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    Thursday, July 30, 2009

    Health Care Reform

    I haven't blogged about the health care reform bills going through Congress (nor anything else for that matter) because I've been doing what good medical students do, and have had my head in a book (or my hands inside someone's body) for the last three months now. This probably won't change.

    But, as I take a five minute break from studying cardiology, I wanted to share with you this:

    The New York Times (7/30, A19, Goodnough) reports that the Massachusetts legislature "failed to restore enough money to the budget to provide full benefits for 30,000 legal immigrants." But, lawmakers did "provide for partial coverage, relieving some supporters of the program, who had feared that the cuts would be deeper." The legislature had "eliminated health insurance for the immigrants, which cost about $130 million a year" in order to cover the state's budget deficit. Now, $40 million will be restored, "leaving unclear just how much care the affected immigrants would qualify for." At issue is coverage for "permanent residents who have had green cards for less than five years." Currently, "the affected immigrants are covered under Commonwealth Care, a subsidized insurance program for low-income residents." Under federal law, "the 30,000 immigrants affected by the loss of coverage do not qualify for Medicaid or other federal aid." But, "Massachusetts is one of the few states...that nonetheless provide at least some health coverage for such immigrants." [emphasis added]

    The reason I point out this article is that this is what we must come to expect from any government intervention in health care. If Washington D.C. is going to draft a new health care system for America (and they are), then whether you like their plan or not, you better be ready for this to happen to you sometime down the road.

    In any system where politicians decide funding, cuts will come based on what is expedient politically. In any system where funding comes from a government that also funds other sectors, cuts will come based on what is fiscally necessary at that moment. When they are together (as we see in Massachusetts and will undoubtedly see in any national plan), cuts come from either or both of those reasons.

    This means that nobody is guaranteed coverage, or the same coverage, from year to year. While yes, some people who may not have any coverage now will be covered, WHAT will be covered is not guaranteed. And for those who have coverage now, the same goes. So, in a system where it's already hard enough to understand what your insurance covers and what it doesn't, how will you feel if those rules change yearly?

    That may be palatable now, but wait until you get sick. Maybe this year you can get your medicine, but next year, who knows?