Health insurance: a matter of life and death

Families USA recently released a report, Dying for Coverage, from all 50 states on the number of uninsured and the estimated number of deaths directly related to lack of health insurance.

Commenting on the report, Executive Director of Families USA Ron Pollack said:

Our report highlights how our inadequate system of health coverage condemns a great number of people to an early death simply because they don’t have the same access to health care as their insured neighbors. The conclusions are sadly clear -- lack of health coverage is a matter of life and death for many people.

A study by the Institute of Medicine, tha basis for the Family USA report, found that uninsured adults are 25 percent more likely to die prematurely than adults with private health insurance. Another academic study found that lack of health insurance is the third leading cause of death, following heart disease and cancer, for uninsured adults between the ages of 55 and 64.

While the percentage of uninsured, working age (25-64) people in the South reported by Families USA in 2006 (20.5%) is similar to overall U.S. percentage of uninsured in the same age group reported by the U.S. Census (19.9%), several Southern states have a significantly higher percentage of uninsured.

For example, the Families USA report found that Louisiana had the highest rate of uninsured among working people at 26.2%. Florida (25.3%), Arkansas (23.2%), and Mississippi (22.1%) also exceeded the regional and national rates. Virginia (15.1%) and West Virginia (16.5%) are well below the regional and national rates.

Other state reports from around the South on the percentage of uninsured working age people include Alabama (20.1%), Georgia (19.7%), Kentucky (19.0%), North Carolina (21.1%), South Carolina (19.7%), and Tennessee (18.3%).

The U.S. Census report shows that the South has the highest percentage of uninsured overall, 19.0%, as compared to 11.4% in the Midwest, 12.3% in the Northeast, and 17.9% in the West.

When you add it all up, there are nearly 8.5 million working age people in the South without health insurance. Even more disturbing, the Families USA report attributes nearly 52,000 premature deaths to lack of health insurance in these states between 2000 and 2006.

The National Coalition on Health Care, an influential, bi-partisan alliance working to improve America's health care, has published a fact sheet about health insurance coverage in the U.S. It explains who the uninsured are, why there are so many, and some of the consequences:

• Lack of insurance compromises the health of the uninsured because they receive less preventive care, are diagnosed at more advanced disease stages, and once diagnosed, tend to receive less therapeutic care and have higher mortality rates than insured individuals.

• Regardless of age, race, ethnicity, income or health status, uninsured children were much less likely to have received a well-child checkup within the past year. One study shows that nearly 50 percent of uninsured children did not receive a checkup in 2003, almost twice the rate (26 percent) for insured children.

• Studies estimate that the number of excess deaths among uninsured adults age 25-64 is in the range of 18,000 a year. This mortality figure is more than the number of deaths from diabetes (17,500) within the same age group

Their report concludes:

The impacts of going uninsured are clear and severe. Many uninsured individuals postpone needed medical care which results in increased mortality and billions of dollars lost in productivity and increased expenses to the health care system. There also exists a significant sense of vulnerability to the potential loss of health insurance which is shared by tens of millions of other Americans who have managed to retain coverage.

Every American should have health care coverage, participation should be mandatory, and everyone should have basic benefits.

The state of health care in the United States is a national disgrace. And it's only going to get worse. Even more so in the South, where the fastest growing region in America continues to struggle with poverty and unemployment which contribute to the higher rates of uninsured.

The upcoming elections could and should be a referendum on the problem. Unfortunately, none of the three leading Presidential candidates has a comprehensive plan to solve it. All they offer are band-aids that patch up various failing components of our broken system.

But that's largely irrelevant, because the President doesn't have the power to fix it alone. Congress will have to act to effect fundamental change.

HR676, which would open up Medicare to everyone and eliminate private and employer provided health insurance, is a radical idea. But it's a good place to start a serious discussion about solving a serious problem. And complex, serious problems sometimes require radical solutions.

Labels: health care, uninsured