5 Stories That Prove Health Care Still Needs to Be Fixed

Last week President Donald Trump introduced a 2019 budget that once more takes aggressive swings at the Affordable Care Act. The proposal removes even more supports for the health insurance exchange and urges Congress to again attempt to repeal and replace the ACA with the failed Graham-Cassidy plan of 2018.

Both ideas would destroy the gains that have been made in opening up affordable accessible health care, but there’s one place where the president is right — what we have now simply isn’t working. While his solutions are all wrong, here are five stories that show a clear need to readdress the health care crisis.

1. Companies are automatically denying claims — without even reading them.

Ever wonder why so many insurance claims are being denied, especially when the procedures were necessary and should have been covered? Well, it turns out that no one may have been reading the original claims at all.

CNN reports:

California’s insurance commissioner has launched an investigation into Aetna after learning a former medical director for the insurer admitted under oath he never looked at patients’ records when deciding whether to approve or deny care. California Insurance Commissioner Dave Jones expressed outrage after CNN showed him a transcript of the testimony and said his office is looking into how widespread the practice is within Aetna. “If the health insurer is making decisions to deny coverage without a physician actually ever reviewing medical records, that’s of significant concern to me as insurance commissioner in California — and potentially a violation of law,” he said.

2. Even those seniors on Medicaid spend way more than seniors in other countries.

Medicare is supposed to be the lowest cost health care there is, yet seniors in the U.S. are still spending way more than seniors in other countries. And this fact hits especially hard when you consider how many are on limited incomes.

The Greenville Times reports:

The researchers looked at Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the U.S. They found a disproportionate share of U.S. seniors face economic challenges, with 1 in 4 worrying that they don’t have enough money for food, housing or other necessities, compared to 3 percent of the elderly in Norway and 4 percent in Sweden. According to the research from The Commonwealth Fund, 22 percent of seniors in the U.S. had spent more than $2,000 in the past year on medical care, more than twice that of all other countries, where fewer than 10 percent spent that much, with the exception of Switzerland.

3. People are dying because copays are still too expensive.

People shouldn’t die due to a lack of health care access for any reason in the U.S. But that happened in Texas, where second grade teacher and mother of two Heather Holland put off filling a prescription for medication to fight her flu and paid the ultimate price.

Care2′s Llowell Williams writes:

As Holland’s husband, Frank, explains, she had visited a doctor who gave her a prescription. However, Holland delayed picking up the prescription; it required a $116 copay, which she and her husband could not afford. When Frank saw that his wife’s condition was declining, he scraped together the money and went to the pharmacy. Sadly, by then it was too late, and Holland’s illness had already advanced. Holland ended up at the hospital, and she passed away less than two days later.

4. Idaho is trying to sell “skinny” plans.

In an attempt to prove that the Affordable Care Act is already broken beyond repair, the state of Idaho is going one step beyond the others by opening the door to health care insurance plans that don’t cover all of the mandated minimums put in place by Obamacare.

The Idaho Statesman reports:

The executive order signed in early January by Gov. Butch Otter and Lt. Gov. Brad Little would let insurers bring new plans to market that break the rules of the Affordable Care Act. The proposal would create a separate health insurance market using many of the rules Idaho insurers followed before Obamacare. Though that’s been considered forbidden since the ACA passed, one state official says the Trump administration isn’t pushing back on the idea.

Not only has the Trump administration refused to push back, officials appear to be encouraging more states to do the same. As Politico explains:

The Trump administration is proposing to expand the availability of short-term health insurance plans that some deride as “junk insurance” — an effort that could give consumers cheaper coverage options but undermine Obamacare’s marketplaces and popular protections for pre-existing medical conditions.

5. Big businesses are starting their own initiatives to avoid the system all together.

The ACA’s failures are now leading businesses to try to take over insurance on their own. Amazon, Berkshire Hathaway and JPMorgan Chase are forming a new insurance company in an attempt to bring down health care costs for their employees, and they will do it allegedly without creating a for-profit system. While that benefits their employees — and obviously their shareholders –  it continues to create a rift between those who have jobs with good health insurance benefits and the rest of Americans who struggle to pay.

And that shouldn’t be the case. Founder and CEO of MCS Industries tells USA Today:

I certainly couldn’t do it for my employees, even though I wish I could. That’s why, if we are going to achieve an improved system for all of our citizens, what we really need is Medicare for all. Whether they know it or not, the leadership of these three companies made a strong case for removing profit from our health care system, and I hope our politicians are listening.

Read more here: http://www.idahostatesman.com/news/politics-government/state-politics/article198322574.html#storylink=cpy5)

Photo Credit: Daniel Frank/Unsplash


Sue H
Sue H1 months ago

Thanks for sharing.

Marie W
Marie W11 months ago

thanks for sharing

Marie W
Marie W11 months ago

thanks for sharing

Paulo R
Paulo Rabout a year ago


Amanda M
Amanda Mabout a year ago

Affordable health care should be a RIGHT, not a privilege!

Danuta W
Danuta Wabout a year ago

Thanks for sharing

Michelle S
Michelle Spradleyabout a year ago

The "Affordable" Care Act simply is not affordable, unless you are content to live on welfare or are an illegal immigrant. Non-wealthy, working citizens are only given expensive options to pay for everyone else's care. If I have to pay $400 a month for medical insurance I want a decent plan that allows me to choose my own doctors and be seen for appointments at my convenience. Please get rid of the UN-affordable care act IMMEDIATELY, if not sooner!

Eric Lees
Eric Leesabout a year ago

Agreed Peggy. Both parties serve their Corporate overlords and both toss some crumbs to we the people to keep us voting for them. There are very few truly progressives from either wing of the Oligarchy.

Eric Lees
Eric Leesabout a year ago

@Brian. Why would we want to use Canada as a model? They are ranked 16th best in the world according to this list:

"The 16 countries with the world's best healthcare systems"
"16. Canada — Canada's 1984 Health Act entrenches in law the country's system of free at the point of access healthcare, known as Medicare. Canada's system is not perfect however, and in recent years the number of Canadians going south for private care in the USA has grown."

Chad A
Chad Andersonabout a year ago

Thank you.