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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