New Orleans Sometimes the gap in understanding the impact of wealth differentials, or what in the old school we called class differences, is so stark that it just blows the top of my head off. An example today in The New York Times was so clear that it forces me back to beating a drum I was hitting all too recently about the impact of high deductibles for so called “skinny” health plans that were allowed by Congress and the Obama administration to qualify under the Affordable Care Act.
The headline was promising: “High Deductibles, Deferred Treatment.” Ok, it was a “no, duh” thing, but sometimes there’s no harm in stating the obvious until people get the point. Then reporter Reed Abelson provides this assertion about deductibles, writing, “High-deductible plans have become commonplace, a deterrent used by companies to lower health care costs by discouraging unnecessary tests or treatments.” He doesn’t challenge that claim. He offers it for all of us to swallow whole, hook-line-and sinker! No, Reed, high-deductible plans are not a “deterrent” to “lower health costs.” Among other things they are a way being used by companies to force their lower waged workers to elect NOT to take the measly, but “qualified” health policy they offer their workers, so that they have NO insurance whatsoever saving the company 100% of the costs and allowing them to avoid 100% of the penalties. Wakeup and look around at what is happening to lower income, service-based workers in nursing homes, home care, mental health facilities, janitorial, wait staff and other jobs, please!
The story tries to recover. Since the reporter can’t fathom the millions of workers priced out of health coverage by their low wages and their companies’ draconian health plan, he does understand some random study since it has a Harvard connection and, lo and behold, finds that women with insurance deductibles of at least $1000 will delay or defer treatment. I could provide the names of literally thousands of women working in nursing facilities under contract with our union that would jump at the chance to have health insurance with only a $1000 deductible. Instead, the economics of the situation make it more financially attractive to pay the penalty for not having health insurance than to pay 9% of their gross wages and thousands of dollars in deductibles before they access any health benefits. Need I mention once again that this is all about the company avoiding 100% of any health care costs for its hourly workers and not about “discouraging unnecessary tests and treatment.”
Abelson helpfully notes that half of all “covered” workers are enrolled in plans with a deductible “of at least $1000” and that 11% of covered workers have a deductible of $3000 or more. The phrase “covered workers” is the critical one here.
The tragedy in the failure of our national health program and the loopholes it allowed employers is in the uncounted millions of workers and their families who are deliberately priced out of care. Perhaps you can imagine the intended consequences for millions of working families who have deferred necessary tests and treatments because there are caught in the gap between not qualifying for Medicaid and their companies’ skinflint policies. We could start with the hundreds of thousands of headstones in the nation’s cemeteries of men and women dead before their time of preventable causes.
Write that story in the New York Times!