Jimmy Kimmel’s monologue about his son’s congenital heart defect and the medical treatment it needed was pretty moving. And Kimmel then followed it with an observation that too many folks without insurance coverage would not have had the medical access he had. It was, ultimately, a personal story about why the Affordable Care Act is so important.
Enter Michelle Malkin for some pushback. She titled her piece, “A Thinking Mom’s Message for Jimmy Kimmel.“ First, she took issue with the fact that Kimmel “turned his personal plight into a political weapon” that so many were willing to re-tweet and like on social media. But then the argument, and not the opportunisim, gets some critical attention:
Kimmel doesn’t need more maudlin Twitter suck-uppery. He needs a healthy fact-check. “Before 2014,†he claimed, “if you were born with congenital heart disease like my son was, there was a good chance you’d never be able to get health insurance because you had a pre-existing condition, you were born with a pre-existing condition.â€
This is false. If parents had health insurance, the child would have been covered under the parents’ policy whether or not the child had a health problem
Malkin is also essentially saying that we don’t need certain protections of the PPACA because they overlap with existing laws and regulations. History tells us that many insurance companies would be more than happy to deny to extend health insurance to newborn babies until they knew that the babies were healthy, or to be able to impose a surcharge the insured if the baby had health complications.
There’s another attack on Kimmel that I have heard, that if a baby is born in need of surgery the hospital will provide it whether or not the parent can pay for it. That’s misleading for a number of reasons — including the fact that a hospital can ‘stabilize’ a patient’s medical condition such that the patient can be discharged or transferred elsewhere for care, and that the parents can be billed for the cost of care. It’s also important to note that high-cost medical procedures don’t suddenly become “free” if a patient can’t or won’t pay the bill — the cost shifts to others, be it other patients or the government.
Further, the argument again takes us back to existing law (e.g., EMTALA) and regulation, that have mostly resolved the historic problem of “patient dumping”, discharge or transfer of medically unstable, unisured patients so as to avoid providing costly care without payment.
Once you recognize the importance of the existing regulatory framework, either criticism of Kimmel seems reasonably characterized as an inadvertent defense of the government regulation of healthcare.
Hi Aaron, I think it’s right to start by asking what exactly is being criticized in many of these cases. Is it the ACA or is it government regulation in any form. The ACA is the primary example in the contemporary discussion about pre-existing conditions not being disqualifying for insurance coverage, and so that’s a feature of Kimmel’s case and many others. But Malkin and many others appeal to the thought that hospitals are also obliged to care for those in need who show up to ER’s. That’s not the ACA, but it is government rules, still. And here’s the kicker: the ethic behind the latter rule, the one that’s supposed to be pushback to the ACA, is that it’s the ethic that inclines us toward single payer.
Malkin is striving for a politically consistent message. It’s no surprise that her arguments lack logical consistency, or even a coherent logical framework or foundation.
Back in 1989, when the Heritage foundation presented its outline of a conservative health insurance reform, it focused on the free rider problem — and used as a specific example a healthy young person who is seriously injured in a car accident, who if uninsured would nonetheless receive extremely expensive medical care with the cost picked up by the rest of society. Today, there is a constant Republican refrain about how unfair it is to spread medical costs across large pools, and how that makes it the cost too high for younger health insurance consumers. You have Malkin using the very problem that Heritage identified as a reason for universal healthcare coverage as an argument against universality.
I’m not sure that Malkin has thought about these issues in sufficient depth to know what she is doing, beyond putting her own spin on the current set of Republican anti-PPACA talking points, but it’s difficult to argue that if you extrapolate from the arguments against the PPACA you should recognize the free rider problem and the need for some form of universal health insurance.
Hi Aaron,
This seems right that Malkin’s not particularly deep on these issues. Often the best explanation for why most Republican pundits are saying what they are is that it’s contrary to whatever the Dems are saying.