In Contradistinction to Heartless Republicans, Obama Cares about Sick People

The New York Times Business section responded to the Florida court decision on ObamaCare not by addressing the issues but by tugging at the heartstrings:

With a court decision on Monday declaring the health care law unconstitutional and Republicans intent on repealing at least parts of it, thousands of Americans with major illnesses are facing the renewed prospect of losing their health insurance coverage.

"We've got to protect people from catastrophic health problems," said Ron Pollack, the executive director of Families USA...Protecting people from facing these extremes is one of the main goals of the law, according to its proponents.

I agree with Mr. Pollack. Sort of. Telling people with catastrophic health problems that time's up on their treatment is another form of a death panel, operated by insurance companies rather than government bureaucrats. We are a wealthy country and we really shouldn't throw sick people into the streets to die.

The reality however is a bit more nuanced.

The Times uses two individuals to make its case, and neither makes an unassailable case for ObamaCare. The first is a hemophiliac on an extremely expensive treatment regimen. The Times reports, "In 2010, the bill for the clotting factor medicine he needs was $800,000 [per year], and his policy has a $1.5 million [lifetime] cap."  I hate to be hard-hearted, but there are many, many medicines for hemophilia that cost nowhere near $800,000 per annum. Examples in a Journal of Managed Care Pharmacy article range from $8,000 to $90,000 per year.

The second individual, Hillary St. Pierre, suffers from Hodgkin's lymphoma.  Her insurance company has spent close to $2 million and she is nearing a cap on her coverage. The Times notes however:

And while Ms. St. Pierre, who has worked with the cancer society, says she knows she is likely to be able to continue to receive some treatment without insurance, she also knows that it is not likely to be the optimal care. The same is true for any patient who runs out of coverage, Mr. Finan said. "You may well continue to get care, but the quality of care is markedly lower," he said.

I might be outraged if lower quality care meant dirty needles and Romanian orphanage standards.  In both cases however I would guess that it means that stratospherically expensive experimental treatments might not be available to every single American. It would be nice if we could devote unlimited resources to medical care, cost be damned, but the reality is that some consideration of costs and benefits is necessary.

And even if we decide that only "optimal care" is good enough for every citizen, the "thousands of Americans" affected by catastrophic disease is around 20,000, according to the Times.  If one of ObamaCare's "main goals" is to protect these people, we could create a special provision to cover these 20,000 for a fraction of the cost.