The Health Care Gap

One of the most surprising (and least discussed statistics) in Virginia is the fact that over one million Virginians are currently without health insurance.  
The reason that the “one million” figure is surprising is that it mostly excludes the poor, the elderly and children — groups covered by programs like Medicaid, Medicare and FAMIS.  The number actually hits the great middle-class, i.e. those who are too “wealthy” for Medicaid but cannot afford private health insurance.
How did this happen?
One reason is the rising cost of health insurance.  Another is the practice by insurance companies to exclude potential customers with “pre-existing” conditions.
These are not just people with high-risk illnesses.  In fact, these are people with diabetes, high blood pressure, or even depression.  In other words, folks just like you and me (or just like our parents).  Increasingly, these potential customers, if they don’t have a job-based benefit, are being left without any insurance.
In 2005, after my mother-in-law suffered a disabling stroke, we faced this nightmare.  Multiple private insurers turned her down, when we applied for a health care plan.   Needing urgent care for the first time in her life, she had become persona non grata in the industry.
Thank God for two saviors:  (1) an old employer who kept her on his plan for several months while she was hospitalized, and (2) the Medicaid program.  
After an obligatory waiting period (and non-stop advocacy by my English-speaking Ivy-League grad wife), my mother-in-law was finally approved by Virginia’s Medicaid program.  Although her care is not perfect, there is now at least a safety net.  
States like Massachusetts and California are moving to a system which requires every citizen to be covered.  Employers that don’t offer health care benefits have to pay into a common fund (like an “uninsured motorists” fund) which is used to provide resources for those in the gap.  The goal is to eliminate uninsured care for working people, and drive down premiums for policy holders that subsidize that care.
It’s an ambitious plan.  Somebody in Virginia ought to looking at this…


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