NYT Editorial: "Any nation as rich as ours ought to guarantee health coverage for all its residents"

[kpete]

Editorial
The Uninsured
Published: August 22, 2009

One of the major goals of health care reform is to cover the vast numbers of uninsured. But how vast, really, is that pool of people? Who are they? And how important is it to cover all or most of them?

Critics play down the seriousness of the problem by pointing out that the ranks of the uninsured include many people who have chosen to forgo coverage or are only temporarily uninsured: workers who could afford to pay but decline their employers’ coverage; the self-employed who choose not to pay for more expensive individual coverage; healthy young people who prefer not to buy insurance they may never need; people who are changing jobs; poor people who are eligible for Medicaid but have failed to enroll. And then there are the illegal immigrants, a favorite target of critics.

All that is true, to some degree. But the implication — that lack of insurance is no big deal and surely not worth spending a trillion dollars to fix — is not.

No matter how you slice the numbers, there are tens of millions of people without insurance, often for extended periods, and there is good evidence that lack of insurance is harmful to their health.

......................

If nothing is done to slow current trends, the number of people in this country without insurance or with inadequate coverage will continue to spiral upward. That would be a personal tragedy for many and a moral disgrace for the nation. It is also by no means cost-free. Any nation as rich as ours ought to guarantee health coverage for all of its residents.

more:
http://www.nytimes.com/2009/08/23/opinion/23sun1.html?_r=2

[jtrockville]

1. Maybe we're not that rich afterall. Think about it. We live on credit.

[KittyWampus]

2. As Sicko points out very well, it's not just the UN-insured. Even those with insurance get screwed

and often either can't get their insurance to pay or have to jump through hoops.

[SammyWinstonJack]

3. K&R

[stray cat]

4. Tax payers should pay to guarantee health care for each other

after all thats what government money is...

[fascisthunter]

5. People Here would rather let their fellow citizens die so the rich can profit

how sick is that?

[dotymed]

7. YES, AMERICAN VALUES HAVE BECOME SICK

I understood that the Congress had agreed to ask the CBO to
investigate and present it's findings on Single Payer Health
Care to Congress. Maybe I dreamed it? If that does happen,
then the American people can (hopefully) understand that by
covering everyone, and doing away with "for profit"
health care(?), then we can all save money and everyone will
be "insured." I think that these numbers should be
put into a commercial (or something to expose the populace to
them). Furthermore, I believe that the reason people are not
aware of this reality is because our governments willingness
to be "bipartisan." They have muddied the water, by
demanding a "public option", that will cost
$trillions, instead of discussing Single Payer, which will
save $trillions and save lives.

[unpossibles]

6. That number also includes a lot of people who wish they had insurance, but are still working

I've worked plenty of jobs without insurance, both as an employee and as a contractor, and I did not ever NOT want it. As for choosing to forego because of cost, is that really a choice or closer to a necessity?

As someone who busted my ass working for jobs with no insurance, it really burns my biscuit when the right claims that only the "lazy" (read: unemployed) don't have insurance.

[Igel]

8. "I did not ever not want it" is

a pointless statement. If you have it and it's the case that you wanted it at no point, you simply don't use it.

When I was a young man, I could afford health insurance. I chose not to. My two visits to the doctor, plus prescriptions, racked up $150 in 1980-something dollars. Health insurance would have been more than that per month. There are those who would argue that I didn't act in my best interests, or acted out of ignorance. Nonsense: I had car insurance that would cover such accidents, when I went skiing I took out insurance for the day. Other than that, my big risks were tripping over my own feet and breaking my neck or having a tree fall on me and crushing me--possible, but not very likely at all. I figure I know me better than absolute strangers advocating for a cause do. Instead, I used the money to learn to play violin, pursue a useless master's degree, live in a house instead of an apartment, take vacations. Hardly "necessities". And, yes, I was also working for employers who didn't have health insurance coverage--small employers for whom 8% of their income would have been fatal to the business (without raising prices, but since their customers were mostly retirees you can do the math) and non-profits.

Of course, that's just anecdotal, but it's enough to show that the claim you object to isn't false. Whether it's a generally valid claim is a different matter, and neither of our anecdotes or hunches can answer that question.

