Imagine not being able to get the proper medicine for allergies.
Or think about not being able to get an MRI if you get hurt doing routine repairs around the house.
Or picture your child not getting the proper care when he or she gets sick.
Those are just three examples of what 45.7 million Americans without health insurance can face each day.
“The issue of the uninsured is alarming, and it’s two-fold: Who is able to get care, and how affordable that care is,” said Gerald Hoffman, executive vice president of the Onondaga County Medical Society.
Hoffman is summarizing the nation’s continuing problem and debate of how to provide and pay for health care. President Barack Obama has renewed this debate with his own sweeping proposal to overhaul the nation’s health-care system.
And experts like Hoffman of the Onondaga County Medical Society say the problem is getting worse, especially as the economy continue to deteriorate. Most — 59 percent — get their health insurance through their employers, according to the National Coalition on Health Care, a non-partisan health organization that looks into ways to improve health care. So losing their job usually means losing health coverage.
And the growing number of the uninsured, experts say, boosts health care costs. Many of the uninsured look to the emergency room to get care. That care is often the most expensive. And others, experts say, simply forego care until their conditions worsen and require even more, and often more costly, treatment.
Consider these statistics:
- Nationally, 45.7 million people were uninsured entering 2008, according to statistics from the U.S. Census Bureau. In Onondaga County, that number is over 50,000, according to Robert Walker, a spokesman from the state Health Department.
- Nationally, the number of the uninsured is up more than 30 million — or 260 percent — from 1987. In Onondaga County, the increase in that same time period is 35,000, or just under 300 percent according to Walker.
- At some point in the last two years, 86.7 million people under the age of 65 went without health insurance for some period, according to a recent Families USA study. Families USA is a non-partisan health-care research and advocacy group in Washington, D.C.
- Nationally, four out of five of the uninsured came from working families according to that same study.
- The median cost for a family of four in Onondaga County who get insurance through a private insurance is over $2,500 a month, according to the New York state insurance department. That is over five times the cost just ten years ago, according to the Kaiser Foundation, a California-based non-profit organization that studies health-care policy.
- About 59 percent of people — about 180 million — who have health insurance get it through their employer, according to National Coalition on Health Care. With unemployment growing in the economic meltdown, the Center for American Progress Action Fund suggests that nationally 14,000 people may be losing their health insurance each day as they lose their jobs. The Center for American Progress Action Fund is an organization that studies health-care policy in Washington D.C.
Others simply never had health insurance through their jobs at all, say health care experts “People think most uninsured are people who don’t work. But a whole lot of them come from working families whose companies just do not provide health insurance,” says Deborah Freund, a healthcare expert at the Center for Policy Research of Syracuse University.
Experts like Freund say the number of businesses who cannot provide health insurance is growing. The reason: Rising health insurance premiums. The average cost of health insurance has risen for small businesses has risen 12 percent annually, according to Freund, over the last decade.
And even if employees are offered coverage, they can’t always afford their portion of the premium, say health care experts. Employee spending for health insurance coverage increased 120 percent between 2000 and 2006, according to statistics from Kaiser Foundation.
Mark Scherzer is a lawyer for the advocacy group New Yorkers for Accessible Health Coverage, an advocacy group based in New York City. Debate over the uninsured, he says, is not whether everyone should have coverage, but how to pay for health coverage for every American.
“That’s always been the question few have answers to. But it is the most important one, especially if 47 million Americans are suddenly going to be insured,” said Scherzer.
The issue of universal health care coverage has been debated in government for over 60 years. President Harry Truman proposed the first national health insurance program in 1945. The last attempt was in 1993, when the Clinton administration launched its own massive overhaul that died with no action in Congress.
Now, Republicans and Democrats in Congress and the White House continue to come up with legislation to overhaul the health care system. Obama has said that he wants Congress to reach an agreement on legislation and put something together by the end of July 2009.
Among the proposed solutions:
- Expand Medicaid
Obama and Congressional Democrats want to expand Medicaid, the joint state-federal taxpayer-funded healthcare plan for the needy, and the related program for children, to cover more people. - Create a national insurance program run by the government
Obama has proposed this new publicly funded national insurance program that would allow individuals to buy their insurance through the government instead of the private insurance market. This system would allow people to get their health insurance at fixed rates. It would give tax breaks or other incentives for people who don’t get insurance directly through their employer. This system is opposed by Congressional Republicans, who object to what they and the insurance industry see as unfair competition from the government. - Create a single-payer or Canadian style system
This would create a publicly-funded health insurance program, much like Canada’s. There, the government is the single payer of medical bills, acting as the nation’s insurance company and collecting taxes to support the system. Doctors remain in private practice but are paid through the government. Most experts agree this would be unlikely to happen, because of lack of public support for the necessary taxes and — despite Medicare’s popularity — concern over government programs. The single-payer system would virtually eliminate the private insurance industry — something that triggers strong opposition from the industry and from Republicans. - Require individuals to buy insurance
This is much like the requirement in many states for drivers and vehicle owners to buy auto insurance. For health care, the proposal requires people to buy insurance. This is similar to the Massachusetts system. This system was introduced a few years ago in the state of Massachusetts and so far has won praise for extending coverage to the state’s uninsured. The plan requires all employers to offer insurance or contribute to an insurance pool. The pool is a quasi-government agency that is responsible for paying the medical bills of those covered by the pool. The difference between this plan and the one that would create a national insurance program run by the government is that this plan requires individuals to buy health insurance. For those who may not be able to afford this plan, President Obama has said they would get government subsidies to help pay the premiums and get into the plan. This plan is generally supported by many Democrats and Republicans.
Hoffman, executive vice president of the Onondaga County Medical Society says it doesn’t matter what the solution is, as long as Americans see some action from the government.
“We as a nation have to be doing a better job,” said Hoffman. “The issue of universal health care has been talked about for sixty years. It’s time to get moving.”
(Matt Cohen is a junior with dual majors in broadcast journalism and history.)
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