Friday, September 05, 2008

Don't count the uninsured: problem solved!

Almost 50 million Americans enter each new day without health insurance coverage of any kind. That fact concerns the vast majority of health care and public health experts.

But, not everyone agrees.

Like President Bush, some people believe that since emergency departments across the nation cannot refuse to treat anyone who shows up in their waiting rooms, everyone enjoys health care "coverage."

This includes Dr. John Goodman (PhD, not MD). Here's what the good professor has to say about the uninsured:

"The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American [even illegal aliens] as 'uninsured.' "

Steve Blow did a feature column in The Dallas Morning News on Goodman last week. Read his entire story here.

Goodman has been a high level advisor to politicians who make decisions about health and wellness issues in our nation.

When I first read Blow's report, my mind shifted immediately to patients who come to our Community Health Services building here at Central Dallas Ministries.

I can't forget one hard working father who battled kidney stones. Uninsured, he went to the ER of a major hospital in town. The hospital treated him with pain killers and antibiotics. They never hospitalized him because they didn't have to. The law requires treatment on an emergency basis, not ongoing treatment for "self-payers" like him. By the time he reached our doors he was in the midst of end-stage renal failure.

We went to work to get him a kidney transplant and helped negotiate the rate and raise the cash to pay for the procedure that saved his life, sent him back to his family and to work. We were glad to help. But our response is not a replicable model for health care.

Sadly, our friend's case is not all that unusual. Emergency rooms were not designed to serve as "medical homes" to millions of uninsured Americans.

Then, what about prevention? You know, regular checkups that often lead to early detection. What about medications that can extend life and control the chronic conditions so many of us suffer with.

From a cost benefit analysis, this preventive strategy saves everyone lots of money.

Dr. Goodman, you've got to be kidding!

We need to do much, much better. All we lack currently is the will and the courage.




lee said...

After the furor and public castigation of his views, Dr. Goodman has now said it was all tongue-in-cheek. Somehow I doubt it. The National Center for Policy Analysis is not a group that puts out humor.

c hand said...

The US health care system has problems. But criticism comes cheaply and easily. Why not point us to the socialized system you think we should adopt? Canada, Cuba, China, Europe, where is it done better?

Anonymous said...

c hand:

You're kinda off-topic. Surely we can all agree the solution is not denying we have a problem. Suggesting, as our president has, that emergency rooms equal access to health care is just foolishness. It demonstrates a depth of denial and an out-of-touch-with-reality quality that boggles the mind. Let's admit we have a problem, then start talking about a solution, whatever that might be.

Anonymous said...

Don't hospital systems help out non-profit clinics so that they don't get this because it is not practical for many reasons?

Anonymous said...

why shouldn't we ignore illegals when trying to determine the scope of the uninsured? I see absolutely no reason why we should ensure that illegals have medical insurance. And if you do, then you and anyone else who believes the same should use your money and raise your taxes to insure them... but leave me and the other 99% of Americans who feel as I do out of the picture. I am sure someone will now make a comment that the Constitution requires us to provide health insurance to illegals since it is implied in the "pursuit of happiness" language, as was stated several days ago in connection with free housing for everyone who is poor and wants a house.

Karen said...

anon 2:41 pm,

You can certainly speak for yourself, but I don't for a second buy your assertion that 99% of Americans hold your view.

Anonymous said...

Count me with the 99%.

Anonymous said...

I do not understand how when the discussion of healthcare comes up, the conversation migrates to the undocumented immigrants. Reading between the lines, it seems that many people dismiss the healthcare crisis, because of their feelings about immigration. There are many AMERICAN CITIZENS who are without affordable healthcare. Immigration and Healthcare are two distinctly different issues. Are there a large percentage of undocumented citizens who lack affordable healthcare, yes of course. I am not dismissing that there are intersections in this issue, but do you have any idea how many of your neighbors, friends, or even extended family member may be without affordable healthcare? I am going to guess more than you think.

