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Does Healthcare Need its Own Version of Legal Funding? (orig)

January 30, 2011
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4min read

As Obamacare provisions rolled out earlier this year, the federally-mandated health care law saw continued debate.  Despite criticism from the law's opponents over everything from the problematic rollout of the healthcare.gov website to the anticipated costs to taxpayers, the Obama administration has touted the benefits of the law, such as providing free or low-cost healthcare to millions of previously uninsured Americans and increasing access to preventative care that will lower healthcare costs in the long run.

A recent article in The New York Times, however, presented research from The Henry J. Kaiser Family Foundation that suggests some of the marketplace plans are falling short of expectations.  The working poor select plans with the lowest premiums, which also happen to be the plans with the highest deductibles.  Many plan deductibles reach as high as $5,000 for individuals and $10,000 for families.

The result? People are foregoing preventative or non-emergency medical care because they cannot pay the full cost of medical care until the deductible is satisfied. Because health insurance companies will not pay for services rendered before the deductible is met, there is often an impassable gap for individuals seeking health care services.

Other insurance industries have created workarounds to this type of gap.

For example, in the context of car insurance, if someone is involved in a car accident, the insurance company may set that person up with a rental vehicle while processing the claim and paying for the car repairs.  They may then seek to be reimbursed by the party responsible for the accident, but the policy holder doesn't have to wait until the insurance company successfully seeks reimbursement before receiving insurance benefits. The effect of the car insurance process is that someone who is involved in an accident will be back on their feet quickly with a rental car and repairs to their vehicle while the insurance company processes the paperwork.

The policyholder does not have to wait until the insurance company gets money from the party responsible for the accident to get back on the road. Similarly, legal funding can provide a plaintiff with funds while that individual asserts a legal claim against a responsible party, thereby allowing the plaintiff to move forward despite the often slow pace in which claims make their way through the legal system.  And yet while people are generally accustomed to car insurance providing interim services, there is less familiarity with legal funding and its ability to help plaintiffs gain access to justice.

Access to justice is a constant struggle for Americans, where the unjust reality is that those who most need access often face economic and other barriers.  Even with recent health care reform, barriers exist for low-income individuals seeking medical care.

Not only is this unfair, it is arguably more costly to everyone in the long run when you factor in the cost of emergency care and lost productivity at work.

For now, it appears we are a long way off from equitable access to health care.

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