Health4all : Why We Need Fundamental Health Care Reform #2

Health4all

Every year more Alaskan families lose health insurance and can't afford health care. Every year more families with health insurance cannot afford to use it because of expensive out-of-pocket charges. Every year more Alaskan elders with Medicare are refused treatment by local physicians. And every year health care in Alaska continues to cost 30 percent more than down south. These problems are a reflection of the crisis across the nation. Not surprisingly, the United States ranks last in preventable deaths compared to 14 Western European nations. We have a lot to talk about.

Lawrence D. Weiss retired from UAA in 2004 as a research professor in public health. He designed and built the Master of Public Health program at UAA, and has published three books and numerous articles on public health and health policy issues. He completed a post-doctoral degree at Harvard School of Public Health in 1982, and has been in Alaska ever since. His favorite expression is "facts matter." Occasionally he can be found in a local pub drinking beer and eating pizza while engaged in passionate conversation with friends.

Why We Need Fundamental Health Care Reform #2

Posted by health4all

Posted: August 25, 2008 - 4:23 pm

In the last posting on health4all I noted some of the reasons why we desperately need fundamental health reform related to the escalating cost of health care. In this posting I would like to touch on some of the issues related to the erosion of health care coverage. Many of these issues also are inextricably tied to the rising cost of health care:

Almost 50 million U.S. residents are uninsured, and the vast majority live in working families. This is a critical observation because it means that being uninsured is not just a condition of the jobless, homeless, and desperately poor, but it is increasingly a condition of lower- and middle-income working families. Look around. I am likely talking about your neighbors if not yet you.

Every two years, one in three working-age people go without coverage. This is an indication of how fragile a situation it is to have health insurance in our faulty system, and it is also another indication of how being uninsured, at least periodically, is becoming a typical feature of the American middle class.

30% of those of working age are underinsured—that is, insured but without adequate protection. Even more startling is that the median family income of the underinsured is $58,000. In other words, half the underinsured earn more than $58,000. One leading cause of being underinsured is the increasing sale of "high deductible" or "catestrophic" health insurance policies. These policies may have lower premiums than standard policies, but often require that families with this kind of insurence have to pay thousands of dolllars out of pocket before the first health insurance dollar kicks in, but they may go bankrupt first.

Retiree benefits are dwindling and retirees with benefits face rising costs. This is a huge, looming problem, especially for seniors in Alaska due to the enormous cost of health care here and the extreme shortage of primary care physicians willing to see seniors on Medicare.

Uninsurance drives up premiums for the insured—by $1,000 a family. We are all in this together whether we like it or not. In health care this is called "cost shifting." When the uninsured person is treated at the hospital, someone has to pay the bills. One form this takes is that those with health insurance are charged a kind of premium on their bill in order to pay the hospital for the expenses of treating the uninsured.