Here is our reality check. We are a family of 5. In 2003 my husband and I started our own company. We immediately purchased an individual health plan to cover my husband and myself. Our children have been insured by CHIP and for that we have always been thankful. We view our health plan as a cost of doing business since this a health plan is something most people afford through their employer. The plan to insure my husband and myself costs approximately $270.00 per month for both of us. That’s great, right? Well if you consider having a $5000.00 deductible, with 20% coinsurance, good insurance, then yes. To be clear, this means our healthcare “out of pocket” expenses have to exceed $5000 before we begin to see the benefits of our health plan. Some would argue that we are under insured. We are in our 30’s / 40’s so this works out most of the time. We are in good health. In October of 2007 the same health plan was costing us approximately $395.00. The premium increases definitely pinched, but we hung in there and cut back on other things to make it priority. A recent letter from our insurance carrier delivered this week announced a new premium of $588, effective in October. Yes, that is correct. Our health plan cost double what it did in 2003 and 49% more than it did this time last year. Like I said, we are not high risk, we do not have a lot of medical expenses (we spend less than $500 per year on medical expenses not related to our premium), the explanation I am given by our carrier is “increased medical costs” are responsible for the premium change.

It is painful to admit, but as of October 1, we will join the ranks of the uninsured. Our cost to do business (and our cost of living) has risen dramatically over the past 5 years; unfortunately what we are getting paid to do the same work we did in 2003 has changed very little. Sure we can charge more, and we tried that. The benefits of charging more were quickly out weighted by the decrease in the amount of work we were getting. The market for our product and services has not allowed for us to increase our prices in accordance to what it cost us to do business; therefore, we are in a holding pattern….trying desperately to hold on to our “American” dream that is slipping away. We work very hard. Our dreams are not unreasonable. We are responsible citizens; we give back to our community. We work hard to do all of things we are supposed to do in order to realize our dreams. I do not want or expect to receive healthcare for free. I want healthcare that I can afford. I want pay a fair price to be fully insured, not a high price to be under insured.

I would like to ask that you reconsider who you consider the “uninsured” to be. There is not room for generalizations and blanket thoughts here. This is a real problem, that will become larger than anyone can imagine left unchecked.

Anonymous said...

Health insurance is a matter of personal choice! Someone has to pay for your insurance if you don't. Have some personal responsibility and take care of it yourself. If you can' afford it - do without it. Life is full of choices - if its important enough to you, make sacrifices in some other area.

Anonymous said...

Maybe most troublesome to me is the tone of this "dialogue," the snide dismissal of another's problems. I can understand the intellectual argument for not providing health insurance to illegal immigrants or politely suggesting that perhaps having insurance is a choice that may require doing without something else. What I do not understand is the vitriol and dismissive tone with which some commenting choose to use. Even if I agreed with the policy reasons against universal health care, I would still feel some compassion for those without real access to health care. No wonder Washington is so partisan and ugly - judging by this blog, many voters are, too.

LaShay said...


I am so glad to see that you wrote on this topic in this blog so recently.

I live in Abilene, TX and just got back from the hospital. There is a young man whose kidneys have both failed today. He is getting dialysis treatment tomorrow (to give him a chance at living for the next 90 days); however, he has only been in the country for a few months, making him ineligible for any sort of benefits (help on dialysis and any possibility of a transplant). The options do not look any better in his home country.

I know you wrote that your helping of the man with the kidney transplant was not replicable, but I hope that there are other possibilities. Do you know of any place that I could get in contact with for any other options?

The family does not believe there are any as of today.

B said...

"Health insurance is a matter of personal choice."

Are you trying to make a joke with a comment like that? I have had it with folks that believe that way. As unChristian as it is, I almost hope you or a family member finds out how laughable that comment really is. The U.S. is pretty much the only civilization without universal healthcare. WHY? Perhaps because rich politicians have led us to believe how good we have it . . . what a joke.