Student Nathaniel Bernal was riding his skateboard at the University of North Texas when he struck his head on the concrete, sustaining a concussion as a result. The emergency department took good care of Bernal, but he would go on to receive a bill for $3,500 that ended up being reduced to $1,000 after insurance.
"It seemed that I got off easy at that point, although it did put me in financial straits for the duration of that semester and most of the following spring semester," Bernal said. "That money was originally intended for tuition, specifically UNT's installment plans. As a result, I ended up having to take out loans through the government and greater than $5,000."
Bernal was under the age of 26, so he was still covered by his father's Blue Cross Blue Shield medical insurance that he earned from his employer. A 2018 census found that 91.5% of people had health insurance that year, a drop from 92.1% in 2017. Polls conducted by groups like Gallup find that 69% of Americans rate their coverage as excellent or good, but the priority Americans place on the topic of healthcare remains high.
A poll conducted by Pew Research Center found that the topic of healthcare was ranked as being 'very important' to 68% of registered voters, and with the general election on the horizon, both President Donald Trump and former Vice President Joe Biden have entered into the final stages of their campaigns with healthcare serving as a major issue. Talk of a healthcare plan that provides affordable coverage to all was a hot topic in the days of the Democratic primary, and President Trump has made recent executive orders aimed at helping Americans afford prescription drugs. The current healthcare system has left many people uninsured and underinsured, with each candidate holding differing viewpoints on how to provide Americans coverage.
An important fact to note is that healthcare works differently in the United States when compared to places like the United Kingdom and Sweden where the healthcare system is primarily government-funded, so all citizens are equally covered. Grapevine resident Cassandra Wendling, who can't afford coverage, experienced a heart attack scare last February where to avoid the high cost of an ambulance she opted to take an Uber instead. Following an 'apathetic' experience with hospital staff and the assurance she wasn't having a heart attack, Wendling was billed $1,600 for an EKG and a shot.
"I still owe about $200, and last month they actually sent it to collections so I now have a collections letter," said Wendling. "I've lived in other countries in my life, Australia and the Philippines being two of them, and when I've had medical issues I ended paying a fraction of that."
Wendling faced a similar circumstance five years ago visiting Finland when she went to a clinic to have her ears de-clogged by a doctor, where she paid 50 euros, but the same procedure at CVS in the U.S. by a nurse practitioner cost her over $100.
"There was no bureaucracy there, they just helped someone in need," said Wendling.
The 2018 census found that 27.5 million people didn't have health insurance, an increase by 1.9 million from 2017. To provide better care for the American people, both Biden and Trump have talked about plans to bring more coverage, but their ideas couldn't be more diametrically opposed.
Since the beginning of his term, President Trump has persisted in the belief that the Affordable Care Act (ACA), alternatively known as Obamacare, is a continued source of pain to the U.S. In the healthcare section of whitehouse.gov, it states that 'Obamacare is hurting American families, farmers, and small businesses,' and that 'replacing Obamacare will force insurance companies to compete for their customers with lower costs and higher-quality service.' While Trump has yet to succeed in repealing ACA, he has promised to do so if reelected.
President Trump attempted to repeal the ACA and pass a plan of his own in October of 2017, but Congress ran out of time to repeal Obamacare and come up with an alternate plan. However, the Republican-led Congress at the time was able to successfully set the individual mandate's tax penalty at zero, opening the way for red states to rule that the revised law is unconstitutional. The Supreme Court decided to hear the case and will reach a decision sometime after the election.
Most recent attempts by Trump to reach voters through healthcare have shown itself in two executive orders focused on making prescription drugs more accessible by allowing the import of lower-cost drugs from Canada, and requiring health insurance companies to cover all pre-existing conditions for all customers. Trump has also repeatedly declared to unveil a new healthcare plan, but has yet to actually do so.
In the other corner, Biden's platform has consistently been to make sure that Obamacare isn't repealed, and as is stated on their web page, 'to build on the Affordable Care Act by giving Americans more choice, reducing health care costs, and making our health care system less complex to navigate.'
Biden served as vice president to former President Barrack Obama when the ACA was signed into effect, gaining 20 million Americans health coverage. Outside of protecting Obamacare from being repealed, Biden ensures that Americans who live in states that refuse to take up Obamacare's expansion of Medicaid eligibility will be covered by offering premium-free access to the public option. The Biden Plan will also prevent surprise billing by barring providers that are out of an individual's insurance network.
Outside of the complaints leveled at the ACA by Trump and Republicans, there are those who believe the ACA doesn't do enough to provide healthcare to all Americans, as Biden's plan would only bring coverage to 97% of the population. Furthermore, Biden's plan does not fully eliminate premiums despite them being capped at 8.5% of an insurer's income. Bernie Sander's Medicare for All plan gained traction among younger voters, and Biden's dismissal of the plan has upset those voters who see Biden and his extension of the ACA as a continuation of the status quo.
Despite both candidates having ideas to bring more healthcare to Americans, there remains skepticism that a proper solution will be produced. Joshua Warner is a cancer survivor who was diagnosed in April of 2016 with Ewing's sarcoma, a rare cancerous tumor that grows in the bones. Warner received coverage through his parent's health insurance, but still had difficulty getting full coverage early on despite his parent's professions as pharmacists.
"Even though my parents know how to talk to healthcare insurance, and we had full coverage at the time, it was still a huge pain in their ass to get the insurance to pay for the first month," said Warner.
Warner believes that the mental state of Biden makes him unprepared to adequately deal with the issue of healthcare, despite being more reliable than Trump.
"I don't really trust Joe Biden that much with his mental state, but he's probably better equipped than Trump," Warner said.
Both candidates continue to starkly oppose one another's plans for healthcare, and while Biden hopes to continue Obama's legacy in the form of the ACA, Trump is equally dedicated to casting it out.