Health Experts weigh in on Dan Daskus’ care

Mark V. Pauly is Professor of Health Care Management and Professor of Insurance and Risk Management at the University of Pennsylvania's Wharton School.

"No one can fail to be upset at what happened to Dan Daskus. Government, the private sector, and Dan himself are all to blame.

The government failed him most directly by refusing to classify him as disabled if he really is disabled. The market we currently have failed him because he relied on the employment-based insurance system, which has some very serious problems. The most serious is what happened to Dan: if you get coverage through your job, and you contract a high-cost condition, if you leave your job (either because you got sick or because you got laid off), you have no long term guarantee of continued insurance coverage.

You are on your own, and you cannot reasonably expect an individual insurer to cover you for a low premium if you are already sick.

Finally, you need to be careful. If you change jobs, as Dan did, you need to check that the coverage in your new job is adequate.

Good coverage costs money because good health care costs money, so it is easy to slip into false economy (or a false sense of security) when there are other things about the job that you like.

Lower middle income people like Dan deserves a more generous subsidy for health insurance than he got by being able to avoid taxes on his health benefits.

Everyone should take insurance when they are healthy, and all insurance arrangements should guarantee continued coverage at reasonable premiums even if you become high risk - as most individual insurance policies but almost no group insurance policies do."

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Michael Campbell is a Reuschlein Clinical Teaching Fellow at Villanova University School of Law. He is formerly the Executive Director of the Pennsylvania Health Law Project.

"Dan Dascus is one of the lucky ones. He had health insurance, got good primary care leading to an early diagnosis of his cancer, and he got treatment. If he were one of a nearly million uninsured Pennsylvanians, his story would likely have appeared much sooner, in a different part of this paper, along with notice of where friends could come to pay their last respects. But like Dan and Debra, the lucky ones under our health care "system" regularly suffer side effects - humiliation and impoverishment - which don't get written up in the medical books.

Why? In part because the shrinking number of employers who can afford to provide health insurance benefits are forced to impose co-payments, premiums and coverage exclusions on their employees, due to uncontrolled insurance costs. In part, because safety net programs like Medicaid squeeze the last dime out of folks (including their retirement accounts) before they help. And in part, because of inane rules, like the federal law that says a person must be disabled for two years to qualify for Medicare. As Dan's unfortunate experience points out that we don't have a health care "system" so much as some places where you can fish for help."