D Gary Grady

Back before the Affordable Care Act took effect, a lot of the health insurance horror stories I heard had to do with short-term health insurance policies. They were typically purchased by people who thought they were getting a really good deal since the policies tended to be cheap.

Unfortunately those policies are generally not renewable unless you stay healthy, so a serious illness or injury near the end of the policy's term could leave the patient suddenly uninsured and back then uninsurable. On top of that, such policies typically provide limited coverage and cap how much the insurance company will pay out. There had to be some reason the policies were so cheap, and that's it.

Under a full Affordable Care Act (Obamacare) policy it's the patient's spending that's limited, not the insurance company's.

The Affordable Care Act did allow temporary short-term policies to be issued, but only for three months, as a way of helping people get at least some inexpensive insurance between jobs. But now the Trump Administration has authorized "short term" policies for as long as a year. This can again lead naïve consumers to buy such bargain-basement insurance under the mistaken impression that health insurance is health insurance. (Others might buy them even knowing the coverage is skimpy because they're convinced that since they've never yet been seriously injured or ill, they never will be.)

Here's Dr Aaron Carroll on the subject:

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As noted by, for example, a report last year from ProPublica and National Public Radio, the United States has by far the highest death rate in the developed world for women around the time of giving birth. It's not even close: As of 2015, there were 26.4 maternal deaths per 100,000 live births in the U.S. while in other advanced countries the rate ranged from 3.8 to 9.4. (These figures are from the NPR/ProPublica report; other estimates differ somewhat because of varying definitions and methods of measurement, but they're similar.)

Even worse, that rate has been rising in the U.S. even as it declines elsewhere. Here's a graph from the article on the NPR website:

For possible reasons why, see this article by Dr Felicia Lester, MD, medical director of gynecologic services at the University of California, San Francisco.

Bad as the overall rate is, maternal mortality among African American mothers is about three times worse. Here's a summary of the situation and its likely causes from Dr Aaron Carroll, whose YouTube videos I often share here:

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