Illness Doesn’t Care if you’re a Koch or a Not, But the Government Does

While studying for my Master’s in Public Administration, I was required to take an introductory course in Microeconomics. Not a numbers person, I loathed this class. I was a people person, so what could numbers tell me that intuition couldn’t? (The answer: a lot.)

I don’t recall much from this class — sorry, Dad — but the lesson that stuck was about insurance. The example was health insurance, as we were in the throws of ACA negotiations, discussing the need for healthy individuals to use insurance in order to make it affordable for the less healthy. At this time in my life, I was healthy…and broke. So, I found this idea frustrating. “Why not invest more in preventative care and community managed medicine. Give everyone that!” My logic was not sound, but it felt right. Intuition, ya know?

Fast forward seven years. I am nearly 30 years old, self-employed, and spending roughly $20,000/year, or nearly half of my annual income, on healthcare expenses. I am the healthy-turned-not case in the health insurance example my Microeconomics professor used. In an instant, I went from the healthy demographic Obamacare preyed on to lower premiums to the person with a pre-existing condition who would require longterm healthcare.

This happened when I learned my body held a mutant BRCA1 gene. No amount of preventative healthcare, accupuncture, meditation, exercise, et all could have changed my genetic makeup. (But if we continue funding genetic research, this may change… but that’s a different fight.) My mutation means I have an 87% and 63% chance of developing breast cancer and ovarian cancer, respectively, in my lifetime. Rather than wait and see if I’d get cancer — which was akin to me getting hit by a car 8 times out of 10 — and need more costly and long term care for chemotherapy, radition, and more, I underwent a preventative double mastectomy. In a few years, I’ll undergo another preventative surgery to remove my ovaries and fallopian tubes.

My mastectomy surgery and the two revisions that followed were covered by my insurance company. Why, you ask? The Affordable Care Act made it so women and men like me, with pre-existing conditions, who require preventative care cannot be discriminated against. And, really, this decision had to be a no brainer. Even my basic understanding of economics was enough to know that prevention is always cheaper than treatment. It’s why we health policy wonks look to countries like Cuba for ideas.

But now I find myself terrified that if I wait until I’m 35 to have my ovaries removed, my annual medical expenses will double. The insurance may not be required to cover my surgery and, because it’s preventative and not the result of a cancer diagnosis, will probably not cover it. This is all under the assumption that someone like me will still have affordable health insurance coverage. Let’s face it, I don’t even qualify for life insurance because of my genetics, so this is not out of the realm of possibility.

I write this story for a reason. And it’s not for sympathy. I’ve made my piece with my situation and don’t ask that you feel bad.

I write it because I am not alone in this. Should the GOP rally enough votes and Koch-scented money, plenty of men and women like me will find themselves facing bankruptcy if they continue to care for their health and treat long-term, chronic conditions. Paul Ryan would like you to believe he’s saving us. Saving us money, saving us from lack of choice, saving us for redemption by his God after we lose our lives to preventative and controllable disease. But Ryan is a liar. He plays the part of David in public but is very much a Goliath.

Are you a moderate — either in office or in the voting booth? This is for you. We need to protect one another because even if you’re one of the healthy ones, you may not be tomorrow. We can all get hit by a car, get cancer, learn about a chronic autoimmune disease. It’s not a complete science as to who or when or why this happens, it doesn’t discriminate based on party or economy lines, religion, sex, or gender.

Spend your weekend calling your representatives, because you elected them. Not Donald Trump, not David and Charles Koch, and certainly not our spineless Speaker. You did.

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