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Health Care? Let's Do It for Charlie

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William and Debra Trujillo worked at the Jim Bridger Power Plant in Sweetwater County, Wyoming. Together they had been with PacificCorp, the company that owns the plant, for 28 years. Then their son Charlie got a brain tumor, which metastasized to his spine. Things looked up for a while, but Charlie relapsed.

Eleven days after Charlie's relapse, PacifiCorp opened up an investigation into "time theft" by the Trujillos, applying rules that were not applied to other workers. Notably, the company checked the Trujillos' time sheets against the security gate log of entries and exits, ignoring the fact that workers often "piggybacked" -- failed to show their badges at the gate, following after someone who had -- and had done so for years without comment by the company. Based largely on the security gate data, the Trujillos were charged with claiming they had worked when they hadn't. PacifiCorp fired both of them abruptly, ignoring the progressive discipline system it applied to other employees.

Why? The answer is key to the current health care debate. A court found evidence that PacificCorps fired the Trujillos to avoid paying for their son's medical care.

PacifiCorp, one of the West's leading utilities, was self-insured. Charlie's medical costs were so high they had caused the company's premiums to spike. Indeed, during the period when Charlie was dying, the company's health care costs were so high it sought a utility rate increase to cover them.

The Trujillos' story is not unique. Although federal law makes it illegal to fire someone to avoid paying for health coverage, employers do it -- usually offering some trumped-up excuse. The Center for WorkLife Law tracks these cases. In another, a leasing assistant was fired after telling her employer she had a high risk pregnancy. Her company abandoned established practice, conducting early performance assessments and extending her probationary period, although neither procedure was applied to other employees. In a third case, Ernst & Young took over a company and re-hired every single employee -- except for the mother of a daughter with cystic fibrosis.

We need to pay more attention to real stories like these, and less to phantom fears of death panels and socialization.

The Trujillos' story dramatizes why our current system is unsustainable. How did PacifiCorp respond to the health care crisis of its long-time employees? It fired them and hired a lawyer to defend that decision. Then the Trujillos hired a lawyer to fight the company. A lot of money was spent, none of it on delivering quality care. We've all heard the estimate that 31% of health care dollars are spent on administrative costs. That estimate doesn't even count costs like these.

All the handwringing about the costs of change is pretty silly. The Trujillos' story shows that we already are paying many of the costs that ignite people's fears. We pay those costs today as higher utility rates. Or higher hospital bills, as I saw when I took my toddler to the emergency room at Children's Hospital in Washington, D.C. I did not feel I was saving money because most people there needed basic primary care, but lacked the health insurance that would allow them to take their sick kids to the (much cheaper) doctor's office. Reform would solve this problem.

The Trujillos' story also punctuates the perverse incentives built into the current system, which leaves employers with choices no better than workers'. Why should PacifiCorp be stuck with the high coast of Charlie's health care? And if such a large company was still too small to spread the costs of Charlie's care, how about the millions of small businesses? We need larger pools of risk, which is another thing reform promises.

Look, I'm not a health care expert. I don't have all the answers. But what I see is a system that both hobbles our economy and causes otherwise decent people to override their most basic human instincts to respect others' right to live, and die, with dignity.

I keep reading that opponents of change are not as passionate and not as mobilized as proponents are, but read my lips: You folks in Washington better get cracking. Do it for Charlie, do it for his parents, or do it for voters like me. You don't have to get it perfect, but you'd better not blow this chance like you did the last one. If you do, you'll hear from us.