La Plata Medical Society

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 institution’s 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 them.

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 women.

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 last year.

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 aren’t. 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 responsibility.

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 boys.

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 can’t 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 afford.

Do you have a solution? I’d love to hear it. E-mail me at

Dr. John N. Withers is a practicing general surgeon in Durango.

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