Healthcare in the USA : Redux

16 04 2010

I have a confession to make.

 I still don’t have health insurance. I have never had health insurance. In fact, I have never needed to have any sort of coverage that would ensure that the possibility of having surgery or needing to purchase prescription drugs to ward off an extreme case of swine flu would leave my bank balance looking like it had been mugged by Bernie Madoff.

I have been lucky. I have lived the majority of my life in a country which has Universal Healthcare in the shape of the National Health Service, a system that has provided the essential services required in the event of individual sickness or elective surgery. For over 6o years, those residents in the UK have been able to see their local doctor, go to a hospital or be able to purchase prescribed medicine over the counter without the fear of being presented with an enormous bill.

Last year, I moved to America.

 They don’t have a system like the NHS. You need to have insurance which you can either purchase privately or have access to through your employer. If you are over 65 you can sign up for the government run Medicare scheme or if you are a military veteran coverage is also provided by the government.

I am currently unemployed (or at the very least earning a minimum wage through freelance work), not over 65, not a military veteran and live in a State where Health Insurance is required by law. If I were to take out health insurance it would cost me $350 per month, which I don’t have. Happily though, I live in Massachusetts which does provide some universal healthcare under the Commonwealth Health Insurance Connector Authority which was part of sweeping reforms enacted in The Bay State in 2006.

But this still doesn’t solve the inherent problems with healthcare that Barrack Obama had identified during his successful Presidential campaign and which he vowed to solve when he took office on 20th January, 2009.

In 2008, the US census bureau estimated that 47 million people in America out of a total population of 300 million were either uninsured or did not have access to adequate healthcare facilities. For a country that prides itself on delivery of The American Dream that is a damning statistic.

 Matt Taibi in Rolling Stone magazine (September 3, 2009) summed it up by stating that “America has not only the worst but the dumbest healthcare system in the developed world. It’s become a black leprosy eating away at the American experiment – a bureaucracy so insipid and mean and illogical that even our darkest criminal minds wouldn’t be equal to dreaming it up on purpose. The system doesn’t work for anyone.” Strong words, but as healthcare costs have continued to soar in the USA then affordable coverage has become harder to find for a country that is still suffering from the effects of the recent economic downturn.

From what I have observed in my short time here, even those with coverage aren’t guaranteed to get access to affordable healthcare and for those who live on or below the Federal Poverty Line the options are severely limited.

According to the BBC, over half of all personal bankruptcies in the US are partially due to medical expenses and even those who have insurance have discovered that the policies designed to provide coverage are severally limited when it comes to actual treatment. The media has highlighted cases where coverage has been denied to thousands of Americans due to “pre-existing conditions”, all of which has merely increased the pressure on the healthcare industry to agree to some sort of reform.

So it came as a huge surprise when in November 2009, both Congress and the Senate agreed to draft a bill that would enable healthcare reform within the USA. It was an even bigger shock when, having spent four months debating and refining what the Bill would actually say and who it would affect, that the Democrats managed to turn their considerable majority in the House into a vote that agreed to sign the bill into law. On March 21st 2010, after some fierce and compelling televised debate, the bill was passed by 219 votes to 212 with no Republican backing. On 23rd March 2010, President Barrack Obama finally put pen to paper and signed his landmark legislation.

From 2014, the system of healthcare in the USA will be set for the largest overhaul since the Second World War and extend coverage to 32 million Americans.

That is not a typo. The majority of the key reforms will come into full effect in 2014. For the uninsured with a pre-existing condition, they do have immediate access to an emergency high-risk pool of cash which will be available 90 days after the Bill was signed into law and children up to the age of 26 can remain on their parents’ policy.

Neither of these helps me out. I still can’t afford $350 a month and, as a resident alien, I am exactly the sort of drain on the system that Glenn Beck and his followers fear will drag the country down into a quasi-socialist welfare dependent state from which it will never recover.

So I will just have to make sure that I don’t get ill before 2014. If I do, I shall be rushing back to the comforting arms of the NHS.

Real, if flawed, Universal Healthcare.

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