The number of uninsured
RE: (rising healthcare costs)
You contend that while nonpartisan sources (such as the Congressional Budget Office) claim that there were between 21 and 31 million citizens who were uninsured for the entirety of 2003 (not including the temporarily uninsured!), there are actually far fewer people who are legitimately uninsured, perhaps 15 million [citing the partisan National Review as a source].
I would say, first, that it is relatively unimportant exactly how many people are uninsured, because the fact is that there are millions of working people supporting families that cannot afford health insurance. This is inescapable no matter whose data you use. And because the numbers do not change over the years [except that they have been increasing since the late 1990s], there are at any given time, 35 million or so uninsured citizens who may need preventive medicine but cannot get it. And 57-59 million people [using, in fact, the sources cited by the National Review article] do not have insurance at some point during a given year, or 24-25% of our nonelderly population.
The major concern I have with the millions of uninsured, whatever their number, is not necessarily out of my being "humanitarian" but my concern for their social burden. People who are uninsured frequently ignore the early symptoms of serious complications -- not because they choose to ignore them, but because they cannot afford to see a doctor. Then later when these symptoms have blossomed into full-blown medical conditions, they end up in the Emergency room of a hospital, burdening our healthcare system with the high costs of illnesses that were treatable and preventable months ago. This creates ridiculous lines at ER rooms [undersupply of a key medical service], and raises the cost of emergency care do to overuse [excessive demand] and thereby raises the cost structure of the whole health system. Economically, it is bad policy and it impedes the ability of the rest of us to get adequate and responsive care.
So let me state that this is a problem. And dealing with it appropriately, by expanding coverage for working American families will lower costs for all of us, do to much greater use of preventive care -- especially if we emphasize that this is our goal. We also will save money in the long-run by expanding coverage (either through the state or otherwise) for people who are chronically out of work, for much the same reasons. (Prescription drug costs are another matter entirely, and we can talk about that later -- part of that problem is simply that Doctors have shifted to a model where they prescribe drugs for everything, and where consumers/patients demand drugs for everything, leading to soaring demand -- and hence, soaring prices -- for prescription drugs.)
You contend that while nonpartisan sources (such as the Congressional Budget Office) claim that there were between 21 and 31 million citizens who were uninsured for the entirety of 2003 (not including the temporarily uninsured!), there are actually far fewer people who are legitimately uninsured, perhaps 15 million [citing the partisan National Review as a source].
I would say, first, that it is relatively unimportant exactly how many people are uninsured, because the fact is that there are millions of working people supporting families that cannot afford health insurance. This is inescapable no matter whose data you use. And because the numbers do not change over the years [except that they have been increasing since the late 1990s], there are at any given time, 35 million or so uninsured citizens who may need preventive medicine but cannot get it. And 57-59 million people [using, in fact, the sources cited by the National Review article] do not have insurance at some point during a given year, or 24-25% of our nonelderly population.
The major concern I have with the millions of uninsured, whatever their number, is not necessarily out of my being "humanitarian" but my concern for their social burden. People who are uninsured frequently ignore the early symptoms of serious complications -- not because they choose to ignore them, but because they cannot afford to see a doctor. Then later when these symptoms have blossomed into full-blown medical conditions, they end up in the Emergency room of a hospital, burdening our healthcare system with the high costs of illnesses that were treatable and preventable months ago. This creates ridiculous lines at ER rooms [undersupply of a key medical service], and raises the cost of emergency care do to overuse [excessive demand] and thereby raises the cost structure of the whole health system. Economically, it is bad policy and it impedes the ability of the rest of us to get adequate and responsive care.
So let me state that this is a problem. And dealing with it appropriately, by expanding coverage for working American families will lower costs for all of us, do to much greater use of preventive care -- especially if we emphasize that this is our goal. We also will save money in the long-run by expanding coverage (either through the state or otherwise) for people who are chronically out of work, for much the same reasons. (Prescription drug costs are another matter entirely, and we can talk about that later -- part of that problem is simply that Doctors have shifted to a model where they prescribe drugs for everything, and where consumers/patients demand drugs for everything, leading to soaring demand -- and hence, soaring prices -- for prescription drugs.)
2 Comments:
One thing you seem to overlook is the position of healthcare organizations in all this. Perhaps part of examining the "insurance crisis" should be looking at the providers themselves and what reforms ought to be applied to them. Just a thought.
~Megan
Well, I don't think I overlooked it, rather I was just focusing on what Ben was suggesting and explaining why the number of the uninsured is a problem for all of us, regardless of how you think we should solve that. The first step is admitting there is a problem.
Healthcare organizations, as in HMOs and such? Of course I believe they need more government regulation, just like the pharmaceutical industry. Both are corporate groups who drive up costs to feed profits when they do not "need" to, and part of this is because our government -- Democrats and Republicans both -- looks the other way because of the campaign contributions, the lobbyists, and also to protect the status quo.
The first step is that only non-profit HMOs should be allowed (like in MN); also it would be nice if some German-style rule were applied that required that both patients and doctors had to make up a significant portion of the Board of Directors, so their views were represented as well as big-time investors.
Bottom line is: I think the healthcare organization is one special area of the economy where the free market, by itself, produces disastrous results and incomplete coverage of something that is a necessity. It is morally wrong to let capital dictate the terms of healthcare for a society. More democracy and less capitalism is the only way forward in this area, I think.
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