Rudy Giuliani was treated for prostate cancer. John McCain has been treated for melanoma, the most serious type of skin malignancy. Fred Thompson was diagnosed with lymphoma, a cancer of the immune system.
And as the LA Times’ Ricardo Alonso-Zaldivar explained in a good piece today, all three could be denied healthcare insurance under their own healthcare plans.
All three have offered proposals with the stated aim of helping the 47 million people in the U.S. who have no health insurance, including those with preexisting medical conditions. But under the plans all three have put forward, cancer survivors such as themselves could not be sure of getting coverage — especially if they were not already covered by a government or job-related plan and had to seek insurance as individuals.
“Unless it’s in a state that has very strong consumer protections, they would likely be denied coverage,” said economist Paul Fronstin of the Employee Benefit Research Institute, who has reviewed the candidates’ proposals. “People with preexisting conditions would not be able to get coverage or would not be able to afford it.”
It offers a helpful contrast between the downsides of the two parties’ approaches to healthcare. The problem with the Dems’ plans is that they’re expensive. The problem with the Republicans’ policies is that sick people of modest means can’t get health insurance.
The Republican presidential hopefuls seem to realize that their plans leave millions of vulnerable Americans behind, but also realize that the alternative is government regulation — specifically, telling insurers that they can’t exclude people with pre-existing conditions, and can’t price these people out of coverage. Given a choice between a large gap of uninsured and government-imposed safeguards for Americans, the GOP candidates prefer the prior.
That means the self-employed and others seeking individual coverage would be subject to a marketplace in which insurers generally pick the healthiest applicants and turn the rest away. Cancer survivors — even if they have been free of disease for several years — are routinely denied health insurance when they try to purchase it as individuals.
Even if coverage is offered, it often comes with restrictions or high premiums that many find unaffordable.
I’d just add that Rudy Giuliani, who seems to emphasize his positions on healthcare more than his GOP rivals, is uniquely punitive towards Americans with no insurance.
If you’re in the top tax bracket, you could deduct 35 cents of every health care dollar you spend. If you don’t earn enough to owe income taxes, or if you have a pre-existing condition and can’t afford coverage, a tax deduction would probably be worthless. Giuliani’s tax deduction remedy would therefore do virtually nothing to cover the uninsured.
Now, many Republicans who feel obliged to have some kind of health care “plan” endorse the health care tax deduction. Most just don’t care very much about the uninsured. Giuliani, by contrast, is not indifferent to the plight of the uninsured. He actually seems to revel in it: “I don’t like mandating health care. I don’t like it because it erodes what makes health care work in this country–the free market, the profit motive. A mandate takes choice away from people. We’ve got to let people make choices. We’ve got to let them take the risk–do they want to be covered? Do they want health insurance? Because, ultimately, if they don’t, well, then, they may not be taken care of.”
Where does this bizarrely punitive view of the health care system come from? It apparently arises from Giuliani’s experience with welfare reform, which he constantly likens to health care. “You don’t start off by promising you’re going to insure everybody,” he warned earlier this year. “It’s the same mistake the Democrats made with welfare.” So providing health coverage to the uninsured will make them irresponsible.
Of course, this analysis is insane, unless you think most of the uninsured lack coverage because they’d rather splurge at Best Buy than spend money on health insurance. Alas, this appears to be exactly what Giuliani believes. “[The uninsured] may be buying a television … they may be buying a cell phone,” he said at [a recent] debate.
Giuliani also thinks that insulating people from the costs of sickness or injury will make them more likely to get sick or injured. “There is no incentive to wellness,” he complains. Perhaps you thought wellness was an incentive in and of itself. Obviously, you lack Giuliani’s grasp of free-market homilies. As Giuliani understands, when you don’t pay the cost of a good, you have every incentive to consume more of it. That’s why those of us with insurance are always borrowing handkerchiefs from people with communicable diseases or juggling steak knives barefoot.
Lucky for Giuliani, as mayor, he received government-financed, taxpayer-subsidized treatment for his cancer. He seems surprisingly anxious to deny others the same opportunity.