Standing in the dimly-lit cave-like radiology reading room, I was looking at a CT scan which was done in the emergency room on a man in his 40s who had a testicular mass -- likely a cancer -- which had spread through out his body. It wasn't that the man did not know the mass was present -- earlier CT scans from the emergency room clearly showed the mass in the early stages of cancer years earlier. He did not get the necessary care because he did not have health insurance.
Health insurance saves lives. One study in Health Affairs estimated that if all Americans had health insurance, there would be 101,000 fewer deaths each year. Based on population estimates, that would be 300 lives saved in a city of one million each year.
The Affordable Care Act, also known as Obamacare, goes into full swing with the health insurance exchange sign up starting October 1, and it mandates all Americans to get health insurance. While this provision, has no direct impact on those of us who are on Medicare, Medicaid or private insurance, it is a game changer for over millions of uninsured Americans who will have to make a decision: to buy or not to buy health insurance.
My answer is simple. Buy. And here is why.
First, no one can deny you insurance. In the hospital, I saw a diabetic woman who had a foul infection in the pelvis, something which could have been managed at an earlier stage with simple antibiotics and fungal medicine, yet her response to my questions of why she did not have insurance was "I could not get insurance due to my diabetes." No longer are preexisting illnesses a reason for insurance company to deny you coverage.
Second, illnesses do not look at political preference. It does not matter if you are a Democrat or a Republican, you favor Obamacare or don't favor Obamacare, getting health insurance is not about your ideology, rather it is about your health.
Third, illnesses and traumas such as a car accident, a cancer, or a skin infection do not do a wallet biopsy to see if you have enough money or an insurance card prior to striking. A young man with a staph infection in an elbow wound at a site of a previous fracture has no insurance. With charity care and a prolonged payment plan -- much like a college tuition repayment loan -- he is improving.
Fourth, when the uninsured get insured -- everyone who have private insurance benefits. Let me explain. There is a common misunderstanding that lack of insurance will lower health care cost and save everyone money. That is not true. By one estimate, those who have insurance pay eight percent or some $1,100 of their premium each year towards the care for those who do not purchase insurance.
Fifth, getting health insurance can help you avoid declaring bankruptcy. One healthy self-employed friend in his 50s with a car and a house decided to stick it out without health insurance, until he began to develop chest pain and needed heart surgery. Each year two million people declare bankruptcy due to medical bills -- it is the number one reason for bankruptcies, more than credit card bills and unpaid mortgages.
Sixth, the money spent on health insurance is well spent. A 40-year-old person with an income of $29,000 would have to pay $125 dollars per month for a bronze coverage health insurance or $195 a month for silver coverage with subsidies. This is as much as a pack of cigarettes or two Starbucks tall coffees each day.
Seventh, health insurance even if never used buys you one thing which is priceless: peace of mind. We will not be young and invincible forever, but we don't want to be old and in poor health.
I don't know any doctors who would not encourage their patients to get health insurance. I wish the cancer patient, the diabetic patient and the heart disease patient had. If you trust your doctor with your life, you should trust his or her advice. Get insurance and encourage your family, friends, neighbors and acquaintances to get health insurance.
For more by Manoj Jain, MD MPH, click here.
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