The missing point

The nation seems to be stumbling toward some kind of “health care reform” but when the dust settles I can’t help but wondering if all Americans will be able to afford health insurance, an issue that seems to be missing from the avalanche of coverage.

I’m not talking about the nation as a whole and the eye-popping cost figures that have been bandied about since the debate began. I’ve tuned the price tag discussions out, because I’ve yet to hear or read a true, apples-to-apples comparison – a basic this for that. If we do nothing and keep what we have it will cost X, if we adopt these changes it will cost Y. Instead, the conversation is stuck on how much the changes will cost.

I’m talking about the daily cost of medical care. Absent from the debate and coverage is the fact that there are a lot of Americans who have health insurance but can’t afford to use it.The lack of coverage of this aspect of health care is a glaring class fault line.

Co-pays are always presented as a “just this much” but sometimes even a $20 co-pay is enough to throw some budgets out of whack. Last month, my youngest daughter crashed with a quick bout of the flu. I know it was the flu – type A – because I took her to the local doc in the box. I paid them $25 to swab her and make a diagnosis and then $30 to the drugstore for her prescription. That $55 didn’t tax our budget. But that isn’t an automatic.

There seems to be an assumption that the only thing keeping people from accessing healthcare is a lack of insurance. But I know there are stories out there waiting to be told about people who cringe at the thought of getting hit with major medical expenditures in the first half of the year, because they won’t have paid down their deductible through routine visits and will face a budget busting deductible.

The question is why aren't they being told? It would seem that the debate has been framed on the conflict model, and that issues beyond the politics of who wins and who loses get shorted in the coverage.
The story of healthcare reform seems to be continually framed from a point of view that if there’s health insurance for everyone, everyone will have healthcare. Somehow, I don’t think it’s going to work that way.