published Tuesday, May 15th, 2012

Sinking health care spiral

One of the most recent authoritative reports on health care showed that more than one of out of five Tennesseans between the ages of 18 and 65 -- 857,000 people, or 22 percent of the 18-to-65 population segment -- did not seek health care when they needed it in 2010. And that's just the number of uninsured Tennesseans in that age group -- a rise of 57 percent in the ranks of the uninsured since 2000.

If a proportional number of 18-to-65-year olds received TennCare -- the state's Medicaid program insurance for people below the federal poverty level -- then the number of uninsured Tennesseans who avoided seeking needed health care because they couldn't afford it would have been more than one in four adults between 18 and 65.

The numbers were similar for the 18-to-65 age group in Georgia and Alabama, where 1,394,000 (24 percent) and 587,000 citizens (22 percent) respectively, were without health insurance and had unmet health care needs in 2010.

Medicare is available for people above 65. Medicaid covers the very poor, and the state/federal Childrens Health Insurance Program, or CHIP, covers most uninsured children. Tri-Care aids particular groups of veterans. So the finding by the esteemed Robert Wood Johnson that practically one in four Tennesseans, and similar numbers in Georgia and Alabama, couldn't get health care when they needed it due to a lack of insurance and unaffordable cost is even more stunning.

These figures largely reflect how many businesses have dropped insurance plans for their workers in recent years. Barely 55 percent of employees in Tennessee, for example, now receive employer-based coverage. Typically, that's because many employers and their employees can no longer afford it. In some other cases, employers' health insurance offers such skeletal coverage and requires such high deductibles and co-pays that some employees either can't afford it or don't find it useful, absent a catastrophe, for regular health care.

One clear result is the rising number of American adults who turn to hospital emergency rooms for care when chronic illness becomes acute or balloons out of control due to lack of preventive care and regular treatment. In a report last weekend, this paper's health care reporter Mariann Martin cited such trends at Parkridge and Erlanger hospitals.

Parkridge saw an increase of 12,000 patients in 2010 over the previous year. In the first nine months of Erlanger's 2010-11 fiscal year budget, the hospital incurred $61 million in uncompensated costs of care it provided; in the same time span for its 2011-12 fiscal year, the cost of Erlanger's uncompensated care jumped to $67 million.

These numbers are reflected in other startling findings. National research by the Physicians for a National Health Program found that medical bills contribute to more than 60 percent of all personal bankruptcies in the United States, and that three-fourths of those bankrupted had health insurance at the time they got sick. The total cost of health care in the United States, moreover, leapt to 17.9 percent of the nation's gross domestic product in 2010, and that figure is now above 18 percent, which is half-again-to-double the cost, relative to GDP, of the universal care programs of all other major industrialized countries in the world.

America's gloomy health care statistics not only leaves 50 million Americans uninsured. They beg the full reform Affordable Care Act measures that are to be implemented in 2014, and an answer by Republicans for an alternative if they manage to kill the ACA.

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EaTn said...

The age 45 son of a former coworker lost his insurance and was one of the unemployed then became ill and could not afford a doctor's visit. He finally landed in the ER, spent several weeks in ICU before dying. In short, the half-million dollar hospital bill wound up on your and my health insurance premium. That's one of the reasons we have one of the highest per person health costs, yet one of of the worst per person health care.

May 15, 2012 at 6:08 a.m.

How does a half-million dollar hospital bill for an uninsured individual relate to insurance premiums? Insurance had nothing to do with payment for his care since he had no insurance.

Seems like the a true cost driver of healthcare has been found. Trying to tie the astronomical fees hospitals charge to uninvolved (in this case) insurance companies just doesn't make sense.

May 16, 2012 at 10:29 a.m.
Rickaroo said...

"How does a half-million dollar hospital bill for an uninsured individual relate to insurance premiums?" - FPSE

How dense must one be not to see the connection between hospital costs and insurance premiums? Hospitals incur billions of dollars a year in costs for treating the uninsured. In most cases they are unable to collect on what is owed them. The government accepts a large portion of this debt but what it does not, the hospital is stuck with. They do not just "eat it." They have to keep inflating their costs in order to stay in the black. The insurance companies keep raising their premiums in order to meet the rising costs of the hospitals. That is the main reason premiums go up each and every year and that is the hidden tax that the insured pay for the uninsured.

Those who complain about how "unfair" it would be for their tax dollars to go for universal coverage are already paying and will continue to pay for the uninsured as long as we keep on with this broken, inefficient model. Whether the government takes on the debt or the hospitals do, either way it is bad for everybody. It would make much more sense and be much more cost efficient to implement a plan whereby everyone was covered and received care on the front end (preventive care and early diagnosis) rather than on the back end (emergency room and late-stage illnesses).

May 16, 2012 at 1:37 p.m.
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