Mar 28 2012

Carlson: ACA is here to stay

Published by at 9:10 am under Carlson

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Chris Carlson
Carlson Chronicles

Let me tell you a story that illustrates why, even with its unconstitutional mandate that everyone participate, the health reform act is here to stay regardless of who becomes president.

In the fall of 2006, I was laying on my gurney at Salt Lake City’s University of Utah Hospital adjacent to the Huntsman Cancer Center where I was being treated for late Stage IV neuroendocrine carcinoid cancer. Having been diagnosed in November of 2005, I already had survived longer than the six months I’d been given.

I was getting ready to undergo my fifth chemo procedure wherein the interventional radiologist enters one’s femoral artery with a thin flexible device and guides it to one’s liver where the chemicals are placed on the lesions.

This fifth procedure, unlike the first four, was considered “experimental” but had been approved by my insurance carrier. Radioactive pellets of Yrtrium-90 were that day being flown in from Australia to be placed on the remnants of the shattered lesions in the hope the pellets, with a half life of a couple of weeks, would kill the remaining cancer cells. The procedure cost about $80,000 and for two weeks I would literally be one hot dude.

Fortunately, the flight home to Spokane was only 90 minutes for I was not supposed to sit close to anyone for more than two hours, could not hold children or pets for two weeks, and had to sleep in a separate room from my spouse.

We had a few moments before they administered the sedative that would keep me semi-conscious through the five-hour procedure and we started talking about the procedure.

The doctor casually mentioned how fortunate I was my insurance company had approved the procedure. He had another patient who would benefit from this same procedure, but her insurance carrier would not approve it. She was a young mother in her early 30’s with four children. But for the cancer, she had many years of life ahead of her.

Here I was entering my 60s, much of my productive life behind me, and our four children self-sufficient adults long gone from the home. Life is not fair, but that’s not a good answer. For me, the experimental procedure obviously played a significant role in rendering my cancer dormant for an extended period. One is never cured — ultimately it returns and is always fatal — but life also is a terminal condition.

It’s all relative, though, and I often have thought of that faceless young mother who I suspect long ago died. Why I was a lucky one and she wasn’t? If there had been any sort of “death panel” as Sarah Palin infamously and falsely charged about the health reform act, objective criteria would have placed the young mother in line ahead of me.

“Obamacare,” as it is infamously called by its critics, is not about rationing an ever more costly health care system. At its core lay two key concepts: Insurance companies cannot refuse coverage for pre-existing conditions and access to money is not going to determine who lives or dies — everyone has access to care and everyone pays something.

Rightly or wrongly, we are fundamentally a compassionate people. We do not turn away people at emergency rooms who are in need of life-saving care because they cannot afford it. Nor do we hold people accountable for poor life-style choices, such as excessive drinking, eating or smoking. Perhaps we should, but we don’t.

My monthly chemo is a sandostatin shot which costs $11,000, half in each “cheek.” I call it my golden ass shot because when I walk out of Northwest Cancer Care my rear is truly golden. If there is anyone who thinks any insurance company would voluntarily have provided me coverage, I have a bridge I want to sell you.

I don’t argue with those that say mandating participation is unconstitutional. I say two things in rebuttal:

* If you don’t want a single-payer system that eliminates the middle person, the insurance company, you have to recognize why private insurers insist on mandatory participation for the largest pool possible over which is spread coverage costs.

* I will grant you a right to opt out if you grant me the right not to pay for your life style choices when you show up at an emergency room door.

You choose to opt out then you choose to pay all costs yourself, including the catastrophic costs of cancer care few can afford, but those that proclaim their constitutional right not to be forced into a universal coverage pool want to have their cakes and eat them, too. They know they can be selfish and still receive care when they show up because the rest of us are compassionate suckers.

It is an imperfect system with kinks to be worked out. At the end of the day, it will survive largely intact because it will prevent denial of coverage for pre-existing conditions and equalize access to comparable care.

The next time you hear a politician ranting about “Obamacare,” think about catastrophic occurrences in life. Hopefully, you will come to realize it is not only a debate about values and principles; it is about who lives and who dies.

CHRIS CARLSON is a writer living at Medimont.

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