What’s Your Cap?

February 1, 2010 by

Most of us recognize the roulette wheel that is health insurance.  This past weekend, I attended a fundraiser for a former student of mine and her family.  Unfortunately, the story is all too familiar.

Jane’s dad has been on dialysis for five years and is awaiting a kidney transplant.  Her mom was diagnosed with breast cancer and had a mastectomy this summer.  As if this wasn’t enough, doctors discovered that Jane (not her real name) had cancer while performing an appendectomy and removed the tumor during a subsequent surgery this fall.  Luckily at 21, Jane is as resilient as ever and has managed to keep pace with her studies.

Jane and her family have insurance.  Unfortunately, they could only afford a high deductible plan and Jane’s father, who is on Medicare, fell into the infamous “donut hole” – a place where despite being covered you’re on the hook for the cost of certain prescriptions.  Fortunately they live in a supportive community and Jane’s mom works for one of the most compassionate and community-minded businesses around, a locally owned grocery store.  Otherwise, it is hard to conceive of how she could have kept her job and maintained what health insurance she has during the many appointments (her own, her husband’s and her daughter’s) she has had to endure.

Stories like these are a reminder that those who wish to stonewall health reform and who claim that the free market and personal responsibility are the solutions to our health care woes are sorely mistaken and have long since lost sight of the human toll of our ideological machinations.

One bright spot from the world of health policy comes once again from Maine.  House Majority Whip Seth Berry has introduced a bill that would forbid coverage caps for health insurance.  This means that people with chronic or life-threatening maladies won’t be cut off from coverage when they need it most.  Already insurance companies have decried this proposal saying that it will boost premiums.  Of course, they’re not willing to say by how much.  In any given year, few people actually hit their cap and the incremental cost spread across all premium holders is likely minimal. 

MECEP is a proud member of a coalition that supports the proposal to forbid health insurance coverage caps.  The hearing for this proposal, L.D. 1620, is 1 p.m. on Wednesday, February 6.

Leave a Comment