Living sicker, dying sooner with no health plan
By REKHA BASU
Register Columnist
03/12/2003
The Des Moines Register
http://www.dmregister.com/opinion/stories/c5917686/20705781.html
My teen-age son has a thing for Ultimate Frisbee. Such a thing that he kept on playing last week even after hurtling into a fence, splitting open his knee and getting an egg-size bump on his cheek. Later that evening, we sat in the hospital emergency room as one doctor stitched him up and another checked for a concussion.
It's not pleasant, but it's life: People are active. Sports come with risks. You just brace yourself for the occasional accident and feel lucky if the worst result is a superficial scar and a $75 hospital co-pay.
But it's not that simple for everyone. The same minor accident that costs one family an evening can force another to fall behind on rent or car insurance.
Ask Anna Dianas of Des Moines. Her $7-an-hour job for a non-profit group provided no health insurance. Her husband, who does seasonal construction work, gets none either. They couldn't afford to buy it and don't qualify for any government program. So when her husband split his head open in a soccer collision, a hospital visit similar to ours set a struggling family back $500.
"We barely make it," Dianas sighed. She racked up another $3,000 in hospital bills after she got chest pains and an EKG at a free clinic was abnormal.
Dianas was one of the people showcased Monday by the organizers of Cover the Uninsured Week, as panelists brainstormed about the health-care crisis and Lt. Gov. Sally Pederson read a proclamation urging solutions.
Dianas will soon get coverage thanks to a job change. But that still leaves more than 230,000 Iowans without insurance. Eighty-six percent of them work. They live with untreated illnesses, turn up at clinics created for the poor, rely on the good graces of doctors to slip them free samples of medicine. They live sicker and die younger, says Families USA, a consumer organization.
People variously lay the blame on: premiums that shot up 30 percent in three years; rising co-pays and deductibles; struggling small businesses unable to cover their workers; costly medical technology and drugs; poor federal reimbursement rates for Medicaid and Medicare; and an aging population using more services. You could also look further, to the loss of manufacturing jobs with union protection that ensured health benefits. In America, 1.4 million people lost their coverage in 2001; 41 million are uninsured.
For all its wealth, ours is the only industrialized country without a national health-care program, says Senator Tom Harkin. "We have the best hospitals, the best personnel and yet we can't cover people."
Working people often are caught in a Catch-22 because their jobs don't come with benefits, but they are paid too much even for their kids to get government help. That's Lorri Swigart's problem. She's a full-time property manager earning around $2,000 a month. Her income puts her 16-year son, who has juvenile diabetes, above the guidelines for Hawk-I, the state's medical program for low-income children. His insulin-related expenses alone run $150 to $175 per month. She takes heart medicines.
They lost their coverage in January after she got divorced, and when she finally found an insurer that would cover them, it cost too much. "You just put things off for as long as you can," she said. "You don't go to the dentist, or you have a tooth pulled vs. a root canal or a cap. I just went to the dentist. I want to save my tooth but it's $1,500 vs. $75."
If something catastrophic led one of them to be hospitalized, she says, she'd have to file for bankruptcy. Medical bills are in fact a leading cause of bankruptcy.
Chances are that someone you know has no medical coverage. My friend Kim Davenport, who lives in Dallas County, works as a waitress and discontinued her employer-supported plan when the premium shot up to $700 a month. Her husband is self-employed, so there's no coverage for them or their two teenage daughters.
"I'm just hoping nothing happens, that's all," she said.
Poignant as these stories are, they're not presented for your pity, but your outrage. Something is terribly wrong when working Americans have to worry about a sports injury delaying the rent.
There is a solution, but no political will for it: a nationalized health-care system like Canada's, which spends less per person and covers everyone (see Andie Dominick's Feb. 14 Register essay). Canadians have a higher life expectancy, and their overall taxes are not higher.
President Bush decried such a system in his State of Union speech, and insurance-industry advocates are fond of spreading horror stories about waits for service and lack of choice in doctors. But there's not much choice in health care for many Americans now.
The good news is that political will can be forced. If you doubted that, just look at how Des Moines schools capitulated to a public outcry last week within 24 hours of floating a proposal to merge 40 high school sports teams into eight. Imagine if such energy were channeled into demands for a better health-care system.