As the furor over the roll-out of the Affordable Care Act has grown these past weeks, I can't help but wonder: Would my brother have avoided a premature death if we had enacted Obamacare's sweeping access to quality health insurance and affordable care years ago?
Three decades ago, while in his 20s, my brother started a business in wholesale produce. Like most such businesses trying to navigate the health insurance market, his company was too small to access any group health insurance options.
Sometimes he went without health care coverage altogether to save money. When he did finally break down and purchase individual insurance, he absorbed the entire cost, paying thousands annually for his policy out of very slim profit margins. With no bargaining power, he had to settle for whatever coverage was offered.
Because my brother was chronically overweight, what he needed was regular preventive care and medical supervision. But under his high-deductible, low-benefit policy, the cost of almost every doctor visit came out of his own pocket. Like millions of other Americans with similar policies, preventive care visits were therefore few and far between.
Eventually, and perhaps not surprisingly, the many more serious maladies related to obesity developed. And with them, the medical bills mounted. At one point, the complications of his conditions forced him to spend a month of convalescent care in a nursing facility. Soon he received medicals bills not covered by insurance in excess of $20,000, on top of a major loss of income.
My brother's individual health insurance policy was barely regulated, but definitely costly. The coverage was full of holes. Deductibles were high, benefits low, and the overall cost of this period of poor health nearly drove him bankrupt. Finally, within a year, his largely untreated heart condition took him away at age 55.
In any individual case, the causes of illness may be multiple and difficult to unravel. Patients even with great health coverage often don't follow doctor's order.
So there is no way we will ever know for sure if access to affordable health insurance with the minimum coverages now required by Obamacare would have extended my brother's life. But we can know to a statistical certainty that better, more affordable insurance coverage for over 40 million Americans, and expanded coverage for children, will save many lives in the years to come. This will be the case no matter how poorly the initial roll-out goes, or how many times the website crashes.
Many Americans are not surprisingly upset to learn that their current individual policies are being cancelled for failing to meet the minimum standards of coverage to be called basic health insurance under the Affordable Care Act. As the health insurance system goes through this major transition, the website holdups and coverage uncertainty is frustrating and anger producing.
But when I hear these stories, I cannot also help but think of my brother, and wonder how much better off he might have been if his insurance policy had to include preventive care, wellness services and chronic disease management, and the other beneficial features that Obamacare coverage will provide.
And I wonder how many other brothers, sisters, cousins, or childhood buddies might live a little longer because they finally will have real access to medical care today that they didn't have yesterday. I cannot be certain if my brother would have lived a longer and healthier life under Obamacare, but I know that many others will.