Billy Kimmel's story
Ryan F. Holmes is assistant director of Health Care Ethics at the Markkula Center for Applied Ethics. Views expressed are his own.
Last week, comedian Jimmy Kimmel discussed the birth of his son Billy and the medical treatment his son required and will require in the coming years to address a congenital heart defect. Kimmel talked through all of the emotions and challenges that parents of babies face when a problem is discovered, from disbelief to shock and concern, all mixed with fear that modulates as things get worse and improve. His son has been lucky thus far. He has had access to excellent health care, and his surgeries have been successful. But Kimmel highlighted that his son’s case should inform how we think about health care for children: “If your baby is going to die and it doesn’t have to, it shouldn’t matter how much money you make… that’s something we can all agree on.”
Kimmel’s description of his son’s case draws out a few issues related to how we consider health care in this country. First, Billy and his family do have access to the best of the American health care system. He lives in an area with three major university-affiliated health systems and received treatment from some of the best physicians in the country. The family likely has excellent health insurance and sufficient wealth to ensure the baby receives the best care.
But, as Kimmel acknowledged, not everyone has the ability to access health care when they need it. Many who live in rural areas do not have the ability to get to a major hospital in short order and, in some cases, must travel a great distance to find a primary care provider who will see them.
Second, Kimmel’s comments about health care for children and the importance of coverage for pre-existing conditions reflect some of the core values of many Americans. We have long valued treatment for children and have enacted programs to ensure treatment. More recently, Americans seem to be developing consensus around the idea that being denied insurance coverage due to a pre-existing condition is wrong. Despite this consensus, however, the health care bill recently approved in the House of Representatives allows for states to opt out of the requirement that insurance plans cover patients with preexisting conditions.
It is important to offer insurance and support for those who face major and persistent health problems, particularly children. In order to ensure that they have adequate support for addressing their health needs, though, we must also be mindful of adequately balancing the system. Aggressive treatments for children and caring for those with pre-existing conditions are expensive. Without shoring up other parts of the system—such as subsidies for state-run programs and the mandate that everyone, including young, healthy people purchase health insurance—hospitals, states, and eventually the federal system becomes imbalanced and risks toppling in on itself.
Finally, Kimmel’s heartfelt account of his baby’s experience demonstrates how we tend to think about health care. We are moved by stories of individual patients facing major health challenges, which Is good. But we also need to be moved by the everyday challenges—the kids who have ear infections or need vaccinations, or are in danger of developing diabetes. This is where the majority of health care happens. Making decisions by looking at extreme and urgent examples of need will keep us fixed on our current model: wait until something goes wrong, usher all resources to fix the problem, and forget about preventing other major issues from arising in the first place. If we only focus on the exceptional cases and do not focus on prevention and ensuring basic health care, we will have a hard time improving care for all.