According to the Census Bureau, the number of Americans without health insurance rises to 46.3 million. This raises the question, where do these people go when they get sick? And better yet, who in the world is going to have to pay for it, and how? It isn't likely that a nation that prides itself upon the ability of its ability to produce one of the globe's highest gross domestic products [GDP] would allow a problem as fundamental as the health of its workforce and citizens to escalate to this size -- would they? Why has the health care crisis grown at such an alarming rate, or is it more profitable for health care officials and pharmaceutical corporations to let certain members in impoverished segments of our communities to go uninsured?Being Uninsured in America
By: Tink
Source: Associated Content
You have likely heard the statistics; there are 46 million uninsured people in America. I am one of those uninsured people. I am not without insurance by choice mind you; I simply just can not afford health insurance. My husbands work offers health insurance, for a cool 600 dollars a
month. There's also a 5000 dollar deductible, and 20 percent co-pay after the deductible is met.
I haven't always been without insurance either. I had insurance as recent as 2001 but my insurance company dropped me after being diagnosed with a massive pulmonary embolism in both lungs. I spent two weeks in the hospital and almost died. My insurance company's last good deed was to cover all the expenses of those two weeks. The total racked up was well into six figures, so for that I am blessed.
However, soon after I was discharged from the hospital I was informed by my doctor that it was very likely that I had a blood disorder. He could see no other reason for a 21 year old to suffer such a massive and deadly health problem. The disorder he believed I had is extremely rare though, and testing for it would cost a fortune.
I was told that I would have to take Coumadin for the remainder of my life because of the potential danger of a blood clot reoccurring. I also would have to have at least weekly blood tests to make sure my blood was not clotting too fast.
After one week of being on Coumadin and 3 blood tests to get the dosage right, I set up my appointment for the testing to be done. Sadly, when I went to my next appointment for blood testing, I was informed that my insurance card was not working. I immediately went home and called them. Their message was simple; we dropped you because your health problems are costing us too much.
I tried to fight it, tooth and nail. The outcomes were not in my favor however. I couldn't afford to pay for the Coumadin and weekly blood tests out of pocket so I applied for Medicaid. Medicaid denied my application because I could not provide documentation that it was a life long condition. I couldn't afford the test for the blood disorder so I was out of luck.
I have applied for other health care, but I get the same message, due to pre-existing conditions I am denied. I also have other health problems such as kidney stones, frequent infections, a severe case of tmdd that requires surgery, and the list goes on.
It has become obvious that health care is a major issue with candidates of the 2008 presidential election. Everyone has their own ideas on how to approach the issue, but instead of ideas, we urgently need action. One professor at Princeton University even
said that being uninsured is an excuse to mooch of the government.
These types of attitudes appall me, as well as other insured and uninsured Americans.
While there are many people who simply refuse to see a physician and are uninsured by choice, most of the medically uninsured Americans simply can not afford health insurance.
Healthcare has become an exclusive privilege of the upper class. Even most people who qualify for state Medicaid have complained that they feel they are being treated inferior, and are provided a lower quality of care than those who have private health insurance.
According to The Keiser Family Foundation, the quantity of uninsured Americans has risen steadily over the last decade and continues to rise. Two-thirds of the uninsured people in America come from low income families, at or below 200 percent of the federal poverty line. The Keiser Family Foundation also states that 81 percent of the uninsured people in America come from working households.
Many people are upset that the uninsured clog up hospitals with easily treated conditions. These people often also fail to be able to pay the bill, leading to poorer quality of clinics and hospitals. The dilemma is then made worse by hospitals and clinics overcharging the uninsured. Health Affairs reported that many hospitals charged uninsured and other self-pay patients 2.5 times higher rates than those with private insurance. (read more...)
Including uncompensated care delivered by private providers, private sources appear to account for just over 81 percent ($28.1 billion) of all uncompensated care (Exhibit 2). However, this greatly understates the role of governments because, as shown below, private providers receive sizable government funds to cover the costs of the uncompensated care they provide. Among explicitly identified government sources, the VA is the largest single source of funding, although these public sources exclude tax appropriations, government grants, and Medicare and Medicaid payments to private hospitals and clinics for care of the uninsured (Hadley).
Hadley and Holahan's table shows how undocumented sources for those who do not have medical insurance are provided from unknown or undocumented sources.
