On Tuesday of this week, as I was starting on my way to Reading Hospital to give a Grand Rounds presentation to physicians and nurses on the Affordable Care Act, I was involved in an auto accident that totaled my car. Due to driver error (mine), I inexplicably side-swiped another vehicle that was in my blind spot, left the road, and hit a tree at 30 MPH. All of this in broad daylight, modest traffic, and no roadway ice.
Fortunately, I am generally okay--some bruises and a fractured sternum, and associated aches and pains being managed with painkillers, but that's it. I have full collision damage and personal injury coverage from my car insurance company, and excellent health insurance paid for by my employer, the American College of Physicians. I will end up paying only a $500 collision deductible when all is said and done.
For obvious reasons, I had to reschedule my presentation to the good doctors and nurses at Reading. But this accident taught me some valuable lessons that I might mention next time I give a talk about Obamacare.
First, the accident shows why everyone needs good insurance. Before the accident, I could honestly say that I had never had a car accident in 40 years of driving, other than minor scrapes and dents when parking in garages. I am way too old to be called a "young invincible" (the description often given to young adults who may feel that they don't need health insurance), but I felt pretty confident, until Tuesday, that I would likely never get in a serious car accident, at least not one caused by my mistakes. But I did--and it can happen to anyone. Even a 27 year old can suddenly experience an unexpected change of life circumstances that puts them in a hospital emergency room. You are only invincible until you aren't.
Second, I am glad that my employer-based health insurance includes comprehensive coverage that includes emergency room care, my follow-up doctor visits, and the painkillers, muscle relaxers and anti-inflammatory medicines that the ER doctor prescribed--all among the categories of "essential benefits" under Obamacare. My plan already covered these things, but Obamacare now requires that plans offered through the individual insurance market do the same.
The fact is that many of the plans available through the individual insurance market before the ACA didn't cover or had very limited coverage for prescription drugs and hospitalizations, leaving the insured person vulnerable to extraordinary out-of-pocket expenses if they ever needed to use their skimpy coverage. Such inadequate policies represented a good portion of the plans that were "cancelled" because they didn't meet federal benefit requirements. In other words, Obamacare begins to level the playing field, giving people in the individual insurance market access to qualified health plans that include the benefits most of us get who work for large employers.
Third, the accident taught me the fallacy of the argument the people shouldn't be forced by government to buy insurance and pay for safety features they think they don't need or want. The District of Columbia, where I reside, requires me to have auto insurance that includes personal injury protection as a condition of my driver's license, just like Obamacare requires of health insurance. Yes, I would have had automobile coverage even if it wasn't required by law, but I am sure glad that it is required, because next time it could be another driver at fault who gets into an accident with me and I would want them to have insurance.
There were other government mandates involved in my accident that may have saved my life. My vehicle was a late model Acura MDX that has front side airbags and front end collision protection that meets federal standards. They worked as intended, absorbing most of the impact of the collision. I was wearing a government-mandated seat belt and shoulder restraint system, a mandate that directly limits my personal freedom but only by making it illegal for me to do something truly stupid.
Had I been driving a "grandfathered" older car that didn't include such government-mandated safety protections, and/or if I didn't have my seatbelt on, I might have been severely injured, even killed. Such government-mandated safety features added hundreds, maybe thousands of dollars to the purchase price of my car, making me pay for things that I might have argued I didn't need or want--just like the ACA does for mandated health benefits. After all, I didn't "need" and had never personally benefited from having to buy a car with airbags--until Tuesday afternoon, when I did.
Now, let's think about what might have been to outcome for someone in the same circumstances as me, but without health insurance and with a much more modest income. Because this person didn't have health insurance, he might have decided not to go the ER after the accident because of concern about what it would cost, and he would never have known that his sternum was fractured. Even if he went to the ER, he might not have gotten the prescriptions filled because of the cost, making his recovery much more painful (believe me!). The hospital ER might have written off some of his costs by cost-shifting to people with insurance, but he still might have left with a huge bill. He might have missed more days of work without pay. And if his car didn't have airbags and he wasn't wearing a seatbelt, he could have suffered a catastrophic life-threatening injury.
Now, consider the tens of millions of people who find themselves in the same circumstances but who lacked good coverage before Obamacare. They will now be required to buy and will get government help in purchasing health insurance that by law must include essential benefits. Their new coverage will also meet various consumer protection standards, like a ban on discriminating against people with pre-existing conditions and on lifetime and annual limits on out-of-pocket costs.
The consumer protections in their new coverage will protect them from going bankrupt if they need healthcare. These safeguards may even be what keeps them alive. Many of them may not think they need this protection -- until they do.