard of this in Ohio) but I certainly believe you.
Now the question is, is Virginia, D.C. or Maryland one of those places where you can be refused? Because I still maintain, he had the choice to look for a job that would provide him the coverage he obviously needed. I know it’s harder to get a job if you have a medical condition but it is still sometimes possible, and I know lots of people who have made decisions about their careers based on health insurance considerations.
Ohio Mom — According to a chart I found, as of 2008 there were only 19 “guaranteed issue” states, meaning that in every other state an insurance company can refuse to insure you if you have a pre-existing condition. And even in some of those guaranteed issue states you still may fail to get insurance if you aren’t careful. For example, in some “guaranteed issue” states (including Ohio) if you have allowed your insurance coverage to lapse for some period of time you may not be able to get insurance again in that state. This is true even if you have a job that offers insurance benefits. So in MOST STATES having a job is no guarantee of getting insurance.
Note that this will change in 2014 if the health care reform law is not revoked before then. “Obamacare” provides that in 2014 and after insurers will no longer be able to refuse to insure people with pre-existing conditions. This was a big issue during the health care reform debate, so I’m stunned you don’t know this. Wake up.
And there are such things as private policies for people who don’t have jobs. They are more expensive than group plans, but if you have the money you can insure yourself. So it’s not just a matter of whether he had a job or not. But again, even if you have a ton of money, in some states the insurance companies won’t touch you.
Boy, Ohio Mom must be one of those heartless Republicans.
So, Texas basically has a Death Penalty for people with pre-existing conditions who can’t afford their own health care.
Why is it I’m not surprised?
And I wonder how much Dr. Paul, Libertarian, and I’m sure, compassionate Christian, contribute to the charitable fund that they had to help pay off HIS campaign managers hospital bill, that was left for his mother to pay off when he died?
Or, is it un-Christian of me to ask?
As for the Math teacher in that PUBLIC School, here’s a simple tip:
I can pray all I want to before, during, and after your math class, or math test.
You just can’t make me do it!
And I ought to know, I did a lot of praying in math classes in HS!!! 🙂
Ohio Mom,
The other question is, since the Paul campaign was a NATIONAL campaign, couldn’t Dr. Paul have offered full-time workers like his Campaign Manager health care from a state that made health care companies cover someone with a pre-existing condition?
Or, doesn’t Libertarian Dr. Paul care about health care coverage for others, even though he’s got the Ferrari system that’s offered members of Congress?
And I don’t know the answer to either of these.
I’ve never heard of a group plan provided by an employer that can refuse to insure you
Happens quite often, actually, as maha explains above.
[H]e had the choice to look for a job that would provide him the coverage he obviously needed
Is Ohio Mom writing from 1999? What an incredibly clueless statement in 2011. Of course, could be her problem is naivete, and not possession of a time machine. Neither is an excuse for failing to think clearly.
And if we have all those choices and freedoms as she argues, it baffles me why she’d “pine for single payer.” Was that sarcasm? Were all her arguments tone-deaf satire? So confusing!
I didn’t have a sense that Ohio Mom was being anything other than straightforward, and I’m kind of upset that you all are so snarky with her. I got her main point being that Ron Paul’s advisor was not the best example of the typical insuranceless person, and therefore, maybe not so meaningful.
It’s because he doesn’t fit the stereotype (poor, unemployed, irresponsible) that he’s a pretty good example, I think. You could argue that he could have moved to New York and gotten a job with health benefits, but people live where they live for a lot of reasons. The point is that in most states people with many pre-existing conditions, employed or unemployed, cannot get health insurance, even if it’s in their employee benefit package, even if they are able and willing to pay top dollar for premiums, unless they are lucky enough to qualify for some kind of government program. Ohio Mom seems to think that he only needed to get a job with benefits, but in most states that’s not true.
Ohio Mom seems to be slighting this man for not making his career decisions purely on the basis of his health care coverage, which seems like she’s gotten confused, if she is really a fan of single payer. The idea that a man could die and leave his next-of-kin in enormous debt simply because he made the wrong career choice (like working for an employer who didn’t provide or provided, but then cut, coverage) is a BAD thing, not something we should accept.
Sure, Ohio Mom, we know people who make career decisions based on health insurance considerations. But that’s part of the problem! It shouldn’t have to be that way! That’s not “freedom”, that’s health-care slavery.
