Just last year, Ramon Rolle couldn’t find anyone to help him care for his bad leg.
“I’d go to the doctor’s office and get turned down at the receptionist. They’d say, ‘Got no insurance? C-Ya,’” he recalls.
Rolle was then among the nearly 50,000 people, in an estimate by the research group Fiscal Policy Institute, in Onondaga County who don’t have health insurance.
That’s in comparison to U. S. Census data that shows:
• 2.6 million New Yorkers without health insurance.
• 45 million Americans without coverage.
• That equates to 1 in 9 people in the country who are hoping they won’t have to face the cost of health care without insurance.
• Most of those uninsured are workers or their children.
Rolle, of Syracuse, lost his construction job when he got hurt at work. And with that, he also lost his health insurance. He couldn’t afford medical fees without an income, he says. He decided to try the Poverello Health Center on North Salina street in Syracuse. The clinic offers free health care to the uninsured. Through the volunteer staff, Rolle learned how to get disability insurance. He says their guidance is why he now volunteers at the clinic.
“I appreciate it, I wanted to show my appreciation and along with my prayers, something compelled me to come and give my time,” Rolle says.
Rolle’s story is a familiar pattern in the American debate about how to care for the nation’s uninsured. The main reasons for a growing number of uninsured: the rising cost of care and rising cost of insurance itself. The question then becomes, what, if anything can the nation and New York do about it?
Let’s start by looking at the current healthcare system. There are several options:
• Have no insurance, and pay out of your own pocket for doctors and hospitals.
• Have no insurance, and try to get some health care through emergency rooms or free clinics.
• Have no insurance, and do without healthcare until your ailments are life-threatening.
• Purchase insurance individually and pay for it on your own.
• Get employer-provided insurance, where the employee typically pays a portion of the insurance premium and a fee — called a “co-pay” — for the care.
• Apply for insurance through a tax-payer funded program like Medicaid and Medicare. Medicaid and Medicare are publicly-funded federal and state health insurance programs. Medicaid is for those with low-incomes, for children and for the disabled. Medicare is for those 65 and older. It’s an entitlement, which means everyone receives it.
Here in New York, those tax-funded programs also include Healthy New York, Family Health Plus and Child Health Plus.
In Syracuse, Sister J.P. Ridgeo is the director of the Poverello Health Clinic. She says the faces of those who she treats tend to looks the same.
“It’s the working class and middle-aged,” she says, “the people who have jobs like washing floors or dishes in a restaurant so they are getting income, but they only make enough to survive. With paying rent and buying food, they can’t afford healthcare.”
They can’t afford to pay the premiums from employer-provided insurance, or it’s not offered. And, they don’t make enough to pay for insurance out of their own pockets. But, Ridgeo says, they often make $5 to $10 more than the cutoff for publically-funded healthcare. They are stuck without coverage.
For example, to even be eligible to apply for Healthy New York, you or your spouse must have worked in last 12 months. You must live in New York State. You can’t be eligible for benefits through your employer — or if you are eligible, the employer can’t contribute money toward your coverage. And, you can’t make more than $2,167 a month.
Kayrn Schwartz is a senior policy analyst with the Kaiser Commission on Medicaid and the Uninsured, a leading national think-tank and research group on the uninsured. She says the rising cost of insurance is one reason why employer-provided coverage is decreasing.
“Either fewer employers are offering coverage, or fewer people are taking up that coverage — which could be due to increases in the cost of coverage,” she said.
The cost of insurance, for an individual with employer-provided coverage, averages at about $4,700 a year. From the Kaiser Commission, some statistics:
• In 2000 , the average premium for employer-provided coverage was about $2,500.
• In 2000, the majority — 66 percent — of those with insurance got the coverage through employers.
• By 2007, that had dropped to 61 percent.
The spike in cost is responsible for the drop in employer-provided coverage, Schwartz of the Kaiser Commission says.
Finding a solution to this issue remains an economic and political challenge. The last major effort to overhaul the American system was in 1996 with the Clinton administration. It failed without major Congressional action. Since then, Congress and individual states have created piecemeal programs. These programs include the State Children’s Health Insurance Plan, or SCHIP, and tax-supported coverage like Healthy New York.
Now President-elect Barack Obama has proposed a system where he would:
• Require all children to have coverage and would allow people up to age 25 to be covered by parent’s insurance.
• Require employers to offer health benefits or contribute money to a new public program known as the National Health Insurance Exchange. This program would be like Medicare for small businesses and individuals.
• Expand Medicaid and SCHIP.
Businesses are opposed to this plan and opponents say it would raise taxes and increase the national deficit.
Among other proposals, and their complications, are:
• Increasing employer-provided coverage: Either through employer mandates or incentives for employers to offer coverage. But because of the cost, employers — especially small businesses — object.
• Building on public coverage: By expanding Medicaid and SCHIP. The downside to this is increased taxes, and with current budget cuts in New York, this plan is not an option.
• Building on individual insurance: Helping people buy their own coverage, by allowing them to buy across state lines. Opponents to this plan say the deregulation will leave the sick without coverage, as insurance companies compete for healthier individuals.
Then there’s also the option of starting from scratch.
“Some people who want to move toward a single-payer, Medicaid for all system,” Schwartz of the Kaiser Commission says. A single-payer system would be similar to Medicaid, where tax payer money goes toward a federal-state insurance program. Unlike Medicaid, a single-payer system would be for everyone, not just low-income people, children or the disabled.
But for the uninsured right now, the proposals don’t matter.
When Rolle, who now volunteers at the Poverello Clinic, needed health care, he says waiting wasn’t an option. That’s why he feels lucky to have found help at the Poverello Clinic, he says. And hat’s why he’s now doing his part to help others in their quest for coverage.
“I know how it feels not to have insurance,” says Rolle, “and they were kind enough to accept me and help me through my difficult times.”
(Torie Wells is a senior broadcast journalism major.)
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