Last week was "Cover the Uninsured Week." We might be
a week late with the column, but the problem will be with us week
after week, year after year.
Is there a solution? What is it?
Health insurance costs continue to skyrocket, and more
people become uninsured because they or their company can no longer
afford the premiums. This forces the uninsured to seek their medical
care in the emergency room of a hospital which increases that
institutions costs. These costs are passed on to the paying
patients and insurance premiums rise.
It is a terrible circle of events that must somehow be
broken. It is estimated that 41.2 million Americans lack basic
health coverage and Colorado is estimated to have 1.2 million of
What happens when a person or family is uninsured for
basic health care? Studies by the prestigious organizations, the
American College of Physicians and the American Society of Internal
Medicine, show that individuals who are uninsured are more likely to
be sicker and to die earlier than those who are insured. For
example, uninsured women had a 49 percent greater chance of dying
following diagnosis of breast cancer than did privately insured
Who are the uninsured? The unemployed? NO! Eighty
percent of the uninsured live in working families. So why are they
uninsured? Twenty years ago, 85 percent of employers offered health
insurance; now only 62 percent do. The reason is the rising cost of
insurance, which has risen 15 percent to 70 percent in just this
Individuals are often faced with the choice of food
and a home or health insurance. Some individuals figure they can
"self insure" and believe they pay more for insurance than they
would for the health care. Some people are gamblers, some arent. I
can attest that 60 percent of my "uninsured" patients are faithful
in paying their bills.
Last week I cared for a young, uninsured, working
woman who had severe abdominal pain.
After her emergency room visit, a CAT scan of her
pelvis, general anesthesia, a pelvic laparoscopy (surgery) and an
appendectomy for a ruptured appendicitis, her over-all bill was
probably $10,000 to $20,000, which she will never be able to pay.
The good news is that she was discharged from the hospital the next
morning and will, hopefully, be back to a normal life this week. The
bad news is that the hospital and doctors will have to write off the
bills and pass them on to those who can pay.
I see only two solution: one is "let the government do
it," the other is to do it ourselves.
The United States continues to have the most advanced
medical care in the world, but is the only advanced nation that does
not guarantee health care for all its citizens. There are tremendous
pros and cons to having the government assume this
Coloradans are hampered from purchasing cheaper health
insurance because state laws require all insurance to meet a "Must
Carry" clause where all medical problems are covered. Only the
largest of insurance companies can meet this requirement, so smaller
companies leave the state and we are at the mercy of the big
A certain number of uninsured will always be with us,
unless there is a national health insurance.
So how is a community to care for them? Individually,
we cant afford our own police department or fire department, so we
band together to supply these services. We need to join together to
provide those health services that too many of our citizens cannot
Do you have a solution? Id love to hear it. E-mail me
Dr. John N. Withers is a practicing general surgeon in