-By Warner Todd Huston
It is interesting to see how people will twist and turn reality in order to support President Obama’s socialistic healthcare program, but this story has to take the cake. It is the story as detailed in The New York Times of Eric De La Cruz, a young man who was sadly diagnosed with a heart condition in his 20s.
Eric was diagnosed with severe dilated cardiomyopathy, a disease of the heart that enlarges and weakens the heart muscle. Unfortunately, Mr. De La Cruz and his loving sister, former CNN on-air talent Veronica, toiled for several precious but wasted years to find a way to get the heart transplant that Eric needed to prolong his life. Mr. De La Cruz was never able to get his transplant and died waiting for a transplant that never came.
The delays were several. To begin with, Mr. De La Cruz did not have any insurance to rely on to fund his care. For several years the De La Cruz’ went through enrollment for Social Security disability benefits — of which he was twice refused — and later successfully for Medicaid benefits that would come through his home state of Nevada. Unfortunately, Nevada’s state enforced rules excluded anyone past the age of 20 for heart transplants. The state of Nevada determined it could not change its 20 and under rule even though it was clear that Mr. De La Cruz would die without the operation.
From there the family tried raising the million dollars needed for a secondary insurance policy and for the operation that Mr. De La Cruz would need. But by the time all this transpired and the family finally got all their financial needs settled, it was too late. Mr. De La Cruz passed away from his condition at the too young age of 31.
Now, from this multiple failure of the system that so ill-served her brother, what did Miss De La Cruz and The New York Times conclude?
They decided that it was the fault of insurance companies.
She is still crusading, sharing the story with lawmakers in Washington and at rallies, including one in Times Square this past weekend. At the very least, she says, insurance companies should not be allowed to turn down patients with pre-existing conditions.
“If my brother had been able to buy health insurance, he would never have been in this situation,” she said. “No one should ever have to go through what we’ve been through. Eric should still be alive.”
But was it? This entire story started with a young man that had no insurance in the first place and then was diagnosed with an extremely expensive, life-threatening condition. Insurance would not take him after the diagnosis.
Then the family tried multiple state and federal agencies and they all denied him for whatever reasons.
Why is it that the insurance companies that are being found at fault and not the government that at every turn refused this man’s medical needs knowing he would die without the treatment?
The fix according to the Times and sister Veronica is for insurance companies to be banned by federal mandate from refusing new enrollees with pre-existing conditions.
The problem with this idea, though, is that this would not be insurance if that government regulation were to begin. It would be charity. The problem with telling insurance companies that they cannot exclude pre-existing conditions is that it would immediately bankrupt any insurance company were they to allow just anyone at any time to get coverage.
You see, insurance works by having a large pool of premium paying customers and a smaller pool of those needing to take money out of the system to cover medical costs. The larger the pool of people that need money taken out, the larger the pool of premium payers needs to be. If, however, people can still get new coverage even if they know they will need large payouts immediately, the pool of money will be so quickly depleted that no one else can get any payouts. The pool of available money will be paid out quickly without time to recoup expenses.
There is another problem, of course. If one can get a new insurance policy at low rates the instant one finds out that a major medical problem has been diagnosed, no one will take out coverage beforehand when it isn’t needed. People will only bother paying premiums when they suddenly find out they have a problem. This, of course, will completely eliminate the ability of the insurance company to gather that large bankroll to fund people’s medical needs.
After all, why pay years and years worth of premiums if one can get covered for just anything at any time. Why not just ignore the expense of paying insurance at all until it is needed if one can get away with that? What fool would pay if it isn’t necessary?
Insurance simply cannot work this way. It is fiscally impossible. So, we are left with government and/or charities to pick up those that cannot successfully comply with the insurance market reality. That is how it works and the only way it can work, really.
Now, let us take another look at the case of Mr. De La Cruz. He never did have insurance and then could not get it after the diagnosis. Then it was government that failed him at every turn.
And can we review who was blamed? Insurance, not government. Yet, it was government programs that refused this man. The safety net that government was supposed to be is what failed this man, not insurance.
So what happened here? Why did this mourning woman and The New York Times blame the wrong party for this situation? Well, because it fits the Obama nationalized healthcare agenda, that’s why. It fits Obama’s tactic of demonizing capitalism and insurance companies, that’s why.
The upshot of this is that The New York Times and Eric’s sister are playing politics with this poor man’s death. And that seems pretty despicable to me.
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Warner Todd Huston is a Chicago based freelance writer, has been writing opinion editorials and social criticism since early 2001 and is featured on many websites such as NewsBusters.org, RightWingNews.com, CanadaFreePress.com, StoptheACLU.com, TheRealityCheck.org, RedState.com, Human Events Magazine, AmericanDailyReview.com, and the New Media Journal, among many, many others. Additionally, he has been a frequent guest on talk-radio programs to discuss his opinion editorials and current events and is currently the co-host of “Life, Liberty, and the Pursuit of Conservatism” heard on BlogTalkRadio. Warner is also the editor of the Cook County Page for RedCounty.com.
He has also written for several history magazines and appears in the new book “Americans on Politics, Policy and Pop Culture” which can be purchased on amazon.com. He is also the owner and operator of PubliusForum.com. Feel free to contact him with any comments or questions : EMAIL Warner Todd Huston
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“The safety net that government was supposed to be is what failed this man, not insurance.”
So your argument is that the government should not regulate insurance companies. Instead it should step in to provide whatever medical care is wanted by a citizen who can’t get that particular treatment from his/her insurance company, or who can’t get coverage at all? The heart patient in question might have already have had insurance coverage under a parent’s or spouse’s policy, but been refused a transplant on the grounds that it’s an experimental treatment, or that the cost exceeds the lifetime benefit. Should the government provide a safety net in that case? Why not? What’s the difference between being refused coverage altogether and being refused coverage for a treatment needed to live? If the government could be depended on to step in to provide any medical care refused by an insurance company, it would certainly take the pressure off the companies to be fair with providing benefits. They could concentrate on maximizing profits and everyone would get treated anyway. So, the government would be subsidizing the insurance companies. That sounds exactly like single-payer, except for all that money being made by the insurance companies.
Why not take that huge pool of potential patients, take the money to finance the health care from their taxes and pay the health care providers directly, eliminating the middle-men and their enormous profits?
Are you seriously saying that the taxpayers instead should subsidize the insurance companies?
Correction: Eric would’ve qualified for SSI, Supplemental Security Income. Administered by Social Security, but funded for out of the general fund.
Eric ran into the same problem thousands of people encounter every year when they apply for SSI, being turned down by some state board because that board either has impossible standards for qualifying for SSI, or members of the board just bloody well don’t feel like qualifying anybody. The standards were established to keep fraud to a minimum, but quite often said standards or very hard to satisfy, or they are applied much too strictly.
Then, as with Nevada’s Medicaid regulation regarding heart transplants, you get regulations that are written poorly. Obvious cases where discretion is called for are ignored, because bureaucrats place following the rules above people they have never met, and likely will never meet.
This is why I’m against universal coverage, and why I’m for regulatory reform. No regulation without representation, let’s make bureaucracies responsible to the voters.
Cowalker, when did I say government shouldn’t regulate insurance companies? Next time try NOT putting words in people’s mouths.