Late Night Host Jimmy Kimmel delivered an impassioned May 1 monologue that did not go unnoticed by lawmakers and supporters of the Affordable Care Act (ACA) also known as Obamacare. Kimmel talked openly about the experience of seeing his son born with a chronic heart condition that requires several surgeries, and the concern about him being denied affordable health insurance in the future under the latest ACA repeal and replace bill before Congress.
“You know, before 2014, if you were born with congenital heart disease, like my son was, there’s a good chance you’d never be able to get health insurance, because you had a pre-existing condition,” said Kimmel.
The reaction was swift with former President Barrack Obama, Hillary Clinton and scores of others commenting.
There are many preexisting conditions that can put an adult in a situation where they cannot afford healthcare coverage. According to the Kaiser Foundation in December 2016, “We estimate that 27 percent of adult Americans under the age of 65 have health conditions that would likely leave them uninsurable if they applied for individual market coverage under pre-ACA underwriting practices that existed in nearly all states.” Heart disease is a category of preexisting condition.
Nick Mulvaney, director of the Office of Management and Budget, addressed Kimmel’s plea as it went viral yesterday with FoxNews. Mulvaney defended the second healthcare bill saying the latest plan is about giving states authority over providing healthcare for their citizens.
The point behind the state waiver program is that state governments know how to treat children like the Kimmel baby better than the federal government does,” he said.
That is a risk to the purses of people with preexisting conditions -- and their Congressional representation -- in all 50 states will have to take, if the new healthcare reform bill moves forward.
But be that as it may, what is really surprising is that there are still arguments that national healthcare kills medical innovation and research, and this perspective is being bandied about as if it were fact.
The National Review’s Michelle Malkin, responded to Kimmel with: “Compassion without clear thinking is just a waste of Kleenex.” She noted how children born with conditions cannot be refused care at the hospital, which is provisionally true, although coverage of that care under the Children’s Health Insurance Protection plan could be eliminated if it’s not replaced in new healthcare legislation.
But Malkin insisted -- without example -- that costs driven up by a national health care system lead to elimination of medical innovation.
“Moving toward a nationalized health system might play well with an emotion-driven late-night comedy audience. But sober observers know it would mean undermining America’s superior access to cutting-edge diagnosis, innovative treatment, top specialists and surgeons, technology and drugs.”
If I’m picking up on her drift -- because I am a thinking mom, too -- all those ‘drunk’ on the belief that the United States can afford national healthcare are going to pull the rug out from under medical progress.
But a decade ago, the New Republic covered this very argument. Many disagree with the logic that higher healthcare costs kill the promise of innovative medical research.
But it’s one thing to say that universal coverage could lead to less innovation or reduce the availability of high-tech care. It is quite another to say that it will do those things, which is the claim that opponents frequently make. That argument requires several leaps of logic, many of them highly suspect. The forces that produce innovation in medicine turn out to be a great deal more complicated than critics of universal coverage seem to grasp. Ultimately, whether innovation would continue to thrive under universal health care depends entirely on what kind of system we create and how well we run it. In fact, it’s quite possible that universal coverage could lead to better innovation,” wrote author Jonathan Cohn.
He cited the National Institutes of Health as a key driver of medical innovation. Congress must agree with that because now -- about 10 years later -- they acted to increase NIH funding by $2 billion. Despite the fact that the proposed Trump budget called for a 20 percent slash to NIH.
Don McCanne, MD’s comment -- whenever he may have made it in the last decade -- sums it up best, “The fundamental flaw in the argument that optimal innovation is possible only in a privately financed health system is the presumption that the quest for profit - the high profits characteristic of Wall Street supported firms - is the primary driving force behind innovation.”
Governments -- not just the private sector alone -- can of course spawn, nurture and drive innovation. They can do things like:
