PLANK MAY 31, 2012
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A new internet video from the Romney campaign focuses on Ann Romney’s diagnosis with Multiple Sclerosis and how it affected the rest of the family. The ad’s apparent purpose is to humanize Romney—to portray him as a sympathetic, loving husband. That's just fine. MS is a serious, life-altering diagnosis and Romney is, by all accounts, a devoted family man. If telling people about this part of Romney's life makes him seem less aloof or more sensitive, I have no problem with that. The video is genuinely moving and, in a classy touch, it closes with a link for donations to the National Multiple Sclerosis Society.
But if you have MS, or any other serious chronic illness, you need more than a devoted spouse. You need a way to pay your medical bills. And, historically, many people with MS have struggled with that. MS is a long-term, progressively debilitating disease, requiring ever more costly treatments and equipment. The bills are high enough that even patients with private insurance have struggled with out-of-pocket expenses or run up against annual or lifetime limits on payments. And those patients have been, in some respects, the lucky ones. People who buy coverage on their own or through small businesses frequently end up with exorbitant rates or skimpy benefits, or can’t get coverage at all. Those are just some of the reasons the MS Society has long supported reforms that would, among other things, provide “comprehensive, quality health care available to all.”
My friend and frequent collaborator Harold Pollack, from the University of Chicago, wrote about this a few weeks ago for healthinsurance.org:
In 2008, I happened to speak at the National Multiple Sclerosis Society’s annual meeting. I was touting health reform. This was a large, friendly crowd. Afterwards, an older gentleman hobbled over. Leaning on a huge antique walking stick, he recounted a host of complex medical and financial difficulties he faced with this painful disease.
MS is financially punishing for so many people who lack economic resources or insurance that really covers a complex chronic disease. A heartbreaking NPR story compared the experiences of two MS patients: one in Great Britain, and one in the United States. I’ll let you guess which one was driven to split his pills, became medically uninsured, qualified for disability but fell into the two-year Medicare waiting period, lost his home, and went bankrupt. Economic hardship and financial barriers to appropriate care are common among MS patients across the United States.
The Affordable Care Act will not fix all of these problems. The standards for insurance it sets allows for substantial out-of-pocket expenses, which means many patients with MS and other chronic disease will still struggle with the cost of care. But the health reform law will certainly make the situation better, by making sure almost everybody can get health insurance, no matter what their pre-existing conditions, and by making sure everybody’s coverage includes at least a minimum set of benefits and limits on cost-sharing. Although those changes won’t happen until 2014, a few of the law’s reforms have already started to take effect—among them, the elimination of those lifetime limits on benefits and an initial reduction of those limits on annual benefits. (The law eliminates the latter entirely by 2014.) These are just some of the reasons that the MS Society, like virtually every other chronic disease group, advocated for the law and endorsed it after enactment.
But patients with chronic disease like MS will lose most or all those protections if Romney becomes president and, as he has promised, he repeals the Affordable Care Act. He's promised to replace it with other reforms but, based on what he's said, his reforms won't be much of a substitute. Worse still, the tax and regulatory changes he's proposed would quite likely undermine existing insurance arrangements without providing a suitable alternative, as experts such as Harvard's David Cutler have pointed out. People with chronic disease who now rely on job-based plans could find themselves with weaker coverage, or even none at all.
Those who rely on Medicare and/or Medicaid to pay for MS treatments will also struggle if Romney gets his way. Although he has not been terribly specific about his plans for for Medicare, he’s made clear his intention to transform Medicare into a voucher program that no longer offers the same guarantee of benefits. Romney has been more specific about Medicaid: He intends to turn the program over to the states but with a lot less money, all but guaranteeing that states dramatically reduce either what or who the program covers.
MS belongs in this presidential campaign, along with every other major disease. But the conversation should go beyond what it says about Romney as a husband and father. It should include what it says about him as a potential president.
follow me on twitter @CitizenCohn
11 comments
Preach on, Brother Jon!
- GSpinks
May 31, 2012 at 10:41am
If it's his wife who has MS, the daughter of his partner in Bain Capital who is lost, or the people in a sinking boat who live on his lake, Romney seems very kind. But if you are an employee of his company, an uninsured, underprivileged or poor person living in his country, or his dog, you are out of luck.
- Nusholtz
May 31, 2012 at 10:57am
Well I hear horseback riding has worked wonders for Ann. Maybe if he wins Mitt can buy everyone a pony.
- Tristan
May 31, 2012 at 11:04am
As difficult as it may be to do so with sufficient sensitivity for Ann Romney's privacy, this is a story which needs to be told and retold in the coming months. When Republicans fall back on their "class warfare" mantra when we talk about taxing people with money to pay for public benefits, they want everyone to think in terms of mansion envy. "You want to tax the rich because they live in big houses and can afford the best cars and clothes and vacations." No. In fact, HELL NO. We want a progressive tax policy because the real class warfare is to deny fundamental participation in the benefits of our wealthy society to large numbers of people based solely on their occupation and earning power. Nurse in my local hospital ($24/hr after 12 years on the job)? Tough - all you get is a high deductible with health savings plan insurance policy that , should YOU have a spouse with MS, reduces your income by at least 25% just for basic treatment of the condition. Family of 4 living on a couple of $12/hr jobs and one of you comes down with MS - just bend over and prepare to be reamed. You're totally screwed. We don't think you're less valuable as a person (heaven forbid a Republican uttering such a thought), it's just that you're in the "screwed if you get sick" class. In fact, on second though, to hell with sensitivity. I want to see an ad entitled "The Screwed if you get Sick Class" that shows the care you can expect at the lower end of the working class compared to what Ann Romney gets solely because she was born to the right parents and married well.
- IowaBeauty
May 31, 2012 at 11:53am
As a person who has a mother and aunt dealing with MS, I can honestly say that were it not for the healthcare coverage my father had as a benefit when he worked as a public-sector employee for the city of Denver, my mother would have had severely reduced access to MS diagnosis, treatments and on-going follow-ups and my middle-class family would have been bankrupted by the illness. That my sister and I were living on our own probably was a saving grace for my parents at the time. That she's had to deal with breast cancer on top of MS, it's amazing that my parents didn't hit the lifetime benefits wall. Alas, even with the best of coverage, the financial impacts of MS treatments can be prohibitively expensive. My mother was prescribed Avonex for a few years. Avonex like many of the other biotech MS treatments, costs on average $30K / year. My aunt, not so lucky in her dealing with MS. Her house was foreclosed on after years of dealing with private insurance caps, 'pre-existing' conditions, high treatment costs, etc. and her husband made pretty decent money as a real estate investment broker until the markets dried up in 2008. Now imagine you are a "retired" 60-something that qualifies for medicare & SS. You're still working part-time because SS & Medicare don't cover everything and your company raided your 401K years ago leaving you with a nest egg that ran dry after a few years. You only work part-time because your MS flares up without the proper medication and physical therapy. You're barely making enough a year so you don't lose your government benefits and you thank the Lord that the government "entitlements" just barely cover your MS medication yet still leaving you with a expensive co-pay that eats into your other living expenses like food and rent. I feel for Ann Romney, I really do. I wouldn't wish MS on anyone. But common. Not only does she have a milder form of MS but she's able to spend a cool $1M+ on her thera-ponies that she boards exclusively out in California at her private dressage trainer's horse farm. It doesn't take much of Mitt's time and energy to "care" for Ann because she truly is one of the lucky duckies. Mitt's response to making life easier for his MS-inflicted wife is to install a car elevator in their house so after parking her Tuesday Cadillac, Ann doesn't have to walk up stairs after a therapy ride. I'm sure he won't be as heartless as Newton was to his MS stricken wife. But Mitt had troubles changing his kids' diapers so who honestly thinks Mittens is going to be lifting his wife from the wheelchair to sponge bathe her every night after a rough day of downsizing America? As everyone has pointed out, the GOP / Mittens solution to the healthcare problems we face individually and as a nation, is based on a simple belief that healthcare and access to healthcare is a privilege and not a right.
- singlspeed
May 31, 2012 at 11:54am
Wisdom better late than never. Chronic illness, as I have commented many times, is the primary cause of the health care crisis, and not just unusual and debilitating illnesses like MS, but cancer, diabetes, and old age (yes, old age is a chronic illness - there is no cure for it). While I appreciate the extension of health insurance to the almost poor, the plight of the chronically ill is a much greater greater concern and crisis. And the number of people with chronic illnesses is growing, as cancer and other diseases that were at one time death sentences are now treatable and chronic. That more wasn't done in health care reform for those with chronic illnesses has been a real sore spot for me, and I have sometimes been critical of Cohn for his focus on universal coverage. In part it's personal. My brother suffers from chronic leukemia, and the path of his disease has been typical: repeated chemotherapy and other very expensive treatments, ruptured spleen, blood replacement therapy, repeated bouts of pneumonia requiring extended hospital stays (he has no immune system), and on and on. As if that's not bad enough, from the beginning there was pressure from his locally owned bank employer for him to quit his job (with the implicit threat that the bank would drop its health insurance benefit for all its employees), resulting in him doing the "right thing" and quitting; exhaustion of his COBRA benefits; exhaustion of his life savings; and eventually bankruptcy. He is back in chemotherapy again now for what seems like the hundredth time, treatment that costs far more than he can afford (though the Leukemia Society has been a big help). Of course, this is an absurd way to treat someone with an illness, and it's the norm in America. And my brother's illness is not the worst in my family: my nephew has ALS, which is a nightmare both in terms of the costs as well as the symptoms. Yes, it's personal, and the reason I have criticized Obama for squandering much of the leverage he might have had in designing minimal national health insurance standards when he made $50 per month birth control part of the standards, rather than addressing the far more important standards for those who suffer chronic illnesses. Welcome aboard Mr. Cohn.
- rayward
May 31, 2012 at 12:01pm
The republicans are no fiends of the middle class. Beware.
- JAIMECHUCH
May 31, 2012 at 1:58pm
No Tristan, a pony will not do; we must all have access to a dressage horse! Seriously, this is not a joke. Therapies involving horses are often successful but alas! they are not often accessible to the poor. This needs to be addressed. Good health care would involve such access. Alas this is probably "class warfare" and/or socialism.
- Sophia
May 31, 2012 at 4:53pm
Rayward is absolutely right about chronic illnesses. The cost is often just brutal. People without means are supposed to do what? The cost of treatment, prolonging life, is enormous. I don't think that throwing religious freedom and women's rights to health care are expendable though. Contraceptives are a vital part of our health, and $50 may not sound like much but if you're making $10/hour it's a lot! The real issue is that Obamacare represents an advance but not a full answer, which is only to be found in universal, single payer health care.
- Sophia
May 31, 2012 at 4:57pm
Romney's health care plan is actually quite simple: 1. Be born the child of an executive and governor. 2. Attend expensive, elite private schools. 3. Make hundreds of millions of dollars by "consulting" and "investing." There, now paying for MS treatments is easy!
- kkseattle
May 31, 2012 at 9:28pm
Anybody who knows MS personally (as I do) understands that Ann Romney does not have a "mild case" because she rides horses, but that she is able to ride horses because she has a "mild case", (so far at least.) To think otherwise is to indulge in self-delusion. That is okay, even mega-rich Republican presidential candidates are due their self-delusions. But it is a little nauseating to read how they take pride in their management Ann's disease. The effects of their contributions to any good (or bad) outcomes, even by seeking and paying for the latest in high tech therapies, are minimal. They might as well gloat about being born the son of an auto-executive. If they had true self knowledge and humility, they would credit only their good fortune.
- aduncanson
June 2, 2012 at 4:52pm