by Adewale Troutman
The writer is the director of the Metro Louisville Health Department.
THE PROBLEM of families, adults and children with no health insurance has grown considerably worse across America in recent years. According to figures released in September 2003, almost 44 million people — 15.2 percent of the total U.S. population — were uninsured in 2002, up from 14.6 percent in the previous year. This was the largest single-year increase in both the number and rate of uninsured people in a decade.
The growing number of uninsured is having serious consequences for the health of the nation. Despite having the highest health care spending per capita, the United States consistently scores at or near the bottom in comparisons with other developed, high-income countries on such public health indicators as infant mortality, life expectancy, and the proportion of the population with health insurance coverage. Almost everyone in these countries has health coverage. In the U.S., by contrast, 15.2 percent of the population — or 43.6 million people — were uninsured in 2003. We now have 35.1 million adults and 8.5 million children living without health insurance coverage. In addition, inadequate health insurance is recognized as a significant contributing cause to the health inequities experienced by African Americans, Hispanics and other groups, including the poor. Although African Americans constitute only 12 percent of the population, they account for 26 percent of uninsured adults. Although Hispanics comprise 38 percent of the overall population, they make up 38 percent of uninsured adults.
Who are the new uninsured? Many of them are working poor people who either can't afford to pay for their own health insurance or who work for companies that don't provide health insurance to their employees. Many of the uninsured are forced by necessity to wait until they face a medical crisis to seek care. Uninsured people are more than three times as likely to die when they are hospitalized as people who have insurance, according to the American College of Physicians. Without access to primary care and preventive health services, those with no health insurance are often forced to rely on hospital emergency rooms for their medical care.
This can be a very expensive option for the community.
In a sweeping six-volume series on the consequences of uninsurance, the Institute of Medicine reported the following conclusions:
Compared to people with insurance, uninsured children and adults experience worse health and die sooner.
Families can suffer emotionally and financially when even a single member is uninsured.
"Uninsurance at the community level is associated with financial instability for health care providers and institutions, reduced hospital services and capacity, and significant cuts in public health programs, which may diminish access to certain types of care for all residents, even those who have coverage."
The nation as a whole is economically disadvantaged as a result of the poorer health and premature death of uninsured Americans. The Institute of Medicine estimated that the lost economic value of uninsurance is between $65 billion and $130 billion annually.
Here in Louisville, there are more than 46,000 uninsured adults, and the number is growing every day. The state budget deficit has forced a situation where thousands of uninsured children have only limited access to the Kentucky Children's Health Program (KCHIP). Our safety net providers, Family Health Centers, the Park DuValle Community Health Center and the University of Louisville are bursting at the seams and are finding it impossible to meet the health care needs of the growing ranks of the uninsured.
While recent new initiatives, such as getCare, which seeks to coordinate care among existing safety net providers, and the Take Ten Initiative of the Jefferson County Medical Society, which encourages each private practice physician to provide care for 10 uninsured people, are valiant efforts, at best they only provide temporary relief to our growing health care crisis here in Louisville.
Certainly, health and unabridged equal access to a single standard of quality health care is the birthright of all citizens of Louisville, of all Americans and of all human beings. We can no longer afford the status quo that allows millions of Americans to go without health coverage. Too many people are uninsured. Too many families are being damaged, and too many lives lost. The human, economic and societal costs of nearly 44 million uninsured Americans are just too great for the country to bear any longer. Recent studies from the GAO have indicated that there is enough money in the system today to provide universal coverage to all Americans without additional expenditure of funds. It's past time that we had a national commitment through sound sweeping comprehensive policy change, to create a national health program that would guarantee every person universal health insurance coverage.
Special to The Courier-Journal
Posted by UFCW 227 at May 19, 2004 06:10 PM