And, since Ron Paul seems to think that people should “take responsibility” for having friends and family and charity pay for their emergent medical expenses, it’s kind of odd that he didn’t pony up to help cover his friend and campaign manager’s bills. Not quite walking the talk there, is he?
I didn’t mean to turn into a troll (and I’m certainly not a Republican).
I only want what I’m not going to get, which is evidence that he did try his damndest to get health coverage, and yes, for him that could include moving because that was his value system, that everyone is solely responsible for themselves.
Otherwise I am left with the irony that my little family of three (all with pre-existing conditions, by the way) has made all sorts of decisions to ensure the best we can that we have continuing coverage, that is, we have lived the Libertarian value of being responsible for ourselves, while Mr. Libertarian very well might not have.
We just don’t have enough information on Snyder. We don’t know when he contracted his unspecified pre-existing condition; maybe he had a job with benefits back then that he could have kept indefinitely (whatever his condition was, it did not seem to impede his peformance as a member of Paul’s campaign). Maybe his condition would have been covered by a new employer’s policy after a waiting period.
We don’t know for sure if he really wasn’t insurable; in at least one of the articles, his sister is quoted as saying the insurance was too expensive. Does that mean it was truly out of his reach or that he wasn’t willing to make the trade-offs required? There are a lot of things I could conceivably purchase that I have deemed too expensive. One of my neighbors is paying as much for health coverage as their mortgage. For some people, what they can afford is what they want to afford.
Yes, he was definitely white and educated, employed and not poor. But I don’t know if we can say how “responsible” he was. I’m just not willing to give a Libertarian activist any slack. I’m not trying to be callous in a general way, I’m just looking for more reasons to be sympathetic to Snyder’s story. You may be right, Maha, that he was uninsurable, certainly many people are, but I’m not willing to assume that about him. That’s all.
And MY point is not necessarily that we should feel sorry for the campaign manager, although I do, but that Ron Paul himself is still so clueless that he continues to say that insurance is a personal choice. Very often, it is not. No, it’s not about him, or you, or me, but all of us.
Perhaps Snyder could have gotten insurance if he had made some sacrifices or tried harder. But your personal sympathies, or lack thereof, are irrelevant. There are millions of people in this country who don’t have the connections and resources that Snyder had and who really are cut off from any possibility of getting insurance, so for them it is not a “personal choice.” THAT IS THE POINT. Get it? Thanks much.
“Before you accuse, criticize, and abuse, walk a mile in my shoes.”
Ohio Mom, my point is you argued employer-based choices and options as if they are widely and consistently available when they aren’t. If the man in question was irresponsible by anyone’s lights, all that proves is that libertarians can be hypocrites (since they always argue personal responsibility over social safety nets). That isn’t news. Essentially you made the same personal-responsibility arguments the libertarians make, which don’t apply because those choices and options aren’t widely or consistently available.
I too have family who were denied insurance from pre-existing conditions, so it happens to a great many people. It seems to me enough is known that I’d consider the man who died to have been in the same boat.
I didn’t like that they acted like the problem is young people not wanting to spend the money on insurance that is provided by their employers. Many of my friends who lack insurance do so because they can’t find a job with benefits and aren’t being paid enough to purchase private insurance. These are people that would not be able to pay their rent, buy food, etc if they bought privately owned insurance. Or, if they choosing to not be on their company’s plan it is again, they are not being paid enough to do so.
joanr and Bonnie, you are just nicer than I am!
I made those personal responsibility arguments because those were *his* highest values, which yes, is just a long way of saying he was a hypocrite. Of course I believe in a strong social service safety net, I am just tired of extending sympathy to those who are actively and successfully working to dismantle what we do have (see note above about who is nicer).
Somewhat OT: I am reminded of an incident about nine years ago, when my husband had a different employer. The company was self-insured. One month at the support group for families of children on the autism spectrum, we were surprised when one of his co-workers and his wife walked in — we didn’t know their child also had a diagnosis.
They in turn were surprised when the group’s conversation turned to comparing notes on various interventions. How did Husband and I afford those therapies, they asked. We answered, Through the insurance. They said, Our claims were denied. We said, Well, Husband is a pet of the HR director ever since blah, blah, blah, maybe that’s why.
We had long suspected she was green-lighting our otherwise unallowable claims, and took the other family’s experience as confirmation. I’ll add that the pet-dom didn’t last, but it was nice while it did.
