Health care in crisis, part 1: Which way forward

By David Hoskins

FIST, Washington DC chapter

A little over one year ago 12-year-old Deamonte Driver died in Maryland after infection from an abscessed tooth spread to his brain. His mother, Alyce Driver, had spent a considerable amount of time prior to his death trying to find dental care for her children. Although Alyce was a working mother, none of her jobs in a bakery, construction or home health care provided the insurance she needed to care for her children.

Deamonte died after weeks of emergency hospitalization failed to save his young life.

Unfortunately, his death is not an isolated tragedy. It is endemic to a system that consistently prioritizes profits before people and allows pharmaceutical companies and big insurers to dictate the terms of the health care debate.

Nearly 50 million people living in the U.S. lack basic health insurance. Another 25 million are underinsured and find themselves woefully unprepared when a medical crisis hits.

The Commonwealth Fund—a private foundation specializing in health policy research—recently commissioned a survey that found many families delayed visiting the doctor, skipped tests and failed to fill prescriptions as a result of inadequate insurance and skyrocketing medical costs.

Almost half of those surveyed took out mortgages or loans or used credit-card debt to pay their medical bills. They are the lucky ones. The unlucky ones, like Deamonte Driver, die far too young from preventable ailments that cause needless pain and suffering.

For decades a lack of insurance has been associated with the working poor and nationally oppressed. According to the U.S. Census Bureau, one in five Blacks and one out of every three Latin@s lack health insurance. The same survey found that one in 10 whites were uninsured.

If national oppression is a fair indicator of who lacks health care coverage, class is the other factor. Statistics from the U.S. Department of Health and Human Services show that 25 percent of the uninsured live below the poverty line and a full 72 percent make less than $27,930 per individual or $56,550 for a family of four.

But as the health care crisis balloons, higher-income workers are increasingly at risk of losing adequate insurance. The underinsurance rate of families earning over $40,000 a year tripled from 2003 to 2007.

The uninsured and underinsured are tasked with facing incredible financial hardship at the same time that they confront life-changing illnesses. A 2005 article for Health Affairs journal titled “Illness and Injury as Contributors to Bankruptcy” chronicled the devastating effect health care debt can have on working households.

According to the article, half of all bankruptcies are caused by medical bills and three-fourths of those bankrupted had health insurance at the time they got sick or were injured. The number of families filing for medical bankruptcies went up by 2,300 percent between 2001 and 2005.

Families cited the high cost of medical bills, prescription drug costs and lost income due to illness as the primary reasons for their financial hardship. The study found that even middle-income households with insurance are susceptible to financial catastrophe when sick. One in five households filing for medical-related bankruptcy went without food at some point in the two years leading up to bankruptcy. Thirty percent had their water or electricity shut off and close to half lost their phone service.

Blaming the victim: right-wing myths and the health care crisis

Right-wing academics and politicians have long sought to blame the health care crisis on someone or something other than the for-profit system and the drug companies and HMOs that make billions off of it. As part of their blame-the-victim scheme, they have repeatedly attempted to scapegoat two groups: immigrants, particularly the undocumented, and the uninsured who seek emergency treatment.

Right-wing scapegoating spearheaded hateful legislation such as California’s Proposition 181, which sought to bar undocumented workers from receiving non-emergency health services. Disinformation regarding the impact of immigration was also responsible for a clause in the 1996 welfare reform law that barred all immigrants who entered the U.S. after 1996 from receiving Medicaid for five years after entry.

The American Journal of Public Health examined the claim that immigrants disproportionately drive up health care costs. According to the 2005 study, approximately one-third of immigrants are uninsured. The study also found that despite the level of uninsured, immigrants are likely to pay $80,000 more per capita in taxes over their lifetime than they will receive in government services.

This coupled with the fact that U.S.-born individuals account for over 92 percent of private and government insurance expenditures demonstrates that immigration is in no way responsible for the current health care crisis.

Research on the cost of emergency room visits similarly disproves the notion that the problem with the U.S. health care system is the uninsured. Emergency department use accounts for a small portion of medical expenditures, while cost shifting from the uninsured emergency patient to the insured is miniscule. The American Journal of Public Health published another study in 1996 that found free care for the uninsured emergency patient totaled just 2 percent of total emergency department costs.

Despite the right wing’s attempt to demonize undocumented workers and blame the uninsured for the high cost of health care, the research demonstrates that this crisis is rooted in the capitalist for-profit health care system.

Next: Democrats’ quick fix is no solution for workers.

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