A few weeks ago, my doctor concluded that I needed an MRI (magnetic resonance imaging) scan of my low back because he suspected injured disks between vertebrae.
I went off to Wilcox Medical Center as instructed and had the MRI. The outcome was disheartening. Two bulging disks and one herniated disk. Physical therapy is helping, but it was a reminder of my own fragility at age 71.
Then a couple of days ago, I got the bill for my share of the cost of the MRI from Hawaii Pacific Health. My health insurance is with HMSA. The bill indicated that Wilcox had billed for $1,785, but that the actual insurance payment was only $170. I owed a $100 co-pay. Total cost: $270.
This was an exercise in bulk purchasing. Because HMSA negotiates prices on behalf of tens of thousands of people, the payment Wilcox got was in full, based on the amount of business HMSA sends to the hospital. But if I had been an uninsured person, I’d have been on the hook for a clearly unaffordable fee.
HMSA’s negotiated price represents the power of insurance, in which everyone — healthy or not — helps share the cost of everyone else’s health care. It’s protection against catastrophic debts when you are very sick or badly injured. The car insurance you are required to have works the same way, for the same reasons.
This lesson is important, right now, today. In Washington, as regards the tax-cut package being considered by the U.S. Senate. Republicans in the Senate added a provision to the tax-cut bill — which in and of itself is, essentially, a give-away to the super-rich — that would eliminate a requirement in the Affordable Care Act that requires most people to have health insurance.
That way, people who are OK right this minute are absorbing the costs of those who aren’t with the understanding that when today’s healthy people inevitably need care, it will be covered and they will not be forced into bankruptcy.
The Affordable Care Act (sometimes known as “Obamacare”) is an imperfect system that needs some revision and adequate funding to make it work. Even then, it’s only an interim system until we as a country can get to universal insurance through a single government payment agency.
Republicans want to repeal the mandate that all people carry insurance. Their argument is that healthy young people should not be forced to pay for the health care of sick old people. Not only does this position conflict with the fundamental premise of carrying any insurance, it disrespects the aloha spirit of caring for kupuna when they need it.
The Hawaii delegation to Congress — two representatives and two senators — is not the problem. All four of them oppose this legislation. The battle is going to be fought, within the next few days, in the Senate. The forces of logic that support keeping the ACA afloat and understand why the insurance requirement makes sense need to capture at least three votes of Republican senators from other states since the Senate right now is split 48-52 Democratic versus Republican. A simple majority would determine who wins.
Raising your voice with either of our senators is preaching to the choir. It is Republicans in the leadership, starting with Sen. Mitch McConnell, who need to be forced to realize that what they propose will throw millions of people off health insurance and do lasting damage to the economy and our social fabric.
Calling, emailing or writing to members of Congress and the Senate may seem like a cliché and a doomed approach. It isn’t.
The rest of the tax legislation, beyond the repeal of mandatory health insurance that will injure millions, is equally onerous. The House of Representatives has already passed a very bad bill. The Senate is considering an even worse one.
But that fight will have to wait a few days. What will count in the next 72 hours or so is the amount of pressure brought to bear on the Senate to preserve the minimal protection provided by the Affordable Care Act.
Your voice can be heard.
Allan Parachini is a former journalist and PR executive. He is a Kilauea resident.