As is typical of Paul and his acolytes, they are quite unable to put themselves in the other person’s shoes. They don’t think calamities will occur to them and to people like them, but they do.
Thanks to those not picking on Ohio Mom, who was trying to make some earnest points. The chart Maha linked to says nothing about and appears to have nothing to do with job-related insurance; in fact, the chart is under the “Public Assistance” section of the web site. If someone can find a link to a chart specific to job-related group health insurance, that would be helpful. (The Federal HIPA Act of 1996 limits the consideration of pre-existing conditions in group health planes.)
Northern Virginia and the other suburbs surrounding Washington, D.C. are full of high-tech companies where I’m sure someone of Snyder’s caliber could have gotten a job and health insurance. In Maryland, where I’ve worked and which is listed as a “no guaranteed issue” state on the chart, I don’t recall being asked about pre-conditions when signing up my family and me for health insurance as part of the new-job paperwork. Perhaps I happened to work for companies with generous health care plans.
After I went on disability and my COBRA ran out, yes, I couldn’t get insurance on the open market for my family and me because of pre-existing conditions. Fortunately, Maryland and other states have insurance programs for people who find themselves in such a situation. In Maryland, it’s called the Maryland Health Insurance Plan (MHIP) and there is an MHIP+ plan for low-income people. I think Virginia has something similar, but these programs are not widely advertised. My sister-in-law happened to have heard of MHIP; otherwise I would have thought we had no hope of getting insurance. I’m now on Medicare, which kicks in after you’ve been on Social Security for a period of time, but my family remains on MHIP.
Snyder’s mother was not legally responsible for paying her adult child’s medical bills. This was discussed at length on another blog. The hospital may have tried to pressure her into doing so, but they had no legal standing. The fund set up in his name came nowhere near covering the $400,000, so the bill ultimately will be divided up among the hospital’s other patients.
And what point would that be? She got hers, and everybody else can just go to hell? It’s that attitude that’s causing the problem.
???? I went back to look at the chart. You misunderstand it. It doesn’t have anything to do with public assistance. It is a chart showing which states are “guaranteed issue,” meaning insurance carriers are required to insure people regardless of whether they have pre-existing conditions or not. Although the chart doesn’t say this specifically, guaranteed issue laws apply to all insurance sold in that state, whether it’s a group plan or a private plan. People are refused insurance by their employer’s benefits all the time.
If you change jobs, and you were insured in your last job, the Health Insurance Portability and Accountability Act is supposed to protect you from being denied coverage by your new employer’s insurance provider. I think it works most of the time, but HIPAA is administered by states and I understand it works better in some states than in others. But if you have been unemployed for a time between jobs HIPAA doesn’t apply anywhere. Since Snyder was, apparently, self-employed or employed by someone who didn’t offer insurance, HIPAA wouldn’t have helped him.
This chart shows state guaranteed issue laws that don’t apply to HIPAA eligible people, and what it shows is worse than the other chart. What it shows is that in most states individuals with pre-existing conditions can be refused insurance by insurance carriers, period, no matter how they are getting their insurance. According to this chart, which is more recent than the other one, in only 13 states are insurance carriers required to provide at least some coverage for people with pre-existing conditions.
This is because Maryland is not a guaranteed issue state, per the chart. In New York, if you apply for open market insurance within some window of time after your COBRA benefits run out, the insurance company cannot refuse to insure you. They don’t even ask about your medical history. However, the policies are obscenely expensive. New York has a low-cost group plan program, but it’s hard to qualify for it. It doesn’t help anyone who has been unemployed for more than a year and whose COBRA has just run out, which I think stinks.
Not the issue. Try to keep up.
The major problem with “hypothetical” situations, is that it is quite easy to divorce one’s emotions from the issue.
If the victim is a beloved relative or close friend, the answer is quite different.
As for the arguement about moving around the country to get health insurance benefits, well that’s just plain silly.
For some strange reason, “we” have no problem spending hundreds of billions making war in Iraq, Libya, and Afghanistan, but we just can’t bear to provide basic health care for our citizens.
My princess just started college and her instructors in “health care administration” are making this point VERY clear; they STRONGLY support nationalized health care.
