Julie has been suffering from leukemia for 5 years (which, incidentally, just killed a friend of mine). Julie was happy with her previous insurance plan (a Blue Care Network plan), which provided all the care she needed with low out-of-pocket costs (in exchange for a higher, $1100 monthly premium), and she lost that plan in spite of Obama’s now infamous “lie of the year”. Undoubtedly, Obamacare has its fair share of both winners and losers, and Julie Boonstra is one of the losers, if for no other reason than because she was forced off of a great insurance plan she knew and felt was giving her exactly what she needed while in the midst of fighting an ongoing battle with cancer. Anyone who doesn't feel for this woman doesn't have a soul, and I do believe that everyone who promised her she'd be able to keep her old plan owes her an apology.
But the absolutely worst part about Boonstra and many, many others' situation is that not only did Obama push them into the proverbial tracks, but he did it with trickery. Instead of just pushing them into the tracks, it is as if he told them that he was taking them out for ice cream, and then, when they weren't looking, he shoved them into the tracks. Of course, as it turns out these victims will most likely not die because of this, but I'm not exactly eager to explain this reasoning to them myself, and regardless of the extent of the damage done unto them, there is no denying that damage has indeed been done.
Incidentally, I don't know of any doctor or hospital that would refuse to let a cancer patient make multiple smaller payments on a bill, so I honestly believe that while her worries about unmanageable up-front out-of-pocket expenses are sincere, they are best ignored (by her, not us). I do realize that this is easier said than done, and I certainly realize that I am in no position to tell her what she should or shouldn't do - I am just trying to explain why I believe that AFP's ad was misleading.
"Clearly AFP’s strategy from the beginning was to challenge anyone from questioning a cancer victim who felt aggrieved (witness the very first statement they gave me) and certainly they have used that to damage the Democratic candidate. But they never responded with any level of detail to answer my questions. It’s a classic tactic to avoid hard questions and then run to a highly sympathetic voice (Calabrese) who will unquestioningly reprint your spin.
I don’t take it personally, and in fact have good relations with the AFP folks. (I am equally tough on the ridiculous things Democrats say about the Koch Brothers.) When they think they have a good case, they answer my questions. When they don’t, they avoid them. Since they avoided them in the Boonstra matter, I was fairly certain there were holes they did not want exposed.
My main goal in writing about these ads is to help readers understand what information is missing. Obviously, if you are going to overhaul 1/6th of the economy—and mandate a certain minimum level of benefits—there are going to be some losers in the new system. Even if it is just one percent of the people in the individual market—and certainly it’s much higher—that’s more than 10,000 victim stories. The Obama administration’s error was in asserting that everyone would be a winner, creating an opening for ads like this."
In any case, this appears to be yet another example of AFP being incredibly misleading, coupling an anecdote about a very typical pharmacy/prescription mishap with her worries about losing life-saving cancer drugs. This all is intended to create the impression that her new health insurance is going to stick her with paying the full amount for incredibly expensive cancer-treatment drugs, or else she will die. Obviously, this is not the case, and it is shameful that AFP is willing to use a cancer victim, who is probably scared out of her mind, to spread this kind of misinformation. This will ultimately end up making her look like she doesn’t know how to navigate the modern world, and all for the sake of AFP and Calabrese's political agenda.
But there is no reason to assume the worst, especially since it is completely unnecessary: First, the ACA has provisions that require your insurance company to fully cover costs for preventive care (which, by the way, includes bone marrow biopsies – see below). That means that if you cannot find a provider in your network who performs the necessary preventive care, your insurance company is still required to foot the entire bill. This is also true for emergency care – if (God forbid) something terrible should happen to Boonstra and she needs an emergency procedure, she can rest assured knowing that she won’t be slapped with out-of-network bills for that service, even if she has to go to a provider that is not in her network.
Having said all of that, I do wish that Congress would pass a law (wishful thinking, I know) requiring that insurance companies a priori charge in-network rates for any procedure a patient needs (not just life-saving), and yet cannot find a provider for that procedure within their network. I am still investigating whether there isn't already some provision in the law that already effectively makes this the case, e.g. the preventive, emergency, or external appeals provisions (please contact me or comment below if you know of anything that could help my investigation!). If so, then a lot of people will be able to sleep better at night, including defenders of the ACA. The fact is that potentially having to resort to an appeals process is the last thing a cancer patient like Boonstra should have to be thinking about. That said, it seems that her odds for success in any attempt to appeal are very, very high.
Most sadly, AFP's campaign probably discouraged many people who would have greatly benefited from buying insurance on the exchanges, due to completely unfounded fears of poor coverage and insurmountable costs.
Even more appropriate, think about my friend, Dave Lamb, who just died from his battle with leukemia. He did not have insurance before the ACA, leading him and his family to amass enormous debt, causing them to have to ask for donations. Fortunately, since he was a well-loved musician with a following, he was eventually able to amass the amount necessary for his treatments. But the bills kept climbing for his follow-ups, and they are still at least $40,000 below their target (please donate!!!). More importantly: Who knows whether he would be alive today if he had been able to immediately go in for treatment, instead of having to wait until they had enough money for his much needed transfusions, bone-marrow transplant, and follow-up appointments without worrying about his astronomical medical bills? If the exchanges had opened two years ago, none of those things would have been an issue for him or his family.
In a concise response to Mankiw's diatribe against utilitarian economic policies like the ACA, The New Republic's Isaac Chotiner has this to say:
"We already had a healthcare system that made all kinds of trade-offs. And many people, of course, never really "voluntarily agreed" to the system, even if they were lucky enough to have had insurance. Was paying high premiums because of pre-existing conditions a choice? Was taking the plan from your employer a choice? In Mankiw's world, however, things only became disruptive after Obamacare.
The status quo, whether in terms of the minimum wage or healthcare, was not just some completely fair system that is now being messed with by statist liberals. Our system of government and economy have been "disruptive" for a very long time."