By Associated Press
The Washington Post, July 9, 2012
They work the front lines of the nationās most explosive wildfires, navigating treacherous terrain, dense walls of smoke and tall curtains of flame. Yet thousands of the nationās seasonal firefighters have no health insurance for themselves or their families.
The National Interagency Fire Center in Boise, Idaho, which coordinates firefighting efforts nationwide, says 15,000 wildland firefighters are on the federal payroll this year. Of that number, some 8,000 are classified as temporary seasonal employees, who work on a season-to-season basis with no guarantee of a job the following year and no access to federal benefits.
In two years, the Affordable Care Act, the new federal health care law, will allow seasonal firefighters the same opportunity to buy health insurance as other uninsured Americans.
Comment:
By Don McCanne, MD
Very few would disagree with the principle that firefighters and their families should be covered with health insurance, even if only seasonally employed. The question then is, should that coverage be provided by the government as the employer?
The issue of health insurance coverage faces all seasonal employees. If coverage is provided, would it be only during the period of employment? Would off-season employment in other occupations be the source of intermittent and therefore fragmented coverage? Would being unemployed off-season qualify the family for Medicaid, again with fragmentation of coverage?
Does the ability to purchase coverage through state exchanges, to be established under the Affordable Care Act, provide adequate opportunities for coverage in these populations with fluctuating incomes, with varying eligibilities for coverage or for subsidies? Are the rules that allow exemptions, based on income, from the mandate to purchase coverage an adequate solution, since it means that the family would remain uninsured?
With variations in the type of coverage and especially in the composition of provider networks between various employer-sponsored plans when there may be more than one employer during the year, or with intermittent coverage under Medicaid, or with individual plans purchased through the exchanges, or with dependency on charity or safety-net institutions during periods while uninsured, is this disruption and fragmentation an acceptable standard for coverage for these families? No.
It would be less expensive and more efficient to provide one single coverage throughout life – coverage that provides choice of health care professionals and institutions. Employment status should no longer be a factor in determining health benefits, choices in health care, and even whether or not one is covered at all. An improved Medicare that covered everyone would finally bring an end to our irrational current and ACA-pending methods of financing health care.