Would Obamacare Have Saved Walter White's Soul?
By Bryan Caplan
[Warning: Non-Finale Breaking Bad Spoilers]
The Daily Beast‘s Jamelle Bouie claims that Obamacare would have ruined the premise of Breaking Bad:
Remember, the instigating action of the series is White’s cancer diagnosis–in
order to pay for his treatments and leave a nest egg for his family, he
teams up with a former student to make and sell methamphetamine. The
moral logic of this aside, it’s not hard to see why he made the choice.
Even with health insurance, courtesy of Albuquerque public schools,
White had to make large initial deposits (in one case, of $5,000) and
deal with expensive hospital stays. The surgery to remove cancer from
his lungs cost nearly $200,000, an impossible sum for the vast majority of Americans, to say nothing of a public school teacher.
Breaking Bad begins in 2008. If it had taken place just two years later, White wouldn’t have had to worry about lifetime limits. Under ACA provisions that
took effect in 2010, just a few months after the law was signed,
insurance companies are prohibited from imposing lifetime limits on
benefits. If the series had started in 2014, the year Obamacare is fully
implemented, White would have had few financial worries. Not only is
that the year the law bans annual limits on insurance coverage,
but it also puts a cap on out-of-pocket expenses for families and
individuals. At most, the White family would have had to pay $12,700 for
Walt’s care. A large sum, but not so much that it makes sense to go
into the meth-dealing business.
Josh Barro, however, knows better:
The ACA would likely have done nothing to help Walter White. And that’s actually a feature of the ACA, not a bug.
Remember, White (on the show, a high-school chemistry teacher who
became a methamphetamine producer to pay his cancer treatment bills) had
health insurance. He didn’t incur enormous out-of-pocket costs because
his plan had a high deductible or a low benefit limit. He incurred them
because his family pressured him into getting treatment from Dr.
Delcavoli, a superstar oncologist who didn’t participate in Walt’s HMO.
Insurance companies have been responding to pressure to keep exchange
premiums down by excluding expensive doctors and hospitals. For
example, none of the plans
that will be offered in California’s insurance exchange will include
Cedars-Sinai, a top Los Angeles hospital; only one insurer will include
UCLA Medical Center.
Bouie raises the topic of lifetime benefit limits, which Obamacare
has prohibited since 2010. But even if Walt had been running up
insurance-eligible bills within an HMO network, he likely wouldn’t have
been affected by a lifetime limit. As of 2009,
69% of workers covered by large employer HMO plans had no lifetime
benefit limit, and another 25% had a limit of at least $2 million.
Like me, Josh argues that the Breaking Bad character with the clearest understanding of the medical industry was none other than Walter White:
There is a voice for this idea on Breaking Bad: Walter White himself,
who initially resists his family’s pleading, arguing that treatment is
likely to be expensive and unpleasant and ineffective. Of course, on the
show, the treatment ends up greatly extending Walt’s life span, because
“Man gets expensive cancer treatment, becomes too sick from
chemotherapy side effects to run his meth lab, dies anyway, and leaves
his family penniless” is not a very interesting television plot.
In short, the show-ruining premise is not the ACA, but medical realism. Thank goodness for suspension of disbelief!
P.S. If you postpone your viewing of critically-acclaimed shows until you know that they deliver on their promise, feel free to begin Breaking Bad‘s transcendent tale of hubris and corruption.