According to the AFL-CIO, in their article "What's Wrong With America's Healthcare",
Working families are experiencing double-digit increases in the costs of health insurance, more out-of-pocket costs for doctor visits and skyrocketing prices for prescriptions, forcing many to delay getting needed medical care or worse—to decline coverage for themselves or their families because of cost. Health care costs are rising at five times the rate of inflation. According to the Center for Studying Health System Change, health care spending rose 10 percent in 2002 and that followed a slightly more than 10 percent increase in 2001—the largest jump in more than a decade. In the first six months of 2003, health spending rose another 8.5 percent. Premiums for employer-sponsored coverage increased nearly 13 percent in 2002. As employers refuse to pay their fair share, this trend may result in millions of workers losing their employer-based coverage (PDF).
Employers are responding to growing cost pressures by shifting more and more health care costs onto workers, especially through larger co-pays and deductibles that must be paid at the time treatment is sought.
Employer’s demands to slash health care coverage for workers was the major issue in the recent Southern California grocery workers' strike and lockout in which nearly 60,000 workers saved health care benefits and beat back employer demands to freeze pension funds after holding strong on the picket line for five months. Under grocery management’s original proposals, a worker making slightly less than $20,000 a year would have had to pay nearly $5,000 to maintain the same level of benefits they had in the previous contract.
Other cost increases hitting workers include larger hikes in the cost of family coverage, less access to needed prescription drugs through stricter HMO formularies and higher prices for more comprehensive coverage. See the Consumers Unions’ Health Care Plans and Managed Care (PDF).
Consumers are using more prescriptions, at younger ages and for more conditions, and substituting newer, more expensive medications for established products. As a result, pharmaceutical spending increased by 17.4 percent annually between 1999 and 2000 and another 16 percent from 2000 to 2001 (PDF).
The lack of quality health care in the United States also stems from our system’s lack of comprehensive quality measure and assurance programs, which unions now are establishing with community partners.
Our most successful public health insurance program, Medicare, is increasingly under attack at a time when the lack of access to health care is already a crisis in America. Most Americans ages 65 and older rely on Medicare, which serves more than 40 million beneficiaries in the United States. Instead of strengthening and modernizing Medicare to include a comprehensive, affordable prescription drug benefit for all seniors, the Bush administration in late 2003 strong-armed through Congress a Medicare prescription drug bill that moves Medicare toward privatization. The Medicare bill also:
Our health care system lacks safety controls that endanger front-line workers and patients. Staffing levels are dangerously low in hospitals, nursing homes and other health care facilities. As a result, medical errors are rising—and account for an estimated 44,000 to 98,000 needless death each year. See Medical Errors and Patient Safety and 20 Steps to Prevent Medical Errors from the Agency for Healthcare Research and Quality.
The way that the current health care system works, medical practitioners weigh out the services they can offer versus how much their patients can afford and the rules that they have to follow based upon their ability to pay. They then use these guidelines to assess the health of their patients, and then refer back to their guidelines for how they can best treat the patients based upon what the guidelines and their resources dictate they can afford. For those who rely on additional help to treat underfunded patients, priority for treatments are often given to those who donate medical supplies and prescriptions [ie to pharmaceutical companies looking to gather information regarding their treatments]. Incentives are often offered to those who can contribute the most to this research. So treatments are often contracted out and dispensed to meet this need with very little invested in the results. And why should they be?So Where exactly is this money coming from? Those at the bottom of the economic food chain [a linear system] aren't expected to contribute funding to the taxes that pay for these medical services, and without this test segment of the market, much of the research that is performed could not be done without the contribution of those who unknowingly participate in the process of medical experimentation through their "clinical trials". It is through this lack of education and institutional manipulation that health practitioners are able to peddle pharmaceuticals without educating their patients of their illnesses, lifestyle adjustments that can be made to prevent the systems, or affordable nutritional alternatives for treatment. This makes their sense of ethics not much better than that of a common drug dealer, and the people who pay the highest cost are the ones who are the least able to afford the cost of the side effects. And they are often enabled to get away with this because their patients are ignorant of the extent of their exploitation and have become used to becoming complacent with the consequences; thus the system of economic enslavement remains institutionalized.
because you didn’t have medical insurance?