As much as I disagree with the social “entitlement” views of The Libertarian movement, I think Ron Paul got shafted on this issue because the entire clip from the debate needed to be seen. He DOES NOT agree to let people die, he is not in favor of using taxpayer dollars to provide insurance or pay for medical services.
I understand his point, but I strongly disagree with him. The time will come before long, when insurance that actually pays for something will be but a fond memory.
People had better wake up to the hard fact that it’s cancer and diabetes, NOT fuckin’ Al Qaida that’s the big enemy. I have lost two family members and four close friends to cancer in the past several years, and another beloved relative has just been diagnosed with it.If Al Qaida was killing people at this rate, we’d be hunkered down in an undisclosed location somewhere.
Libertarians can howl all they want about the “free market”, but that principle depends on honesty and integrity which are in short supply.
In Florida, we have a building crisis in the property insurance market. Many new companies are poping up that don’t have the reserves to pay out in the event of a large disaster, and the old companies are increasing rates to the point where thay are unaffordable. We already have a state insurance company, but our new republican administration wants it gone.
Eventually, we’ll have to arrive at the conclusion that some industries will heve to be either highly regulated or be “not for profit”.
He has some fantasy that private charities or church groups or somebody will step in and pay medical bills if the patient cannot, but this is not a practical solution in the real world. The amount of unpaid medical bills in this country far exceeds what charities and churches could possibly pay, even if all they did was raise money to pay for medical bills. So it’s fine for him to say he doesn’t want people to die, but it means nothing if he’s not willing to allow people a means to live.
Erinyes, as a diabetic without a paying job (and no insurance either – I am rapidly spending the money which was intended to keep me alive as an oldster), your comment really struck home (although sometimes I feel as if I already AM hunkered down in a cave somewhere:) ). It took a long time for me to realize that Congress no longer responds to the average American citizen, and that it is all bread and circuses – or maybe not even the bread – from here on, unless we figure out, quickly, what to do about it.
Maha,
I agree with you regarding Ron Paul’s fantasy that friends and family and church will pick up the slack. (Unless the victim happens to be LDS, Amish, or Mennonite), the family, friends, and congregation will eventually tire of the expense; not to mention there will eventually be more victims to tend to.
Lynne, I’m sorry to hear of your situation.
The memories of my indigent brother’s struggle with cancer are burned forever into my brain;it was horrible.
Regarding what to do about uncaring politicians, perhaps we should quit electing wealthy candidates who are clueless to the plight of the unwashed masses.
There was a film clip on the local news a few hrs ago showing a bunch of people who formed a fire brigade type chain to keep a stranded dolphin on a beach alive.
I remarked to my wife that might not have happened if a homeless person was the one in the distress.(Something I wave seen in person also)
Erinyes, thanks. I don’t feel sorry for myself; I know that there are thousands and thousands in worse situations than myself. And we are about to throw them all to the wolves (I know, a vile insult to wolves, who are in their own bad situation!).
This is not Christian, for one thing, so those who claim to follow that creed are, at the very least, fooling themselves.
Lynne,
Wolves, unlike Conservatives, are social animals.
The only similarity between them is that they both hunt in packs.
And, while wolves howl, Conservatives cry “Mega-ditto’s!!!”
And wolves are not known to hunt and enjoy killing members of their own species.
http://smirkingchimp.com/thread/eric-margolis/38457/no-freedom-for-palestine-thunders-washington
I stopped by to thank everyone, because this discussion did sharpen my thinking on why I think Snyder isn’t the best example for our cause; if you think he is a good example, let’s just agree to disagree on that small point.
I say our cause because I think it’s past awful, terrible and shameful that we are the only industrialized, developed nation with so many people without health care, and that we spend so much as a nation to get so little. I certainly do not think and have never thought “I’ve got mine” — my family is one job, and however many COBRA payments our savings would cover, from not being insured (and we all have pre-existing conditions). My child will probably need some level of services his whole life. And I don’t have any problem with Snyder getting as much medical care as he did.
The story about the HR director greenlighting a few months of our claims as an unasked for favor was meant as a parable about a certain aspect of health care that isn’t always apparent to those of us on the bottom. In self-insured companies, when the boss’s wife or child has a Rare Syndrome, it is covered. No, my husband was not the boss but the HR director was one.
A note to Theo: Yes, those miles and miles of high tech and defense industries office parks in the DC suburbs were exactly what I was picturing in my first comment about using his connections to get a job.