Poverello Health Center (above), on Syracuse’s North Side, has been treating the uninsured since 2000. Now, the clinic, part of the Franciscan Collaborative Ministries, has been active in advocating for health care legislation. (Liam Migdail-Smith)
For Sister J. P. Ridgeo, it all began with a man named John.
John came in about three weeks after the Poverello Health Center opened on Syracuse’s North Side, recalled Ridgeo. “He had a pretty bad ear infection,” she says. “So we took care of John.”
Ridgeo started the Poverello Health Center on North Salina Street along with Sister Dolly Bush in March 2000. The center is a part of the Franciscan Collaborative Ministries and Central New York’s only walk-in clinic for those without health insurance. And it’s the front line in America’s ongoing struggle to get health care to 46 million of the uninsured.
With support from the administration of President Barack Obama,Congress is again debating legislation to overhaul the nation’s health care system to provide coverage to the uninsured. The reasons: Lack of insurance threatens the health of those without coverage and creates a drain on the American economy.
Kathleen Stoll is the director of health policy at Families USA, a nonprofit organization in Washington, D.C., that advocates for expanding coverage. “We all have a stake in making sure everyone has coverage,” Stoll said in a telephone interview. “It may not be obvious to people with insurance, but we all pay the price.”
Insurance premiums are higher and the nation’s economy is less productive, said Stoll and other experts, because, for example, taxpayers are saddled with the responsibility of covering the emergency care of the uninsured. Many delay treatment until their ailments are more serious — and more costly to treat. Others seek care in emergency rooms, which by law cannot turn them away and which are the health care system’s most expensive places to give treatment.
The Kaiser Family Foundation is a non-partisan research organization, based in California, that’s considered by experts to be a premier source of information about health care and insurance. Consider these numbers from the Foundation on the uninsured:
- About 16 percent — or about one in six — of Americans lack coverage.
- In Central New York, it’s about one in ten people.
- The number of uninsured Americans younger than 65 has risen from about 39.6 million in 2000 to nearly 46 million in 2008.
- The vast majority of them— 75 percent — comes from families of part-time or fulltime workers.
Against that bleak backdrop, say health experts and advocates for the uninsured like Families USA, Americans pay more per person — an average of $7,421 per person a year — than any other country in the world.
But among industrialized nations, the U.S. ranks 37th overall in the World Health Organization’s rankings of the world’s health systems — in between Costa Rica and Slovenia. The U.S. ranks 14th in preventable deaths, 14thfor the rate of death among infants and 24th for its life expectancy of about 70 years, according to the WHO’s surveys.
The recent recession, say experts, adds to the number without insurance. As they lose their jobs, many Americans also lose their health insurance. About 60 percent of insured Americans get their coverage through their employers, according to Families USA. And without that, many can’t afford to pay the insurance premiums or their medical bills out of their own pockets.
And the prices keep going up, according to a 2009 study by the Kaiser Family Foundation. An average yearly family health insurance policy was $13,375 this year, up five percent from 2008. It’s also more than double the average premium in 2000.
By contrast, wages rose three percent in the past year. The study also found that 40 percent of small-business employees pay deductibles — the portion of an insurance plan not covered by the insurer — of $1,000 or more. That’s almost twice the amount from a year ago.
“We hear a lot of stories about how people can’t afford their insurance pretty much every day,” Stoll of Families USA says. “No one should be worried about affording their well-being.”
In Washington, Congress is locked in a fierce partisan debate over how to solve the problem of the uninsured. Many Democrats want to overhaul the system to include a strong, government-run public option similar to Medicare, the tax-supported health insurance program for the elderly. It would compete with private insurers and, supporters say, force them to lower their costs.
A conservative minority of Democrats, called the “Blue Dogs,” wants more direct cost controls and oppose a public insurance program. They,Republicans and the insurance industry argue that the private market can still provide a good system of coverage. They oppose a public insurance program as what they see as unfair competition for the private market.
In the House, Democrats, who have the majority, in November approved a health-care overhaul bill with only one Republican vote. The measure would cost just under $900 billion over 10 years and cover 36 million Americans. It requires everyone to buy insurance, creates the tax-supported public program to compete with the private market and provides subsidies to help those who couldn’t otherwise afford the premiums.
As of mid-December, the Senate was still deadlocked on its own version of legislation. But Majority Leader Harry Reid, D-Nevada, was still predicting a vote before the Christmas recess. The latest Senate bill also required everyone to buy insurance, and two other provisions. But it dropped efforts to include a government-run option, perhaps as an expansion of Medicare, when Sen. Joseph Lieberman, a former Democrat turned Independent, threatened to vote against it. That would deprive the Democrats of the 60 votes needed to overcome a threatened Republican filibuster.
If the Senate succeeds in passing legislation, it and the House will have to confer and resolve differences in the two pieces of legislation before a final bill can get to President Barack Obama.
Republicans are accusing Democrats of using the bill to increase spending and taxes, adding more to the deficit pot that already contains a whopping $1.4 trillion in IOUs.
Doug Holtz-Eakin, the former chief economic policy advisor to 2008 Republican presidential candidate John McCain, acknowledges the two problems of Americans’ access and cost in the current healthcare system. But he dismisses the House version of the reform bill as too partisan.
“It’s far from the best way to change the system,” Holtz-Eakin said in a telephone interview. His main objection, he said, is Democrats’ efforts to get the government more strongly involved in the system.
But most Democrats insist that healthcare must be overhauled — now. All the New York Democrats in Congress support the overhaul measures.
U.S. Rep. Dan Maffei, D-Dewitt, was among the 219 Democrats who voted for the House legislation. He is constantly bombarded with e-mails, calls and letters from constituents telling him their personal stories of struggling with payments under the current system, says his spokesperson, Abby Gardner.
Ultimately, these personal accounts convinced Maffei, sitting on a narrow fence in the days and leading up to the vote, to support the House version of the bill. “There are a lot of constituent contacts about personal stories,” said spokesperson Gardner. “We feel that those stories were important, and they pushed us to get reform going.”
U.S. Rep. Michael Arcuri, D-Utica, is one of the conservative “Blue Dog” Democrats who resisted early versions of the House legislation. In the end, he voted with the majority to pass the House bill. And he sharply disputes descriptions of the House plan by Republican critics like Alaskan governor Sarah Palin, who still is leading the fight against the proposed version of reform.
“You hear people like Sarah Palin talking about death panels,” Arcuri said in an interview. “And you have to wonder what she’s thinking. Did she even read the bill? You hear some of these things, and they just don’t make any sense.”
In Syracuse, the Poverello Health Center serves the uninsured two hours a day for two days a week: Mondays from 5 to 7 p.m. and Wednesdays from 1 to 3 p.m.
Today, the clinic treats what founder Ridgeo estimates to be 40 people in each two-hour session. The patients come seeking relief from an array of problems — the common cold, high blood pressure or even chronic diabetes. They don’t qualify for the government-run insurance program for the poor called Medicaid.
“It’s really heartbreaking because a lot of them work part-time and are only five, 10 dollars over the federal line for Medicaid,” Ridgeo said. “So the only thing you can do is give them what they need — help.”
Ridgeo works with a volunteer staff that includes 19 rotating doctors, 25 rotating nurses and two dentists who can give routine dental treatment. But she would like to see Congress overhaul the system, she says, to get care to everyone so that the Poverello Center can go out of business.
“If they do it right, where everybody gets healthcare and is taken care of, that would be wonderful,” Ridgeo says. “If I’m out of a job because of that, it’s a good thing.”
(Brett LoGiurato is a junior with dual majors in political science and newspaper journalism.)
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