Paul's Heart

Life As A Dad, And A Survivor

We All Deserve Affordable Health Care

(photo courtesy of HBS Online – Harvard Business School)

Let’s make sure to get the obvious out of the way. My health history serves as a great example for the importance of health care. I am a 37-year survivor of Hodgkin’s Lymphoma, cancer, and as a result of my treatments nearly forty years ago, I deal with a multitude of late side effects, all requiring medical attention. I probably pay more attention to health care news than many for this reason. I understand health care news than many for this reason. I know the importance of accessability for all to have health care for this reason.

Historically, I recall a time, watching my mother pay cash for a doctor appointment, a low flat fee, no need for insurance. In my twenties, when I got diagnosed with my cancer I learned of the necessity of health care. And because of the inadequacy of the coverage that I had through my employer to deal with my cancer, my employer advocated for much better coverage, allowing me to recieve the treatment that has given me my long term survivorship.

Following a change of employment, I lost that health insurance completely, and was unable to get any other health insurance due to my history of cancer, a blatant act of discrimination due to this pre-existing condition, which our country allowed at the time. But that was okay for me, right? I was in remission, done with my treatments, back to being a healthy person again, no need to worry, right? RIGHT????

In 1997, a new employment opportunity came up for me, and it was going to grant me health insurance, because I was being hired into a union, which meant I had to be covered. And it was a good thing too, because eleven years later, a new direction in my cancer survivorship would take a hard turn, requiring emergency heart surgery (you can read about it “CABG – Not Just A Green Leafy Vegetable). This surgery and hospital stay back in 2008 cost nearly $300,000 which fortunately was covered by insurance. This was the first of many, and continue to this day, many more health issues that I deal with as a long term cancer survivor. It is a fair statement to say, I understand health care, and health insurance real well.

But health care, AND health insurance (meant to help with health care costs) are very expensive, like a runaway freight train, nothing stopping the costs from escalating every year. At one point, medicine was considered “non profit” only to be changed during the Nixon years, and then our country became “profit over patient,” especially when it came to the insurance companies. Insurance companies have found ways to increase their profits from skyrocketing premiums, co-pays, deductables, and all other means to increase their profits.

And that was where the Affordable Care Act (nicknamed “Obamacare” since he was the president at the time to sign the bill). This law was supposed to rein in out of control health care costs and premiums, by requiring everyone to carry insurance. The theory was simple. Insurance companies only make money, if they do not pay out claims. The only time they do not have to pay out claims is if the people paying premiums are healthy. Therefore, you need to have health people buying insurance to counter all the sickly people using the insurance. And that makes sense. But another major factor of the ACA, it required coverage for those of us with pre-existing conditions, and for some of us, like me, that is an expensive condition. By all means, requiring everyone to pay into the ACA, in theory, insurance premiums and health care costs were supposed to lower, but they did not. The ACA had its faults, but our government over the years bears the blame for not fixing the things wrong with the ACA, one party for not correcting those mistakes, the other for trying to scrap it all together, a financially lethal decision for many of us if that happened.

Which of course, leads me to my usual battlecry, “UNIVERSAL HEALTH CARE!” We are the only industrialized nation not to offer it to our citizens, and the reasons are many, but not qualified.

“We can’t afford it as a country.” China, India, both larger than the US have it. England, Japan, Germany, Canada, Brazil, France, and Italy have comparable populations and have it. And with the money the US pays out in “defense”, health care costs of universal health care pale in comparison.

“The wait times are too long to be seen.” Yeah, this is not really an argument to have to deny universal health care coverage as anyone paying for insurance will tell you, even with insurance, the wait times are too long. It took me nearly a year and a half to be seen by a gastroenterologist for a pre cancerous condition I have with my esophagus from my cancer treatments. Yes, if I develop cancer in that time, it is a year and a half until I can see her. And I have this kind of wait time issue, though not as long, but six months, with the other doctors I have to see. So, this argument does not hold water. We already have the wait times.

“You can’t see the doctors you want to see.” Yes you can. There may be some limits such as health care across state lines, but that is where a private option would come into play. And here is the thing, try actually seeing a doctor today. Chances are you are instead going to see what is called a PA (physicians assistant) who went to medical school, but is not a doctor, or perhaps a nurse practioner (and I will never knock a nurse, they are the best), and possibly what is referred to as a medical administrator. Who you see is already dictated by the insurance companies.

“I don’t want people who don’t work getting free health care.” Ah yes, the “cutting your nose off to spite your face” argument. Without even knowing why a person may be in the situation that they are in, a judgement has been made against that person, and even if it was to your benefit, to hell with offering healthcare to someone you have deemed not worth it. Even if it costs you more money.

