Jonathan Cohn has picked up on Matthew’s story for The New Republic. He recounts the details of the kinds of choices Matthew’s mom and dad have been forced to make as they decide whether to take Matthew for a particular medical treatment. They know that his frail medical condition means that delayed treatment could be dangerous, but they also know that every trip to the doctor or emergency room counts against the rapidly-approaching lifetime cap on his medical coverage medical coverage he will need later in his young life.
Cohn uses Matthew’s story as a grim reminder that even those with insurance are not fully protected. Lifetime caps mean that babies like Matthew or anyone with a truly awful medical condition could bankrupt a family when the insurance coverage runs out. For most of us, insurance actually means limited coverage, not protection when a family needs it most.
Cohn observes that the current insurance system isn’t well designed to handle the costs of extraordinary cases like Matthew’s. One employer or group of employers isn’t well-suited to a multi-million dollar outlay for the care of a single child. So they put caps in the insurance coverage, which protects them and which the employees never really see until they need extraordinary medical care. Private insurance isn’t enough for Matthew or for any of us. We need a bigger pool for spreading the risks and the costs of these extraordinary medical events. That’s where government can be most helpful, putting us all in the same risk pool for extraordinary care. Without that step, even the tens of millions of Americans with health insurance will remain financially vulnerable to an extraordinary medical crisis. We just don’t know who will be hit next.
