I grew up in the Deep South. Most of my family members–and my in-laws for that matter–vote Republican. I mention this for the sole purpose of providing some context when I say I’m quite familiar with people who don’t much approve of President Obama or his signature piece of legislation, the Affordable Care Act. As an academic with expertise in health policy and health services research, this can be pretty frustrating. After all, I chose my career as a way to help improve the health and healthcare of the people I grew up around, yet they are the very people most likely to reject what has been done in an attempt to help them, and understandably, they’re rarely open to having me explain things to them.
With that in mind, the recent news around Luis Lang has particularly resonated with me. Mr. Lang is a Republican from South Carolina who, like many of the people I know, was staunchly opposed to “ObamaCare.” Unsurprisingly, he didn’t sign up for health insurance via the marketplace (healthcare.gov), and he wasn’t eligible for Medicaid, because South Carolina is one of the many states that refused to participate in the expansion of that program. That’s what he did, and things were just fine, until they weren’t.
You see, Mr. Lang is a diabetic, and his condition has led to him developing problems with his eyes (diabetic retinopathy). Unfortunately, the treatment for his eye condition is too expensive for him to pay for out-of-pocket (remember, he has no insurance), and without the treatment, he will go blind. Here’s a good overview of his situation. To raise the money he needs to pay for the surgery he so desperately needs, Mr. Lang turned to the crowdfunding site GoFundMe. At the time of this writing, he still needs about $3500. So, if you’re so inclined, I’m sure he’d love your donation.
At this point, if you don’t see the irony, let me try to clarify it for you: Mr. Lang was opposed to the ACA, so he didn’t obtain the insurance coverage it would’ve helped him to obtain. Then, his health took a turn for the worse and he desperately needed insurance that he couldn’t get because the open enrollment period–the one he ignored because he was so opposed to the ACA and didn’t see the need for insurance at the time–had closed. Finally, to avoid cognitive dissonance, he continued to blame his problems on the President and the ACA and went in search of donations from strangers on the internet. Underneath all of this, are a number of incorrect assumptions that Mr. Lang had to make. For example, he thought he could just buy insurance if he got sick. Of course, that’s not true. He also wasn’t clear on the fact that it was the state of South Carolina’s decision, not President Obama’s, that denied him access to Medicaid.
None of this is to blame Mr. Lang. The details of our healthcare system are many and they are complicated. Most people don’t fully understand them. However, that doesn’t stop them from forming an opinion on the matter, acting on the basis of that opinion, and living with the consequences of that action. As Harold Pollack writes, “Lang is not the only conservative who needs serious help. Millions of low-income, sick, or injured Americans are uninsured or going without needed care because they disdain President Obama or because they misunderstand and distrust the Affordable Care Act.” Fortunately, as this excellent audio interview between Harold Pollack and Luis Lang reveals, while we are masters of maintaining illusions that feed from, and reinforce, our political beliefs, our personal experiences can educate and enlighten us in ways that nothing else can. I just hope that others can learn from Mr. Lang’s experience, put aside their politics, and get covered, rather than learning it for themselves the hard way.
Brad Wright, PhD
Shirie Leng, MD
Nicole F. Roberts
Wright on Health 