HIGH COST OF HEALTH INSURANCE
and the CONSEQUENCES OF BEING UNINSURED
for DEMOCRATIC POLICY COMMITTEE HEARING , July 14, 2004 HOME
Provided By Robert A. Mason, LCSW, CAC, CEAP
Chair of the Social Policy Committee, Pennsylvania Chapter of the National Association of Social Workers [NASW]
NASW serves over 6500 members in the Commonwealth. NASW is the largest association of professional social workers and was founded in 1955. It is comprised of over 150,000 members worldwide in 56 chapters, the Pennsylvania Chapter being the eighth largest.
For several years the Social Policy Committee has collaborated with the Kensington Welfare Rights Union/ Poor Peoples Economic Rights Campaign to promote the integration of universal human rights standards:a living wage, safe and affordable housing, quality education, nutritious food, affordable public transportation, and health, in the laws and policies of Pennsylvania. This effort has included working closely with the House Select Committee to Study and Investigate the Integration of Human Rights Standards in Pennsylvania's Laws and Policies, co-chaired by Representatives George Kenney and Lawrence Curry.
As proud citizens of Pennsylvania and professional social workers we are acutely and intimately aware that guaranteeing the inalienable human right to economic security insures individual wellbeing within healthy communities. We also know that employment, housing, education, food, transportation, and health are intertwined in a complex web of relationships, and that each strand demands attention.
Nevertheless, today I wish to focus on health and health care. As a Licensed Clinical Social Worker, Certified Addictions Counselor, and Certified Employee Assistance Professional with close to thirty years of work in the field, I can speak from first hand knowledge of the vital role that good health insurance plays in the wellbeing of individuals, families, businesses, and communities.
As an employee of a small business, a respected, successful, twenty year old professional psychological services corporationand as the husband of a clinical social worker in solo practice I have personally felt the impact of the health care crisis. Therefore, I will address the crisis from both a professional and personal perspective. You are well aware that approximately 43.6 million Americans and 1.4 million Pennsylvanians are without health insurance.
The latest Institute of Medicine report, "Insuring America's Health: Principles and Recommendations" details the impact on individuals, families, communities, and the nation. (I am sure that Dr. Wilhelmine Miller of the IOM, who is testifying in person on the 14th, will provide valuable analysis on the consequences of being uninsured.)
In addition, about 75 million Americans are underinsured, having policies that provide less than adequate coverage, and the IOM notes that they face similar, if not as severe, adverse consequences as the uninsured. The underinsured face high deductibles, high co-pays, and some vital services - mental health, medication, not to mention dental and vision - uncovered.
On June 16, 2004 Families USA released a report that revealed 81.8 million Americans,one out of three people under 65 years of age, including many in the middle class, were uninsured at some point during 2002-2003. Pennsylvania had the 6th largest population of uninsured, 2.8 million people without insurance for some portion of that year.
The IOM estimates that 18,000 Americans die needlessly every year due to a lack of health insurance. That translates into 600 Pennsylvanians annually. In addition, health insurance is no guarantee of the outcome of care. The United States has approximately 100, 000 iatrogenic, caused by medical treatment-- deaths per year. One cause may be the nursing shortage and another cause may be the time constraints for doctors who are pressured to treat patients rapidly to decrease cost and maximize profit. In comparison to many other developed, industrialized countries the United States has fewer doctors, fewer hospital beds, and shorter hospital stays.
Despite the laudatory statements about the American health care system made by some, our health care outcomes should prompt serious concern. A few years ago Dr. Barbara Starfield of the Johns Hopkins School of Medicine compared the overall health of Americans with those of other industrialized countries. The United States ranked 12th out of 13 countries on 16 available health indicators.*
Turning to my personal situation, my family is underinsured, and this has led, as studies show it does with other underinsured people, to delays in seeking medical attention because of the inordinately high out of pocket cost of care. My 17 year old daughter and I have catastrophic coverage - with the misnomer "Complete Care - for $300 a month in premiums. This is because my employer - with 20 employees - can not afford to offer the benefit of health care.
This is largely due to the freezing of mental health and drug and alcohol services reimbursement rates by insurers for the past 15 years. These same insurers have steadily increased premiums at skyrocketing rates. I am 55 and should not be factoring in economics when I am deciding if a symptom warrants making a doctor's appointment. My wife pays $400 a month in premiums for a plan that neither covers medications nor mental health, a supreme irony since she's a psychotherapist.
She is like a cobbler without shoes. Our overall medical expenses despite relatively good health, consume about 18% of our income, equal to our mortgage and utilities. Ours is hardly a dire situation, but it is one example of how the high cost of health care insurance is impacting even the middle class.
Many years ago when I worked in the corporate world I was admonished, "Don't come to me with complaints, bring me solutions!" I have spent the past three years studying the health care crisis, attending conferences addressed by internationally acclaimed experts, reading prodigiously, and participating in monthly conference calls with health care reformers from around the country. It is abundantly clear that the IOM's call for universal coverage, not incremental change, is the answer. The only way to accomplish this affordably is a single payer plan, sometimes dubbed "Medicare for Al l" that preserves the best of our health care system of independent providers (and freedom of choice for patients) and provides the administrative efficiency of one source of health care financing.
For a detailed plan and supporting data you can contact the Physicians for a National Health Plan (www.pnhp.org). While the ultimate solution requires federal initiative, states have a significant role as laboratories of and advocates for change. Many other states have been working hard on fundamental reform. These include California, Delaware, Illinois, Maryland, Maine, and West Virginia. I implore you personally and professionally to add Pennsylvania to the list. The fundamental, human, inalienable right to health is a matter of life and death.
*Dr. Starfield's study is referenced in a New York Times column, "A Second Opinion", by Bob Herbert, 6-28-04 edition.
412-823-5155, ext. 659 bobamason411@cs.com