Thanksgiving for Healthcare in the US

With just a short time away, Thanksgiving is surely in the front or your mind.  Maybe it’s that growing grocery list on your kitchen counter or a half-packed suitcase in the corner of the room.  Maybe it’s the paper plate affixed to your refrigerator with a child’s hand traced on it disguised as a Tom turkey.  If it’s the latter, I bet it came with a repeated rendition of the story of the first Thanksgiving.

As most of us may recall, the typical grade school story centers on the pilgrims, slightly out of place in the New World, until they received some assistance from their local Native Americans.  Together they celebrated and gave thanks for a bountiful harvest.

With winter approaching the importance of that harvest could not be overlooked.  Many early settlers met with an early demise I am sure for lack of food.  Another major cause of deaths in those early settlers was disease.  Medical care was certainly not advanced at the time, but I am sure most went without any at all.

I bring this up because many Americans take the access to healthcare for granted.  According to the United States Census Bureau, in 2009 there were 48.6 million people in the US (15.7% of the population) who were without health insurance.  Unfortunately lack of health insurance severely limits access to appropriate healthcare.  The provisions in the Affordable Care Act, many times referred to as “Obamacare”, are aimed at extending healthcare coverage to all Americans.

This is a truly a polarizing subject, but I do not write about it to be controversial.  Instead I would like to focus on this point.  We very commonly hear that “Healthcare is broken”.  We are confronted daily with all the ways the ACA is not working.  Frankly, if the pilgrims only thought about how tough they had it, they would have gotten back on those boats and sailed back to where they came from.

They expected hardships, mistakes and hard work.  They were breaking “new ground”, exploring a “new world” and isn’t that exactly what the ACA is all about.  It’s an attempt to move our healthcare system forward, see the obstacles faced by many people needing medical treatment and find solutions to those problems.

So I am simply suggesting, instead of concentrating on the negatives or imperfections of the ACA or the entire “broken” healthcare system as wholes, we should look at the good parts and be thankful.

1.       Minimum levels of covered services are now mandatory for all insurers in the individual market.  They must also offer preventive services with no cost sharing for the beneficiary. 
2.       Preventive screening coverage items have been added for Medicare beneficiaries and the prescription drug “donut hole” has been closed.
3.       Most insurers can no longer deny coverage for pre-existing conditions.  This is of course great news for patients with chronic illnesses like asthma or diabetes and those with a history of cancer.
4.       The age for dependent coverage has been raised to 26.
5.       Individual and small group plan insurers can no longer charge more for coverage based on sex.  Currently 92% of health plans charge more for a woman than a man for the same coverage.
6.       Plans offered by individual, small group and Marketplace insurers must cover maternity and newborn care as well as vision and dental for children.  If our children start off healthy, this provides a good foundation for a healthy adult.
7.       The limits insurers could place on lifetime benefits for essential health services have been eliminated.  More great news for anyone who suffers from a chronic illness.
8.       Wide varieties of individual coverage options via the Health Insurance Exchange (HIX) for those who are just above the income limit for government programs.
9.       Increased access for the underserved in our communities to appropriate government programs.  By having access to insurance, thus care for minor issues and preventive services, many more complicated illnesses and diseases can be avoided.  Reducing costs for treatment in the long run.

Happy Thanksgiving from Medical Business Systems