Yes, YOU Pay for the Uninsured

This past week has been “Covering the Uninsured” Week.  As mentioned before, I do not know why the people in this great country are comfortable with the shame of 47 million uninsured and at least half as many underinsured – one illness or traumatic accident away from bankruptcy.  But in this economic climate, we should finally lose our comfort zone, for selfish reasons, if no other.  When the uninsured receive emergency care, who foots the bills?  Chances are, you do.

I’m going out on a limb and presume no cabinet appointees are reading this entry, meaning you pay your taxes.  Some of those tax dollars go to funds for safety-net hospitals, particularly those who have a disproportionate share of Medicaid and uninsured patients than other hospitals.  Established in 1981, the Medicaid Disproportionate Share Hospital reimbursement programs are meant to balance out public hospitals and other entities who couldn’t survive on comparatively low payments from Medicaid and the no or little payments that fall under the category of “uncompensated care.”  So when someone who works full week as a construction worker (as 8 of 10 uninsured Americans are part of families where at least one person works full time) ignores the warning signs of early diabetes because he doesn’t have insurance, doesn’t manage his chronic disease because he can’t afford the doctor’s visit to prescribe insulin, can’t afford the blood monitors or insulin either, and therefore fights through the increasing pain and discomfort until he has to go to the Emergency Room for care because he can’t take it anymore, only to discover he has advanced stage diabetes and will require a four-week course of antibiotics and a foot amputation, effectively ending his construction work career as well as his ability to pay – yes, his care is paid for by the rest of us.  And obviously, since primary care is cheaper and could prevent these expensive complications, we’re not getting a great deal.

But it’s not just about government creating a safety net for us all or picking your pocket (depending on your political point of view).  You’re also seeing higher premiums because we don’t cover the uninsured.  Providers must find some way to recoup the emergency medical care they provide that will never be compensated because the patient has no ability to pay.  That way is to charge insurers more for their services.  And, as you can probably guess, the insurer passes that on to its customers.  A report by Center for American Progress puts a dollar figure on it -- $410 per individual and $1,100 per family.  That’s 8% of your premium paid for no other reason than we haven’t covered every American yet.  As you might suspect, there’s huge variance between states.  Massachusetts, for all the flaws of its universal health care model, only has seen $180 per individual and $500 per family of this cost shift.  In New Mexico, it’s a shocking problem -- $830 per individual and $2,300 per family.

By the way, none of this is new.  We’ve known that there’s a financial cost to having millions upon millions of Americans uninsured for a long time, but have been as comfortable ignoring it as we have the moral cost.  But as with so much else with the economy, it’s only getting worse.  47 million are uninsured at any given time, but nearly one-third of Americans (87 million) went without insurance for part of last year.  As we shed jobs, we also shed coverage – and over 14,000 people lost their insurance just in December and January.  And yes, that means you’ll be paying even more.

Make no mistake, more people than ever are fed up with our broken health care system.  But for those who continue to resist any government question is, When will it be enough?  How much more do you have to be overcharged for your premiums for no other reason than because we haven’t fixed this problem before you think it’s worth your attention?  And, finally, are all the name-calling, fear-mongering and tired 20th century clichés worth the money coming out of your pocket, let along the lives and limbs and eyesight of your fellow citizens that fail every day for no other reason than we haven’t fixed this problem?

(Photo credit:  njmcgregor on Flickr.)