“I don’t want government controlling my health care.” I really do not understand the reasoning of supporting this argument because it just does not make sense, common sense. If you compare what we pay out in insurance premiums and co-pays and deductables, versus what a taxpayer funded health care system would cost, the money per person would be over $20,000 less each year spent on health care coverage for universal health care coverage. And I don’t know about you, but if I had a chance to save 20k a year, why wouldn’t you do it? To some it is worth spending that money just to keep the government out of their health care, not allowing the government to control their care. But wait, don’t the insurance companies actually do that? Health insurance companies most certainly interfere and deny health care, using AI roadblocks to fight your doctors and make it nearly impossible to be taken care of. Claim denials range from 20% to over 50% depending on the insurance company and state. Patients get denied for current safer and more successful means of treatments, just because AI says so. But to some, “at least the government is not doing it” and that makes it better, right? RIGHT? Better to pay 1000% more to a for profit insurance company that does not give a damn about your health and will deny you the care you need than to have it paid by the government.

While the ACA had its errors, and politically its enemies in the Republican party, Republicans actually had their own form of the ACA back in 1994. Republicans blocked President Clinton’s plans for health care, but at least had their own. So at least, back in 1994, Republicans were at least not against health care like they are today. But our typical government, could not get any agreement reached.

So here we are, in 2026, health care costs and insurance premiums continue to skyrocket, with no restraints in sight. The results are catastrophic with millions losing their health care coverage, no longer affordable. Patients having to make the choice between rent and medicine, bankruptcy or life. For over ten years, we have listened to President Trump talk about a plan, a framework, but so far, nothing as far as an actual bill, actual help in reducing costs. Unfortunately, I do not see any details, just words, and not very assuring words either. I am referring directly to the White House website, so there is no media bias in what I am saying or arguing.

President Trump’s “plan” “will slash prescription drug prices, reduce insurance premiums, hold big insurance companies accountable, and maximize price transparency in the American healthcare system.” I will simplify the concept. Instead of taking money that was given to the insurance companies as ACA subsidies, he wants to give the money to the taxpayer. But you have to understand, it will not be every taxpayer. There will be qualifications just like there was for the ACA, and the money given will be nowhere near what is needed to help with the costs of the premiums. The bait is that you will be able to “shop” or “make a deal” with insurance companies for best price which you do not have to be a major material goods supplier to know there is not bargaining edge being a single person entity.

The “switch” in this “bait and switch” is that the claim is that by taking the ACA subsidies away from the insurance companies, to be paid instead by the subscriber, the insurance companies will lower their premiums. If you believe this, I have beachfront property in Vegas to sell you. This “plan” takes away profit from the insurance companies. Why would they lower their premiums and take the hit to profits? That just does not make sense. If anything, the insurance companies will raise their costs even more, well overshadowing any dispersement to taxpayers to help with costs.

Another part of the Trump idea, basically amounts to what is called “pooling.” In order to lower our costs, we simply sign up for a particular plan that offers only certain levels of coverage which will obviously exclude anything catastrophic. As much as people objected to paying for insurance under the ACA because they were health and didn’t need insurance, having a pool of really sick people, chronic diseases and cancers, will face astronomical and unaffordable rates and not have any coverage. And it is completely disingenuine to make the statement “and those with pre-existing conditions will still be able to have coverage. This type of idea is not a good one at all if it does not provide affordable coverage.

The president also addresses drug pricing, and again, I just do not see his strategy reducing costs by taking away the profits to Big Pharm. His claim is by ordering foreign countries to raise their prices for other countries, will lower ours, and that just is not true. It is just going to increase their profit margins.

“Transparancy” is also on this plan, requiring entities dealing with Medicare and Medicaid to display and explain charges, which should be a no-brainer anyway. I can remember a time, even back in 2008 with my heart surgery, seeing a breakdown of my charges from a tylenol to the bed on my pillow, as well as the surgery itself. So making that law, which currently the president is not doing in this step of his plan as of right now, would be a good thing.

The truth is, as long as our health care is treated as a for profit entity, costs will continue to rise, become more unaffordable, and more will die. It is time to take the insurance companies out of the equation in trying to figure out how to lower costs. And universal health care, with a private option is the way to do that. I pointed out the cons above, but when you consider the pros; access and affordability for everyone, a healthier society, lower costs overall and reducing the need for bankruptcy which is not good for the individual or the economy, and being healthier, would lead to a more productive country, and definitely outweigh the cons and the spite against universal health care.

But hey, what do I know? This is not a political thing for me. It is literally a matter of life and death. And as costs continue to rise while no solutions are being sought, the answer is right in front of everyone, universal health care. It works for the other countries, it would work for us.

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