Meet the Uninsured
Published August 24, 2009 @ 06:00AM PT
At our Universal Health Care blog, Tim has an entire category concerning the uninsured and underinsured. (You need to be reading his blog.) But for those of you with little time to familiarize yourself with the 47M or so Americans estimated to lack adequate health insurance, the New York Times this weekend offers a handy little summary of just who these folks are:
- The working poor are the majority, at about 30M people.
- The "better-off", as judged by total household income of up to $75k per year. Includes roommates, non-family households, etc. D'oh!
- Young adults - this is the mythical group who rejects health care right before they go bungie jumping and compete in a triathalon. Irrepressible youngsters! Turns out most are poor. See the first bullet.
- Medicaid-eligible poor, who are not enrolled for one reason or another. This is the most popular crew featured in the "all their emergency room care is bankrupting us!" storyline.
- The underinsured - crazy deductibles and restrictions make health insurance theoretical.
- Non-citizens.
The NYT points out which potential reform bills would help who, but ends on this sharper point: "Any nation as rich as ours ought to guarantee health coverage for all of its residents."
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Comments (4)
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Author
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Leigh is a PhD candidate in urban planning at MIT, and a consultant on U.S. Gulf Coast recovery. She sits on the Board of the Allston-Brighton Community Development Corporation in Boston, and has worked with non-profits, foundations and local governments on policies and programs aimed at reducing urban poverty and inequality.
Featured Poverty in America Actions
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Repeal the Hyde Amendment!
88 People
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Repeal the Hyde Amendment!
I can tell you one trap that keeps many at least theoretically Medicaid eligible fighting to stay off of it. It's that getting Medicaid due to disability requires being disabled to the point of not working at all. Which, IMHO is highly discriminatory on the basis of disability (and I'd suspect legally too, but who's going to take the states and possibly also CMS to Federal court?). After all, if you need Medicaid due to children, you can get it solely on the basis of income - and in most states a more generous measure of income and assets at that. So it's really hard to convince me that the "cost control" and "fraud prevention" doesn't somehow also include some discrimination nor that it doesn't take away some very important dignity by forcing us not to work and into dire poverty (incredibly dire considering this nation's vastly underestimated measure of poverty) just to get the crapola called MNP Medicaid - which isn't even full Medicaid. So many of us will avoid it if we at all can.
There's the closely related issues of discrimination by health insurers and by employers. It's almost impossible (if not impossible) to get a private plan with a chronic condition or disability - and if you do, it's almost certainly one of those really expensive to buy and use policies. Which makes a disabled person dependent upon managing to get a job that offers insurance and to keep the job - AND to survive any periods that exclude coverage for a "pre-existing condition" as allowed by any applicable law (like HIPPA). Now depending on the exact disability or disabilities involved, this can have varying rates of difficulty - and expense - involved.
Both of these go to show that the UN gets it right and we (the U.S.) get it wrong. Health care is a human right, not a business or a priviledge to be extended to whomever can afford to pay for it.
Posted by Danetta Amschler on 08/24/2009 @ 08:52AM PT
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The key point, it seems to me (and the one I missed until that article today), is that the uninsured are, in fact, largely poor. That's a reminder that what we need, most, is Medicaid reform, and probably some sort of subsidized access to insurance for people who fall just outside of Medcaid eligibility (or, transform Mediciaid into that subsidized plan, which I think would be brilliant). But I think it's gooten terribly lost,as usual, in an Administration where talking about poverty, never mind advocating for solutions, seems anathema. We should be shouting it over and over... the uninsured are people in poverty. Do something!
Posted by NYC Weboy on 08/24/2009 @ 08:54PM PT
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I think you're right. I think however that a closely related - if not inseparable - problem that must also be fixed is how we figure poverty. Unfortunately, as much as they're seemingly unwilling to touch any real Medicaid reform, I can't imagine them touching the Federal Poverty Line's basis and getting it fixed correctly with hazmat suits and ten-foot poles. It's like poverty has become the elephant under the living room carpet and unfortunately if we leave it there much longer it's going to start to smell so we can't ignore it forever or even all that much longer. Someone is going to have to do something and do the right thing for once. Not just feel good, cost cutting welfare "reform".
Posted by Danetta Amschler on 08/24/2009 @ 09:02PM PT
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http://www.change.org/actions/view/prosecute_ascension_healthsacred_heart_hospitalcardiology_associates_et_al
It doesn't help when politicians--such as FL Atty Gen and Republican Governor-wannabe Bill McCollum, and FL CFO Alex Sink (formerly of Bank of America) and Democrat Governor-wannabe--whose pockets are lined with corporate healthcare campaign contributions, refuse to take action against healthcare providers who commit Medicaid Fraud at patients' expense.
Nor does it bode well for poor Americans when the government fails to hold accountable employers--particularly public employers--for discriminating against past, current, and prospective employees based on "perceived disability," i.e., medical history, lawsuit history, and past health insurance and worker's comp claims filed.
If government fails so miserably at enforcing ADA, HIPAA, and Federal EEOC case law, then any healthcare reform under consideration MUST have systems in place to hold accountable any violations and abuses of power in such a system.
http://healthcare.change.org/actions/view/please_urge_the_us_supreme_court_to_hear_this_perceived_disability_case
Carol Tucker, MA
Court Reform-NOW
(I am also in the process of initiating a Court Reform-NOW movement and creating a website, as our country's judicial system is in as much dire need of reform as is our healthcare, employment, housing, and education systems.)
Posted by Carol Tucker on 08/25/2009 @ 11:19AM PT
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