Hillary Clinton has lately been delivering a very powerful anecdote about the state of health care in this country. It is a story of a woman named Trina Bachtel who lost her baby because she had no health insurance and was unable to obtain timely prenatal care.

Well, the right has done some research, and can assure us that everything is really fine in this best of all possible nations. It seems that Ms. Bechtel had health insurance at the time of the tragedy. The clinic she tried to go to for prenatal care wanted to charge her $100 per visit because she had run up a considerable debt previously, at a time when she did not have insurance. Besides, she delivered her baby in the hospital because, as our president tells us, hospitals can not refuse care for anyone who is really sick.

1. Trina Bechtel had considerable unpaid medical bills as a result of a previous illness without the benefit of health insurance. This probably showed on her credit rating and would have made any hospital or clinic shy away from treating her.
2. When she sought non emergency, prenatal care she was presented with the demand that she pay an additional $100 per visit so that she could begin to work through her unpaid debts. Other demands on her limited income - maybe eating and paying the rent - seemed more pressing at the time.
3. Hospitals are obligated, under the Emergency Medical Treatment and Active Labor Act, to treat anyone who presents at the Emergency Room with a life threatening medical condition or in active labor. Of course by the time Ms. Bechtel presented at the emergency room her baby was already lost, although she probably underwent heroic and expensive medical treatment in an attempt to save her or the child.

The story provides a fine example of the "cracks" in our glorious health care finance system that far too many people fall through. It also points to a highly inconvenient truth about the new "consumer driven" health plans that are being actively promoted by the insurance industry and by some presidential candidates. These plans set very high deductibles - as much as $5,000 per year - which must be paid before health care is covered. 

A woman "covered" by one of these plans would be in the same position as Trina Bachtel:  She would have to spend $75 to $100 per doctor's office visit for the first 50 visits. When some individuals, as Trina Bachtel's case demonstrates, are faced with high initial payments they will effectively choose to take the chance and not get needed care. This is why "consumer driven" health plans richly deserve their other name: "catastrophic health plans".