Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, September 18, 1995 TAG: 9509180030
SECTION: EDITORIAL PAGE: A-5 EDITION: METRO
SOURCE: MIKE ERVIN
DATELINE: LENGTH: Medium
A great deal of the uninsurables are people with disabilities. I've been denied health coverage because I have the ``pre-existing condition'' of muscular dystrophy. It doesn't matter that I've spent four days in the hospital in the last 20 years. I've never had surgery. I still have my tonsils. I've never even had a cavity.
Insurance companies deny coverage to people with disabilities by the millions with no questions asked. Nothing in the Americans with Disabilities Act requires insurance companies to have a good reason for denying us coverage. The architects of the ADA purposely left out insurance companies so as not to draw their powerful lobby into the fray.
The price we pay as a society for not having the guts to make the private sector do the right thing is ever-growing Medicare and Medicaid bills. It's either public support or no support at all.
And now the right-wingers in Congress have come up with the brilliant idea that the way to improve the public system is to turn it over to the same industry that created this problem in the first place. A popular idea being floated on Capitol Hill is to heavily pressure Medicare recipients to go into an HMO by charging stiff penalty premiums to those who refuse.
Obviously, people with disabilities have more health problems than others. And then of course we have all these other picky little needs too, like wheelchairs. All these things are a threat to the profit margin. Insurance companies will make a whole lot more money ignoring us. That's why they do so. They're much better off selling health insurance only to the healthy, which is as much of a heads-I-win-tails-you-lose scam as selling life insurance only to the dead.
And don't think that simply requiring certain HMOs to accept uninsurables will solve anything. You can bet your firstborn that there will not be an accompanying requirement that they actually provide us with the extra attention we need. Once again, those who need the most will get the least.
It's the same problem with the idea of block-granting Medicaid. To just turn Medicaid money over to states to spend as they wish with no minimum standards is a guarantee of even more abandonment. No one loves a license to do as little as possible more than an obedient bureaucrat. And no one suffers from that attitude more than people with disabilities. Bureaucrats looking for the easiest way out will drop the biggest ``burdens on the system'' first.
And then there's the concept of means-testing Medicare, which may force people with disabilities to refuse to take jobs. Here's why: Insurers quite often refuse to cover people with disabilities even when they are part of an employer's group health plan. So no matter how badly we may want a job, if taking it means losing Medicare with nothing to replace it, it becomes a foolhardy risk few would take.
The last thing we need is to give people with disabilities yet another incentive for staying broke and useless by means-testing the only insurance a lot of us can get. If anything, we should be thinking of making Medicaid even more of an entitlement. If getting off Medicare rolls wasn't such a high-stakes gamble, more people would be willing to try.
If cold conservatives get their way, I may be forced to do the unthinkable. In order to get comprehensive health coverage that I never have to worry about, I may have to stoop so low as to run for Congress.
Mike Ervin is a Chicago-based writer and disability rights activist with ADAPT (American Disabled for Attendant Programs Today).
- Knight-Ridder/Tribune
by CNB