UNISURED (YET)?
By Christopher J. Kearney
More than 45 million Americans have no form of health insurance - roughly 15% of the population. That’s bad. But it’s worse in Texas. The percentage of Texans without health insurance has eclipsed the 25% mark. Think of your four closest friends. Statistically, one of them has no health insurance.
The typical uninsured individual is uninsured for a plainly obvious reason: health insurance is too costly. Some are the working poor. That is, they are employed, but make too little to purchase health insurance. Ironically, while they are too poor to afford health insurance, they are too “rich” to qualify for Medicaid – the state and federally sponsored healthcare plan for the poor. However, more and more uninsured are not the working poor. More and more are middle class folks who have found the cost of health insurance just too costly.
So what do the uninsured do when they get sick? Well, if persons can’t afford health insurance, it’s probably safe to assume they can’t afford a trip to the doctor, either. So the usual answer is two fold: 1) nothing and 2) get sicker. For instance, it’s allergy season. A person wakes up with pressure in his/her sinus. A simple trip to the doctor for a potent allergy medication would solve the problem; but the person can’t afford it so he/she doesn’t do anything. Days later, the pressure gets worse. The non-treatment of the allergy has led to a sinus infection. Still nothing is done and the infection persists. Soon, the person’s inner ear becomes infected. The person becomes dizzy and disoriented. The infection eventually becomes so bad that the person cannot get out of bed without collapsing. Emergency services are called. The person is taken to the hospital and admitted only to discover that infection has spread to the brain. High risk surgery is performed. The person spends the next three weeks in intensive care. A simple script for a $20 medication has become a $50,000 bill. A bill that most likely can never be paid. It’s not that the uninsured don’t get healthcare. It’s how they get care that’s the problem.
The crisis of the uninsured is escalating drastically. As health insurance premiums rise at double digit rates each year, more people find themselves in a position in which they can no longer afford basic healthcare coverage.
Interestingly, the rising premiums don’t help stabilize the situation. This is because as the premiums rise, the numbers of people in the “insurance pool” decrease because they can’t afford the premiums. As the numbers of people in the pool decreases, there are fewer people to support the risk. In conjunction with these rising premiums are rising healthcare costs. Ironically, healthcare costs are rising, in no small part, because of the growing amount of non-reimbursable care provided to the uninsured! As healthcare costs rise, health insurance premiums rise to ensure the financial solvency of the health insurance company. To close the vicious circle, as health insurance premiums rise, even fewer people can afford the cost of coverage, and the cycle begins again. If you play this out to the end, eventually, only the richest of us will be able to afford healthcare; and the costs associated with paying for health insurance will be astronomical. In the end, the only people winning will be the health insurance companies. That is, until no one can afford coverage, and then they go out of business.
The scenario described is, admittedly, extreme. But so is the situation, and it will get more so unless the fundamental way in which we financially support our healthcare changes. Did you know that the typical health insurance company has overhead charges of 40%? Some as high as 60%! That means that for every dollar you spend on health insurance, 40 cents goes to something other than paying for healthcare! Most of it goes to salaries. In Kansas City, a large local health insurance company pays it’s CEO $500,000 per year. How many people’s premiums pay just for the CEO’s salary?
Until we pull together and support legislation that reconstitutes the system by which we pay for healthcare, the situation will only worsen. I strongly urge you to educate yourselves on the current healthcare environment, because one day, we may all be without health insurance.
If you have a question or suggestion regarding mental health issues, please fax to (325) 698-8200 or send to 4225 Woods Place, Abilene 79602, ATTN: Mental Health Matters.
Chris Kearney is the Administrator of the Abilene Psychiatric Center. Mental Health Matters is sponsored by the Mental Health Association, phone (325) 673-2300, e-mail mhaa@bitstreet.com. Need help? Call the Hope Line (325) 673-2300.