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Republicans in Congress say they want to protect individuals with pre-existing conditions, but where is their concern for the uninsured in Virginia?
Wednesday, May 15, 2013
Republicans still fighting hard to turn Obamacare into a short-lived failure suddenly have grown in compassion for the uninsured sick.
Virginians living in high-poverty, medically underserved rural areas should recognize crocodile tears when they see them, and ask: Where was the GOP’s concern for the uninsured before the Affordable Care Act? Where would it be were the party able to kill the ACA by a thousand budget cuts?
And where will it be if Virginia’s refusal to accept expanded Medicaid — part and parcel to the ACA’s plan for making coverage affordable to working (and working, and working), but still poor, adults — denies thousands access to insurance?
Having it would allow preventive care that actually could save health dollars. And, by the way, lives.
These questions gained new currency with results of a comprehensive cancer needs assessment survey of the Mount Rogers Health District, reported recently in the Bristol Herald Courier. The survey found “a significant number of residents” do not seek treatment after a diagnosis, the newspaper reported, “because it’s too expensive, not easily accessible or the disease is just too advanced to treat.”
Between 2005 and 2009, the mortality rate from all cancers in the district, in Virginia’s far Southwest, was 191.1 per 100,000 people compared to a statewide rate of 180.9 per 100,000.
Researchers attribute most of the difference to late diagnoses because people do not get early screenings that can pick up signs of cancer when it is most treatable.
Eighty-four percent of doctors said money worries were the main reason patients gave for skipping recommended screenings. 17.4 percent of residents surveyed by Virginia Commonwealth University researchers said they couldn’t afford to see a doctor, and another 16.2 percent had no health insurance — in each case, about 5 percentage points above the state average.
“Basically because of cost, we have 33 percent of our population that doesn’t really have primary care, or their version of primary care is urgent care or the emergency room,” Virginia Tech faculty member Amy Smith told the newspaper. “Those aren’t places where physicians urge you to have a colonoscopy, unless that’s why you came in.”
Before passage of health care reform, the E.R. was the final refuge of conservative politicians who professed to see nothing disgraceful in the growing numbers of America’s uninsured.
Now Republicans see an opportunity to undo the clunky effort at marketplace reform that is the Affordable Care Act — having killed any hope of a simple, single-payer system by roundly denouncing it as “socialism.”
On its way to full implementation in 2014, the ACA has run short of money for the temporary Pre-Existing Condition Insurance Plan for people who have been unable to buy insurance because of market “efficiencies”: They need, or likely will need, expensive care.
The administration has quit taking new enrollments for bridge coverage, leaving otherwise uninsurable people in the lurch until next year — when private insurers will have to throw high-risk and low-risk policyholders in the same big pool, and spread costs.
Republicans in the House are so very concerned about these very ill Americans, they have introduced H.R. 1549 — the Helping Sick Americans Now (But Not Later) Act. Parentheses added.
The bill, Democrats objected in a lengthy footnote, “would strip the Prevention Fund of virtually all of its monies for the next four fiscal years in order to continue the PCIP program for just another eight months — until those eligible for the program will be able to take full advantage of the insurance coverage provided under the ACA.”
For the GOP, nothing succeeds like failure.
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