Health reform reportage could use some freshening up. We’ve been through nearly seven months of pronouncements, misstatements, and miscues, of phony mandate vs. no mandate rhetoric and scary fake buzzwords like “socialized medicine.” (Now, with McCain stepping up his health care talk, we can add to the buzzword list—“big government solutions”—with which he erroneously suggests his rivals are advancing a government-run system).
What we haven’t seen much of is how any of the proposals will affect those ordinary people. Along comes Megan Carpentier, one of six young women Glamour asked to comment on the presidential race via its Glamocracy blog. The idea for such a blog is a good one and so was one of Carpentier’s recent posts, in which she talked about her own unhappy encounters with the health insurance system.
Carpentier does know insurance—not from actuarial mumbo jumbo—but from first-hand experience. And what she does, with clarity and insight, is examine how the three candidates’ plans would help or hurt her.
She is in a good position to know. She tells us that she has had eight jobs in the last seven years “at companies large and small with headquarters in five different states.” She has had to venture into the jungle of the individual insurance market either because her employers didn’t offer health insurance or because some were exempt from offering COBRA coverage (very small employers don’t have to). She knows the insurance alphabet soup— HMOs, POSes and PPOs—and understands what it is like when a pharmacist says, “Sorry, your insurance doesn’t cover your $100 prescription.” She has gone without coverage because it cost more than she could pay.
Carpentier sums up her predicament: “I know enough about my own health insurance situation over the last decade to be able to say with absolute certainty that our health insurance system in this country sucks.” The fix she’s in parallels those of other young people who face uncertain job prospects, often without insurance. They will move from job to job at a time when employers are rethinking whether they want to provide coverage for their workers.
So her diagnostics on the presidential proposals are worth considering:
Carpentier concludes that McCain’s plan “would do nothing for me.” She says his proposed $2500 tax credit would not help her because she already buys her own insurance for $2000 a year, and, because she is self-employed as a freelancer, she says she already gets special tax treatment. She is spot on when she notes that his plan could eliminate the major financial incentive for employers to offer insurance and thus leave low paid workers, young or old, stranded. Full time workers at Starbucks, Carpentier points out, could see their coverage vanish and still not make enough money to take advantage of McCain’s tax credit.
Carpentier says that both Clinton’s and Obama’s plans might help her in the short term. Their proposed combination of employer mandates, tax credits, and a public option might help her buy into the system as an individual rather than as part of an employer group.
She is uncomfortable with Clinton’s individual mandate. There was a time, she says, when her only insurance option would have cost $400 a month, and she says she doesn’t have that kind of money. She points out that both Obama and Clinton would force insurers to cover and renew policies for people with pre-existing conditions, and also change the way insurance companies create risk pools, “which, as someone born with a birth defect who has been known to get sick, would provide me with peace of mind and likely lower my premiums.”
At the end off the piece, Carpentier asks her readers: “Which one do you think is best for you?” We’re at the stage in the campaign where everyone should ask themselves that question. To answer it, though, they need more help from their friends in the press.Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.