Support Health Care Reform Now
by Robert Roy Pool
The primary impetus for health care reform in the United States has been the large number of individuals who do not have health insurance at any given moment. That number is usually estimated at 40 to 50 million, out of a total U.S. population of about 300 million, so it represents between one sixth to one eighth of our population on any given day.
It is important to remember that the individuals without health insurance are changing constantly. Each day some people lose coverage while others acquire it. I myself lost coverage on October 1. By November 9th we had found new coverage through my wife’s employer. Our family was among the uninsured for forty days. Fortunately, nothing disastrous happened during that window of time.
This article examines some of the reasons every American should support the health car reform bills passed in Congress
Most of those without insurance are like us. Most have had insurance in the past and are likely to obtain it again in the future. Only a relatively small minority of the uninsured remain that way for many years. But quite often gaps are much longer than the 40 days I experienced, and therein lies the danger and the risk.
Please Help Me, I’m Falling
Almost every American will go without health insurance at some point in their lives. Our economy is rapidly changing; jobs are less secure than they have ever been. A larger percentage of our workforce is working free-lance each year. I myself have worked free-lance for more than 25 years, but I was fortunate enough to be a member of the Writers Guild of America, a Guild of free-lance workers that provides health coverage to its members. Most free-lance workers are not so fortunate. Many of these highly-skilled, highly paid artists and technicians have had great difficulty obtaining coverage in the past. So have the unemployed, the uneducated, the underskilled, and the tens of millions of Americans who work for small businesses.
The Uninsured Are Us
The uninsured, therefore, are not just a collection of illegal immigrants, impoverished African-Americans, and ignorant hicks, as those opposed to health care reform would have you believe. The uninsured are us. There is a hole in our social safety net in the United States. Tens of millions fall through each year. Most of these people do not get injured or seriously ill – fortunately – but some do, and for these the consequences can be catastrophic, even deadly.
Those who have fallen out of coverage also create enormous stresses on the system. In many cases, when the health insurance victims have no means of payment at all, their health treatment is provided nearly gratis by the hospitals and doctors who treat them. Hospitals are in the business of helping people. Few of them are driven exclusively by financial considerations. Most will treat the uninsured even though they know they will lose money by doing so. The treatment of the uninsured, then, represents an expensive hidden tax on the present system, a tax that adds up to about $43 billion per year, or around $380 per year for each individual insured, or about $1,017 per insured family. We are all paying this “uninsured tax,” but we can’t see it.
In many cases the treatment of the uninsured results in bankruptcy or the loss of a home. While the causes of bankruptcy are complex and almost always involve more than one factor, the best study of the influence of medical factors on bankruptcy, published in the American Journal of Medicine in June this year, estimated that medical costs and loss of work caused by illness contributed to more than 60% of all personal bankruptcies in the United States in 2007. Personal bankruptcies involve about one million families each year in the United States.
Do or Die
Our health care system is far more deadly than both wars we are fighting. This fact is astonishing.
Worst of all, those without health insurance are dying at a higher rate than those with health insurance. In a Harvard study published in September in the American Journal of Public Health, uninsured people of working age had a 40% higher death rate than those with insurance. The Harvard study estimated that this translates into about 45,000 excess deaths each year in the United States. This is more than ten times more each year than all the combat deaths we have sustained in Iraq and Afghanistan in eight years of war. Our health care system is far more deadly than both wars we are fighting. This fact is astonishing.
A disproportionate share of those who die prematurely for lack of health insurance are young – in their twenties and thirties. Most die of diseases that can be treated effectively if diagnosed and medicated: heart disease, diabetes, and cancer, the very same diseases that are most likely to kill any of us. This loss of these human lives is a tragedy for each and every one of these individuals and for their families and friends. If the Harvard study is correct, it means that the 45,000 people killed indirectly each year by lack of health insurance is more than the number killed by suicide (33,300 in 2006) or the number killed in auto fatalities (42,708 in 2006, including pedestrians and motorcyclists.) Lack of health insurance would thus rank as the tenth leading cause of death in the United States, but the only one that is entirely preventable.
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