Pre-existing condition? Even Superman had one!

Jon and Martha Kent of Smallville never imagined the life threatening allergy their little alien baby Clark had to Kryptonite.  The American people never imagined being witness to the all white, all male, Senate Committee working on their version of TrumpCare, the world is watching closely.  I am watching, from two perspectives: first as a person with a pre-existing condition (a birth defect, Streeter Syndrome resulting in the amputation of my left foot at age four), and second, as a seasoned health policy wonk that served on two state Medicaid boards, and taught health policy courses for 22 years. I am but one among the 50 to 129 million people with pre-existing conditions.  Setting aside the disputes over numbers, let’s be conservative and use the lower figure, 50 million.  

This low estimate is 16 million people more than the combined population of the ten largest cities in America.  The population ‘at risk’ of major changes to coverage grows annually, and will only continue to increase as 380,000 babies are born prematurely — the majority of whom will have at least one problematic health condition. 


Most of the ‘repeal and replace’ impact comes down to where you live (which I guess is its own pre-existing condition).  33 states are led by Republican governors who campaigned against the Affordable Care Act and are likely to request waivers to create (underfunded) pools for those with pre-existing conditions.

The current proposal also cuts Medicaid by $880 billion, or 25 percent, over 10 years and imposes a “per-capita cap” on funding for certain groups of people (children and the elderly) — a dramatic change in the health care provided to people who are most in need.   This is the cut to fund a major tax cut for the top 1%. Poverty is truly a pre-existing condition for health and quality of life.

Those in poverty, or those with chronic conditions are at odds with the health and insurance industries who have spent nearly $200 million on lobbying in the first three months of 2017, and who contributed to the 13 members most recent campaigns and PACs to the tune of $25.5 million.

The disenfranchisement of women, children, people with HIV, and those with chronic illness, by abandoning the national approach and leaving it up to the states is a foolish approach in an aging America.   

The truth for us all is: Disability is not a matter of diagnosis; it is simply a matter of time. 

Josef Reum, PhD, MPA

Published May 24

The Sun Sentinel

http://www.sun-sentinel.com/opinion/commentary