What About the Folks Who Won't Take Medicaid?

Today's Star Tribune editorial about a Kentucky man who died of colon cancer because he didn't have health insurance was moving, of course. It ended with a reminder that people with incomes like "Mr. Davis" would be eligible for either Medicaid or tax credits for purchasing insurance, and that 71 percent of people in the current individual insurance market (only 5.7 percent of the population to start with) would qualify as well.

But the novel I'm currently reading, Charlie Quimby's Monument Road, plus a recent Facebook post, remind me of another reason why a single-payer system would be better than the ACA's patchwork of current programs, subsidies, and full payment.

The novel opens on the one-year anniversary of Inetta's death from pancreatic cancer. She and her husband, the main character, were eligible for Medicaid coverage, but refused it:

"We're being screened," said Inetta. On the top of the statements, bills and official letters she showed him a pamphlet: Colorado Indigent Care Program.

"Not for welfare," Leonard said. They were not indigent. They were not a case.

"Don't get all in an uproar. They're trying to help us. It's just how they do it when you don't have insurance. They want you to put it on a credit card or show you can pay or show you can't. If you can't, well, you do this form…"

"We'll pay."

As he said it, he knew what it meant. Not the exact dollars and cents of it, but the simple choice: the ranch for Inetta.

(By the way, that's sure a nice shaming name you picked for your Medicaid program, Colorado!)

This response rings true to me, especially because I had just recently read this response to a post by a friend of a friend on Facebook:

I am truly glad that your insurance options went down, but mine didn't, mine got cancelled. And I guarantee my company cares more deeply for me than yours does for you....because I work for MY company, me. The one that was trying to get off the ground in a shaky economy. The one that didn't borrow a dime, but bankrolled ourselves for thousands of dollars. Who employed myself, my husband, my children, my parents, then expanded into a depressed area and created 3 more jobs, where once there were none.

And what do I get for researching, refiling, and begging companies to take thousands of my own dollars to insure me, from being "blacklisted" from getting private insurance ANYWHERE because 12 years ago I couldn't have babies? I got the cancellation letter. The one that tells me that the high-risk insurance pool in my state (which ironically is my President's own state as well) is cancelling me because of the new ACA--which it promises will give "better and cheaper" insurance (yes, I have that in writing!)

But what do I have? A website that I generally can't get logged into, and when I do, it tells me to go sign up for MedicAid--telling a hardworking, self-employed citizen who WANTS to pay thousands of dollars a year for her own insurance that she should take the easy government handout. Oh, and what is the next surprise? Hubby and kids policy cancelled as well, first of the year! What happened to the "If you like your insurance, you can keep it" line?

I researched it, I had our policies in place, I paid the premiums, managed my HSA, and it was all jerked out from under me. The easy answer...go back to work for big business, keep my cushy job I used to have. Oh ya, and back to unemployment go my employees...Great plan for growing the middle class!

So this woman also would qualify for Medicaid, but refuses it because she sees herself as an entrepreneur, not a "welfare" recipient.

Single payer, based on the idea that health care is a right, like voting, would not have this stigma (or could overcome the stigma). If everyone feels like they are contributing to it through taxes, the way they feel ownership of their Social Security and Medicare, there will be no stigma.