By Tarif Haque
My visits to doctors' offices date back to childhood. Life and illness progressed parallel to one another. In my adolescent years, as the entrapped patient, I looked upon the world of medicine with cynicism, after a chronic disease diagnosis at 12. My father and mother worked at the University of Alabama, and consequently, I received top notch health coverage.
But in the clinic, I'd look away when doctors sent patients to the second floor of UAB Hospital's Kirklin Clinic, where the patient billing department stood solemnly, awaiting those who couldn't afford the costs of health maintenance that ranged from clinic visits to regular tests.
When my doctors deemed transplantation the final, cure-all treatment for my deteriorating health, I disregarded the costs of the procedure. I thought treatment was my right. My textbooks taught me America was based in equality of opportunity. Treatment was my only option to move on, to go to college, to live. But when all was said and done, I came out of UAB Hospital with a hospital bill exceeding a million dollars, after a stay of nearly five months.
Transplantation wouldn't have been a feasible option my senior year of high school if it weren't for my extensive coverage. But even with such a fine premium, my family and I stood at a crossroads, for I'd already taxed my insurance for years with the costs of expensive medication I'd used prior to the transplant. I was approaching what's commonly known as an insurance cap, an undisclosed limit when an insurance agency will stop providing coverage for an individual.
As I recovered from transplant, parts of President Obama's Patient Protection and Affordable Care Act materialized. An insurance company could no longer place lifetime dollar limits on policies. Before its passage, not only could my coverage be capped off without notice, but if I were to leave my parent's policy, every insurance company would be reluctant to take me on. In a purely capitalist insurance market, I'd be a cost risk. Now, the law eliminates insurance companies' ability to deny coverage for pre-existing conditions.
What many people don't realize is that the pre-existing condition clause is closely tied to the individual mandate, the more notorious clause of PPACA, which penalizes those who do not purchase any type of coverage. If the individual mandate and pre-existing clause weren't in place concurrently, when people became ill, they would immediately purchase insurance -- and insurance agencies couldn't deny them coverage because of the pre-existing clause.
These reforms are necessary because for those with insurance, bankruptcy from medical costs becomes less reality and more worst-case-scenario. How could I foresee being born into this body, to this family, at this time? I never asked for a heart that failed or lungs that choked. It could happen to anyone. What about my freedom from disease? Paul Starr, a Pulitzer-Prize winning Professor of Sociology and Public Affairs at Princeton, puts it best: "Health itself is a matter of personal freedom. To be ill and debilitated is to be less free. To be made destitute by sickness, and therefore dependent on others, is also to be less free."
Many argue the purchase of health insurance should be a choice. To them, it is a matter of freedom. I understand this concern -- but it's naive to think anyone has the foresight to predict disease. Because of this, the mandate requires everyone purchase some form of health insurance by 2014. This will prevent Americans from sinking into insurance funds only when they get sick. Insurance is a safety net, not something you buy when you get ill.
I have a hard time digesting the traditional argument against the individual mandate -- that it limits freedom -- because of personal struggles. I am usually a proponent of the free market, but I think healthcare requires an approach that is less mercantile. Patients aren't commercial products that compete in the free market based on the cost of their risk. It's a heartless system that begs for reform, and what we call Obamacare has done that, substantially reorganizing healthcare to make it more accessible and affordable for those who need it most.
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