When the truth slips free

Every once in a while, when people let their guard down, the truth slips free.  Most of the time they are able to cage it, to hold it prisoner.  But not always.

Kaiser Health News had a good piece up on Friday about the waiting period for people with full disabilities who qualify for Medicare:

Under federal rules, most people with disabilities who are younger than 65 aren’t eligible for Medicare until more than two years after they qualify for Social Security disability income. A coalition of more than 65 organizations led by the Medicare Rights Center has been pushing Congress to do away with the waiting period. But the effort has stalled because of the high cost to the federal government – an estimated $113 billion over 10 years, according to the Congressional Budget Office. That takes into account a $32 billion reduction in federal spending on Medicaid, the state-federal program for the poor and the disabled. Many people with disabilities go on Medicaid while they wait to become eligible for Medicare.

Some will tell you that the two year waiting period is to make sure people are really disabled before they are let into Medicare.  It’s to catch the people who are otherwise committing fraud.  Unfortunately, these hypothetical freeloaders aren’t nearly as common as real life situations like these:

After Russ Hillard developed Huntington’s disease, a devastating neurological disorder, he lost his $35,000-a-year job as a welder and, with it, his health insurance.

His wife, who was working part time, had insurance, but it didn’t come close to covering the medical bills for the incurable disease, which causes uncontrolled movements, emotional problems and the loss of cognitive abilities. Eventually, Hillard qualified for Medicare, which covers disabled people under 65 after a two-year waiting period. But the coverage didn’t kick in until after the family went deeply into debt and had to take out a $20,000 loan on their home in Methuen, N.H. The delay was a “cocktail for disaster,” says Hillard’s daughter, Laura Quinn, who is 29.

So why don’t we do away with this waiting period?  Why don’t we let people who are disabled get the care they need right now?  We’re not talking about the worried well here.  We’re talking about people with permanent life-altering disabilies.

KHN asked Joseph Antos, who is a health care policy scholar at the American Enterprise Institute.  Here’s what he said:

“Across the board eliminating the two years just doesn’t seem practical… This really is a money issue.”

I give Mr. Antos credit.  No hemming and hawing.  He just said it.  It’s the money.

Remember that the next time someone tries to scare you away from universal health care systems in other countries with specters of rationing.  They will tell you that in this country, we don’t ration.  They will tell you that in this country no one waits for care care because they are too old or because they are deemed not worth it.  But they are wrong.  Mr. Antos just told you so.

In this country we make people wait for care all the time.  We have waiting lists because “it’s a money issue”.  We ration by ability to pay.

And that may be the most indefensible kind of rationing of all.

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