[Editor’s Note:
Following are three short versions of the popular Christmas story, all
telling what it would be like if Republicans implemented their plans for health
care in the United States .]
VERSION 1
Marley
was dead. Well of course he was
dead. He had used up his lifetime limit
of Medicare benefits and when he went to the Emergency Room for treatment he
was told he had to have three bids from health care providers before he could
be treated. Marley died after getting
the second bid, his eyes closed up over the fine print in the contract that
absolved the physician from all liability.
So
Bob Cratchit went to the surving partner of the firm, Mr. Scrooge, and asked if
there could now be some new health care plans.
Scrooge had recently undergone a transformation from greedy boss to
benevolent supervisor. “Of course my boy”
said Scrooge, “we have this new program that will be completely paid for by the firm of Marley and Scrooge. It is, of course, a high deductible plan.”
The
high deductible amount for the plan was a modest $225,000. “We will cover everything after you pay the
first $225,000” said Scrooge magnanimously.
“Bob, your only other costs will be the income tax you have to pay on
the premium benefit we give you.”
Bob
Cratchit left the offices speechless.
And not in a good way.
VERSION 2
Marley
was dead. Well of course he was
dead. At the age of 72 he had not yet
qualified for Medicare because Republicans had raised the age to 75, and his
health insurance company had dropped him because in their words “you are likely
to get sick and file a claim”. After his
heart attack the emergency room care was delayed while he mortgaged his house
to pre-pay for the hospital stay, and right in the middle of the appraisal
process he dropped dead.
So
Bob Cratchit went to the surviving partner of the firm, Mr. Scrooge and asked
about new health care plans. “Oh my dear
boy” said Scrooge, “of course we have plants that cover your family. Now none of the plans will cover pre-existing
conditions, so Tiny Tim will not receive any treatment for that leg disease
that will eventually kill him, but any new ailments he develops will be
covered.”
When
Cratchit asked about deductibles Scrooge assured him there would be none, but
Scrooge did inform his dedicated and loyal employee that the co-pay would be
124% of the bill, the extra amount being use to cover the profit requirement
surcharge of the insurance company.
Bob
Cratchit left the offices speechless.
And not in a good way.
VERSION 3
Marley
was dead. Well of course he was
dead. After suffering from a
debilitating disease he found out his insurance did not cover that particular
ailment. Marley was puzzled since the
denial occurred before the ailment was diagnosed, but the insurance company
explained that their coverage limitations were not based on a particular type
of illness, but on the expected cost of treatment. Before paying a claim the company required a
total cost estimate from the health care provider, and if that cost was in
excess of $575.00 the claim was automatically denied.
So
Bob Cratchit went to the surviving partner of the firm, Mr. Scrooge and asked
about health care plans. “Sorry said
Scrooge, employers no longer provide health care insurance, but here is a list
of companies that you can buy individual coverage from. Good luck, let us know how it turns out.”
Cratchit
found out that each application required about 11 hours to fill out, but since
his son Tiny Tim was suffering a serious leg degenerative disease he took the
time to apply to seven companies. Six of
the companies turned him down, and the seventh approved his application. But subsequent investigation by that firm determined
that Cratchit has committed insurance fraud, because he inadvertently listed
the left leg of Tiny Tim as the one with the problem, when it was the right
leg.
Because
the insurance company found fraud in the application, Cratchit was denied
eligibility for any coverage. He took
his case to an attorney, who for an upfront fee of $35,000 promised to pursue
legal action to right this horrible wrong, and who predicted that after working
its way through the court system Cratchit would be vindicated in about 9 years. “We would expect compensation for pain and
suffering also” said the attorney, “except that is no longer allowed”.
Bob
Cratchit left the lawyer’s offices speechless.
And not in a good way.
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