It was depressing to pick up my Tampa Bay Times the other morning to read: "Most Floridians still oppose federal Affordable Care Act health reform law." A recent opinion poll indicated that only 43 percent of Florida voters support the health care reform law while 52 percent oppose it. For those who feel like I do that when the law is fully implemented in 2014 it will add significantly to the security of America's middle class, the poll was a real downer. • But as I examined the results more closely, one detail was particularly infuriating: The group most vehemently opposed to the reforms are folks 65 and older. Only 39 percent of this group support the law, compared with 57 percent support from voters ages 18-34. What that means is that seniors on Medicare, a taxpayer-funded program that provides secure health insurance and is a European-style single-payer system, are the ones most interested in denying medical security to younger generations.
My mom would call that being selfish.
I'd love to do a John Rawls-type thought experiment with this group and have them design a system of health insurance for the country. One option would be what we have today, where one group gets Medicare. But under the Rawlian rules, the seniors couldn't be sure that they would be part of that group.
Would those 65 and over be willing to chance it and possibly find themselves subject to today's free market? Would they choose Medicare-for-all, where taxes would have to go up? Or would they pick something that looks like "Obamacare" that builds on the current employer-based system yet makes coverage universally accessible and affordable by requiring everyone to obtain health insurance?
I'm willing to bet the last two options would be quite popular, with relatively few willing to subject themselves to the vagaries of the free market.
That brings us to a friend of mine we'll call Sarah, one of the current system's victims, who asked that her real name not be used so she could candidly discuss personal medical issues.
Sarah has a typical middle-class American life. She's married with two young daughters and lives in St. Petersburg in a home she and her husband own. Her husband is a commercial artist while she takes care of the girls, one of whom has Asperger's.
A short while back Sarah's family suffered a devastating car crash. It landed Sarah in the hospital with traumatic brain injury, among other medical issues. Thankfully they had health insurance, but since then Sarah's husband lost his job. His new one doesn't come with health insurance benefits, and there is no way for them to afford the $1,800 per month to stay on their old employer's policy under COBRA.
Since July 1, the family has been uninsured. Sarah has been desperately shopping for affordable health insurance, but she has come up empty. Her past injuries make her uninsurable, and she's gotten turned down flat without even a price quote.
Sarah's plan right now is to cover her children through a state program, while the adults go without insurance for six months until they qualify for the federally subsidized high-risk pool that's part of the Affordable Care Act. Sarah will keep her fingers-crossed in the interim that they are not bankrupted by medical bills. That's her plan — hope — the only thing available to her.
Sarah's sisters live abroad, one in Singapore and one in the U.S. military in Germany, in nations that provide their citizens with universal coverage. They can't believe the unfairness of the fix she's in. Americans alone, among advanced nations, face this high-wire act with their medical and financial security.
Sarah can't wait until 2014, when health insurance companies must offer coverage without considering her pre-existing condition in determining cost or eligibility. But if all those older, anti-Obamacare voters put Republicans in office, that day may never come.
Of course, they don't have to worry if the law is repealed. They will still have Medicare. But as fellow Americans, they need to answer: What will Sarah have?