Imagine waiting along the side of the road because you don’t live along the part of the bus line where the city pays for sidewalks. You pile onto a crowded bus. Young single mothers sit with crying babies looking agitated because they can’t afford to take their children to day care. Rowdy teenagers in baggy pants sit in the back cursing and giggling because their parents work too many hours to be aware that their children aren’t in school. Achy old men with weathered faces discuss stories they’ve heard on the news or how they have to wait for their disability checks before they can go to the doctor and you feel guilty. As you peer out of the salt covered panoramic windows of the city bus, you look out past the abandoned parking lots toward the dilapidated buildings that used to be locally owned businesses wondering what used to be there and how things could have gotten so bad. The side of the road is littered with discarded fast food wrappers, paper cups and rusty beer cans. You pass a liquor store, drugged out prostitutes stand in front smoking cheap cigarettes and you wonder if the young man on the corner in his baggy jeans and long white t shirt is dealing drugs. You don’t want to assume such a negative stereotype about a person that you don’t even know, but still you can’t ignore the obvious as a car pulls into the side street and slows to a stop and the man runs over to the window.The bus pulls into the station. You wait in line as people push past eager not to miss their next bus. Judging by the uniforms for fast food restaurants and major grocery stores, you realize that they are simply headed to work as you pile onto the platform and fumble through your pockets and sort through old convenient store receipts to find your transfer slip to get into the train station. The fluorescent lights are dim as you ascend the escalator to the concrete platform. When the train finally arrives you ride the light rail down back into the city and transfer to another train that will take you down the line to your next destination. Then you hop onto another bus. By the time you have ridden the bus out to your final destination an hour has passed. Your agitation level has risen, having witnessed the mother of a screaming child smack the child in the face as people silently watch on. The bus driver does nothing.
As you step out onto the grass you glance across the street at the county welfare office with disgust. You know they will do nothing. You’ve learned that lesson time and time again, and instead focus your attention to the time on your prepaid cell phone and head off to the county hospital clinic so that you don’t miss your appointment. Upon entering the clinic, you place your things upon the table before passing through the metal detectors and checking in with the security guard. Then you head to window to check in with the medical assistant and pull out your from your plastic card from your wallet. This card proves that you’re eligible to receive medical care in the county that is paying for your medical treatment. The attendant checks it, instructs you to be seated and then closes the window.
In the lobby, an angry woman, thin and lanky as if she’s being treated for a drug addiction becomes belligerent and begins to yell at the waiting room attendant about having waited several hours for her name to be called. Before you can make a decision about whether or not to stay, the security guards come rushing forward and your name is called by a man in a sweater vest. You go off into a tiny room before you get a chance to see what happens. He tells you that you’re expected to make a five dollar copayment, give him the money and he makes you out a receipt. When you return to the waiting room, the woman is sitting quietly and looks dangerously peeved. You avoid eye contact and find a seat farthest from her in the room.
As others watch old episodes of Jerry Springer and Judge Joe Brown, you pull out a book to read for the next few hours. Periodically you glance around as the nurse appears to call out names that you wished was yours. You catch a glimpse of a woman giving her son a bottle full of some sort of sugar concoction and force a smile as the guilt sets in that you may be being just a tad too critical; and you don’t know her. Moments later you catch yourself wandering over to the vending machine for no other reason than just to have something to do. You ponder over the options – should you go with something loaded with refined sugar or simply settle for the salt and preservatives. You’d go to the hospital gift shop where at least you could get a sandwich, but the prices are less affordable for the concoctions they put on the stale bread they serve. Your stomach grumbles and you decide that the vending machine is more affordable and pull the change from your pocket for a bag of Sun chips. It’s the closest thing to a healthy option and you hope that it will be enough to hold you over.
You fall asleep for a while. When you wake up you meander over to the window to find out how much longer it will be before your name is called. You have to step outside to call home as mandated by the posters taped to the walls in the clinic. You call your grandmother because you know that she will be home. You know that she’s bored and will be interested to know that you’ve been there for several hours. But really you’re just looking for anyone who has the time and you know will supervise. You pass through the metal detectors once more and sit long enough for the depression to set in before your name is finally called.
You’re weighed. Your blood pressure is taken by a kind old nurse. She’s obviously a veteran, but for some reason she can’t seem to find your chart. You learn that despite that number of people walking around in scrubs, that day there are only two doctors available to work on the free clinic staff. But as far you as you can remember, the situation has been like that in the clinic for several months. As you sit in the smaller waiting room, you hear the angry woman screaming again, and she is pissed. You wonder how anyone can consider such deplorable working conditions to be a good job. The old couple in front of you nods in agreement that she does have a point. Then as they rush the woman out, an older woman shrugs it off commenting, “hey, sometimes you have to be the squeaky wheel just to get what you want in these parts.” You force a nervous smile. Then the conversation shifts to how the woman’s cousin just got out of jail on work release and was lucky enough to find a job at a grocery store where he can get health benefits; which for her is the definition of a good job. She sounds really proud of him.
