Charles C. Mann
Charles C. Mann is the author or co-author of seven books, including 1491 and 1493. He is now working on a book about the future that makes no predictions.
(Photo: Michael Lionstar)

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REASON 53: If Mitt Romney is elected, insurance companies will continue to discriminate against Americans with pre-existing conditions.

I am going to vote for Obama out of naked personal self-interest.

Four years ago, my daughter Emilia got a bone infection in her hip. We don’t know how she got it, but the story we tell ourselves is that she took a hard tumble in her gymnastics lesson. As I know now, almost every time you fall hard you break a bone—micro-fractures, one of Emilia’s doctors called them. Usually these minute breaks heal without incident in a few hours. In rare, unlucky circumstances, a bacterium can swim into the fracture, which then closes behind it. Hidden inside, the organism happily eats away at the bone. The first sign of the infection, commonly enough, is when the bone collapses, flushing the body with infected splinters. Anaphylactic shock is followed by death.

In Emilia’s case, the infection was close enough to the surface that pus leaked out into the space between the ball and socket of her hip. The result was tremendous pain. We rushed her to an emergency room in Springfield, Massachusetts, half an hour from where we live. There a surgeon opened up her hip and scraped out the infection. She spent nine days in the Springfield hospital and came home with a box around her neck that pumped antibiotics into her arm.

Unfortunately, the infection and subsequent surgery had damaged her femur. The weakened bone began to crumble. It got harder and harder for her to walk. She was in constant pain. She was in the hospital a lot. Eventually she was on morphine 24/7. I’ll spare the details. It was pretty bad.

Because Emilia’s case was unusual and difficult, we ended up going to five different hospitals in three states. We spent a lot of time with doctors, nurses, and medical technicians. You know, they would tell us, whatever happens to your daughter’s hip, she’ll be a prisoner of Massachusetts for the rest of her life. She’s going to have a whopper of a pre-existing condition, they said, and your home state, thanks to Mitt Romney, is the only place in the country where she can be sure of obtaining health insurance.

No economist has ever studied how many people with pre-existing conditions are turned down for insurance, because insurance companies won’t release the data. But Congress demanded the rejection numbers from the four biggest firms in 2010. During the previous three years, they had rejected one out of every seven individual applicants, a number that does not include people who were discouraged even from applying.

I didn’t need a study to fear for my daughter. Twenty-some years ago, my father switched jobs. He lost the insurance from his first job and had to wait several months for his new insurance to kick in. While he was waiting he had a stroke. In an instant my father acquired a pre-existing condition; his new insurance wouldn’t cover it. He couldn’t get health insurance that applied to cardiovascular disease, no matter where he looked. For years, my parents lived in terror of my father getting some stroke-related ailment that would bankrupt them.

In Emilia’s case, we finally found a hospital that could treat her. A month after her thirteenth birthday, she got an artificial hip. Today she is fully recovered, but like the doctors said has a whopper of a pre-existing condition. Before her surgery, though, Congress passed the Affordable Care Act—Obamacare—which means that she won’t have to go through what my parents went through. My daughter can now live anywhere within the borders of our great country, or will be able to after 2014.

Romney is running on a program that, as far as I can tell, will result in re-imprisoning Emilia. He says he wants to “repeal and replace” Obamacare with a package of reforms that will nibble away at the problem of pre-existing conditions without an outright bar to insurers. I’m skeptical; an earlier piecemeal reform, the Health Insurance Portability and Accountability Act of 1996, has completely failed to address the problem, as that 1-in-7 figure shows. In any case, so many Republicans are committed to eliminating every vestige of health-care reform that I don’t believe even these modest ideas would be enacted.

I want my daughter to be able to live where she wants, so I'm voting for Obama.

Charles C. Mann
 North Amherst, Massachusetts

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