Wendell Potter: Former insurance company executive; author
Posted: March 24, 2011 08:45 AM
Is the health care reform law a good deal for Americans or is it so badly flawed that Congress should repeal it? Now that the measure is one year old — President Obama signed the Patient Protection and Affordable Care Act to law on March 23, 2010 — I humbly suggest we attempt an unbiased assessment of what the law really means to us and where we need to go from here.
To do that in a meaningful way, we must remind ourselves why reform was necessary in the first place. I believe the heated rhetoric we’ve been exposed to since the reform debate began has obscured the harsh realities of a health care system that failed to meet the needs of an ever-growing number of Americans.
Among them: seven-year-old Thomas Wilkes of Littleton, Colo., who was born with severe hemophilia. You would never know it to meet Thomas because he looks and acts like any other little boy his age, but to stay alive, he needs expensive treatments that over time will cost hundreds of thousands of dollars. Thomas’s parents were terrified before the law was passed because the family’s health insurance policy had a $1 million lifetime cap. Thanks to a provision in the law that makes lifetime caps a thing of the past, they can sleep easier at night.
Another person who faced the real possibility of not being able to pay for needed medical care is Robin Beaton of Waxahachie, Texas. Her insurance company notified her the day before a scheduled mastectomy two years ago that it was canceling her coverage. Why? Because Robin had forgotten to note when she applied for insurance that she had previously been treated for acne.
So Beaton – who told her story to a congressional committee — was a victim not only of breast cancer but of “rescission,” a once-prevalent practice in the insurance industry. The congressional panel – the House Energy and Commerce Committee — discovered that just three insurers had rescinded the policies of 20,000 people over the course of a five-year period, confirming for lawmakers that the practice was widespread and growing. By rescinding those 20,000 policies, the three companies avoided paying for more than $300 million