The research is mixed, and you have to watch your terms carefully. Those temporarily without insurance tend to be at much lower risk than those without insurance long term. Sometimes "without insurance" is taken to mean without private insurance. Sometimes what's being compared are those who sought care, with and without insurance. Sometimes it's "access to health care", which holds whether or not there's health insurance--a lot of impoverished communities largely covered by Medicare, i.e., a kind of health insurance, lack sufficient doctors to ensure access to health care, or the health care is substandard.

It's easier defining your terms narrowly. Take somebody with insurance but with a high deductible. They have insurance, but unless there's something catastrophic they're not going to pay the $1000 or $5000 for health care; perhaps they can't afford it. What pool do you include those in--those with access or those without, those with insurance or those without? They're different things, aren't they, now? And "access" is the important term, not "insurance". For example, I lacked insurance and yet had adequate access.

Then there are the lessons from my student health plan. The place was always packed because it was free. That meant if you had an ache or pain you went to the doctor. The quick result was that you couldn't see the doctor: You saw a nurse practitioner, and they decide if you get to see a doctor. And it was still packed, constantly. The sheer inconvenience worked as a kind of triage--if the pain of waiting was greater than the pain from your cold, you left. If the pain from your foot wasn't too great while you waited for hours until the x-ray technician was free, then 48 hours or more before an X-ray specialist would look at the film and send the report of the results to the nurse practitioner so that s/he could call you and ask you to return for a follow-up appointment at which she'd decide whether or not to forward you to a specialist, then you stayed. Otherwise you went to a doctor off campus. And, well, I say "free," but it wasn't. It was over $1200/year. Of course, it was painless for many people: If you were a TA or RA, it was covered under the terms of your employment; as a required fee, student loans and grants covered it. Those who suffered were those who didn't get low-cost loans, were paying their own way or had their parents paying for them, who weren't employed by their departments as grad students, or who really didn't want the additional $5k (as an undergrad) or $7.5k (grad students) in student loans. I exited my program with $13k in student loans and paid over $9k for health insurance.

Do you include the person who has lacked health insurance for the last month after having it for 20 years with somebody who just got health insurance last month after not having it for 20 years?

Or take people like my father: He had warning signs of a heart attack, of inner ear problems, of joint problems, for quite a while before each one got so bad that he was literally forced to go to the hospital--after keeling over from a heart attack, when he couldn't stand up because his ears said the ceiling was 'down' (a simple ear infection), when he'd been in pain for a decade from eroded knee joints. Even when he had a stroke he got dressed, hobbled into the kitchen, and then went out and tried to use his exercise bike; then he tried to mow the yard. Only when my mother woke up and found the left side of his face slack, his speech garbled, that he was limping very badly (using the mower virtually as a walker), and could barely move his left arm could she start to convince him to see the doctor, and that took hours. (Then he visited a community care clinic, who sat him down for an hour and only when they called him realized they shouldn't see him but send him to a hospital.)

There is very little simple that can be said about health insurance and health care access. Research *must* simplify the problem, and when editorializing about research you can't make the theory on how to solve the problem simpler than possible. "As simple as possible" is about the best you can ever hope for. This editorial makes it simpler than possible.

[unpossibles]

10. I think maybe you misread me

Or maybe I have not had enough coffee yet. My point was I wanted insurance and could not afford it - therefore the double negative. I did not ever NOT want it means that when I did not have it, it was less by choice than necessity. I wasn't spending my money on luxury goods, but on cost of living and school, and very little else.

[prairierose]

9. Exactly, unpossibles, I work two or three jobs to make ends meet and...

none of them include any benefits whatsoever. As for paying for health insurance, I have pre-existing conditions and would never be covered under the current scam available to the so-called health insurance companies. It has been my belief or quite some time that as insurance has become more un-regulated, it has become more of a scam. I object to paying money to con artists.

But yes, I am one those the rw calls lazy because I do not have health care.

I work all these jobs because I had to take care of my youngest brother while he died of cancer because we do not have universal health care. I work all of these jobs because I had to support my other brother because it took 5 years for him to get SSDI after he became disabled and now he is almost done with the mandatory waiting period and will soon have medicare, we hope.

I, still, will not have health care. Yes, I am one of those lazy people who just does not care about having health care.

I wish I lived in a country that had a social conscience but I have become convinced that this country will never develop one.

[Wednesdays]

11. K&R

:kick:

[indepat]

12. An argument could be made that making America safe for millions of personal tragedies

to the moral disgrace for the nation is really at the center of 'puke family values of concentrating the nation's wealth among a very few of those families and letting the public (taxpayer) pay for their follies, greed, and outright fraud. :P