You wait approximately for another 45 minutes before your name is called. Then you wait in the doctor’s office alone for another 20 minutes before he finally arrives. For all of the time that you’ve spent waiting, the doctor only sees you for about five minutes, which makes you wonder what in the hell he could possibly be doing that could be making everything take so long. The doctor takes no interest. He looks tired and overworked. He simply asks a few questions as he fumbles around on his ancient computer. You wonder how old the software is as he struggles to put type in your answers for a moment before writing you a prescription. The worst part is, he doesn’t really even explain to you what he thinks is wrong with you. Hoping the pharmacist will at least give you some kind of answer, you take the elevator down to the hospital pharmacy.
The pharmacist asks you if you’d like to come back and pick the prescription up. You quickly do the math. The amount of time that it would take you to ride the bus back to the train station, go anywhere and come back wouldn’t be worth the time you’d waste, or so you think. The determining factor is the food you bought from the vending machine. The bag of chips you bought has just made in unaffordable for you to afford the round trip back; so you decide to wait. They give you a number and waiting is worse than the DMV. There are a LOT more people, a lot more numbers, and by the time you leave the hospital, you’re tired, hungry, and irritable and you’ve waited a total of 16 hours. So you head home. Your day has been wasted as you pile on the bus for the next hour trip home.
This is the situation for thousands of urban dwellers who live without health insurance. Many uninsured patients have to wait on average between two and eighteen hours to receive care for their medical appointments depending upon the degree of accessibility of resources such as funding for medical supplies and staff. It is because of the lack of education of how the healthcare system is funded, that leaves many who struggle to afford the dangerous costs wondering why we're left feeling duped by the dopes who are supposed to know how to fix the problem.
Ironically this is the same medical system that has been accused of violating patients’ rights, misdiagnosing patients with various medical and mental health disorders and failing to catch the early emergence of illnesses that could be prevented through adequate medical treatment, healthy lifestyles choices and a proper diet. Because of the flaws in the medical system, inadequate care and inequitable distribution of funding, many people without health insurance have become so disillusioned with the quality of service of the tax funded health care system to the point that they refuse to seek medical treatment unless confronted with an illness that can no longer be avoided. Sound like anyone you know?
The most disturbing fact is that many health problems and ailments that go untreated often develop into even bigger medical problems that are costly, complicated to treat and in some cases are even fatal. This plays a huge factor in the development of genetic and environmental related illnesses that can lead to widespread epidemics, poor community health standards or lifestyles, or an even greater variety of social and poverty related ramifications. Overworked and undernourished workers begin stealing or turning to a life of crime to be able to afford the food they need, leaving children abandoned and unsupervised to raise themselves. Improper diets and lack of physical stimulation of latch key children who are locked in their apartments spend afternoons watching music videos or playing video games leading to child hood obesity.
Without the skills to prepare meals, many families are reliant upon the most convenient and affordable dietary options, relying upon fast foods or food that is frozen and mass produced and processed with chemicals that weaken the consumer’s immune systems or stimulate their nervous systems to create the onset of developmental diseases. Diabetes, nervous system sensitivities and mental health disorders such as ADHD or bipolar disorder have been highly diagnosed within these communities with little knowledge of how the foods that are consumed are the biggest contributors to these problems. Instead medications are dispense, but the side effects are often so alarming that patients cannot handle the disruptions or lethargy caused by their prescriptions that they often abandon the medications choosing other forms of self medication instead.
With all that we know about proper diet, health and nutrition, people often wonder how the impoverished can tolerate living in such deplorable living conditions within these dangerous communities. Community leaders who are often out of touch with what those living in this lower economic bracket must experience struggle to find solutions to the problems but are ignorant of what to do to fix what seems to be, inherently, a systemic problem. But how do you fix the system, when you are unaware of how it works? Without enough education to know what the problem is how can you ever fix it? Community activists and scholars often research the effects of political systems and ideologies, but fail to get to the root of the problem and therefore are not educated enough to know how to fix it – that is, until now.
Check out our future posts to get a better understanding of how linear economic systems work and how agricultural reforms and sustainability practices are being developed to reeducate educators and activists about how to generate and keep the money that they invest in themselves and their local communities.
By reducing impoverished communities dependence upon external resources through sustainable food production, dietary prevention, and nutritional education, those who rely upon governmental agencies and charities can release themselves from the bondage of economic enslavement and create a more healthy and sustainable future for themselves.
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