The Record (Bergen County, NJ)
12-02-2004
The shame of health care in America
MARY ELLEN SCHOONMAKER
Date: 12-02-2004, Thursday
Section: OPINION
Edtion: All Editions.=.Two Star B. Two Star P. One Star B
THE UNITED STATES spends more on health care than any other nation, and our medical care is widely considered the best in the world. But it's not for everyone.
Top-notch specialized care in this country is only guaranteed to the rich and those with gold-standard health plans. Even the most basic care is only guaranteed to the poor and the elderly, through Medicare and Medicaid, and to the rapidly shrinking number of Americans lucky enough to be insured by an adequate and affordable plan.
Those with no insurance - even in doctor-drenched Bergen County, where there are 963 listings in the Physicians and Surgeons section of the Hackensack area Yellow Pages alone - take their chances.
In my last column, I asked uninsured North Jersey readers to describe their experiences. We need to hear more voices like these.
* A single 38-year-old construction worker, who does seasonal work that pays an hourly wage: 'It is impossible for me to afford individual health insurance coverage as I need to pay for rent, utilities and transportation to get me to the jobs. Even though blessed with good health for the most part, I ended up in the hospital emergency room last winter for 10 hours. I could not pay the extraordinary amount charged to me for my care.'
* A 56-year-old woman, who works for a lawyer in private practice, cannot afford health insurance and has not been to a doctor in more than three years: 'Forget about preventive medicine like mammograms. I cannot afford it. I'm not ashamed to say that when I needed an antibiotic I used my daughter's leftover dose. I often wonder what would happen to me if I needed surgery and a prolonged hospital stay.'
* A 63-year-old laid-off truck driver: 'I could have picked [insurance] up with COBRA at a cost of $725 a month. I never could understand why my single rate is the same as a family of five. Common sense shows there would be a greater need with the latter. It is a shame I have to take a gamble with my health.' (COBRA allows the unemployed to stay insured by paying the same monthly premium as their former employer.)
* A 29-year-old divorced woman who does facials at spas that do not offer insurance: 'I go to Planned Parenthood for my annual gynecological visit. When I get sick, my parents have to pay my doctor visits. I hate taking from them, but there is no alternative. I have something that should be looked at, but I am afraid. When and if I get insurance, I don't want them to say I am not eligible.'
* A 24-year-old home health aide who says she has had 'horrific experiences dealing with emergency rooms': 'One treated me like a drug seeker once the staff passed the word I was uninsured. I was treated so badly I promised myself I would be almost near death before I went to another ER. Last winter I visited an emergency room only because I had an infection for over two months. I was in so much pain the staff couldn't believe I waited so long.'
* A woman who was offered COBRA coverage for $1,200 a month but could not afford it and later had some temporary bare-bones coverage through her husband: 'I was hospitalized during this time with chest pains. I was in the hospital for a day and a half and had two outpatient procedures, and my bill was $31,000. The insurance paid just under $3,000.'
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It's a well-kept secret that hospitals often charge far more than the actual cost of treatments - and often charge the uninsured far more than the insured for the same procedures. In a recent study, New Jersey ranked second behind California in the number of hospitals that charge the highest markups. Generally, patients with insurance don't pay the highest prices, since big insurers have the leverage to bargain for discount rates. But uninsured patients can sometimes end up paying bills for years or even going bankrupt.
The huge inequities are perhaps the most infuriating part of the American health care system. They mean that in Bergen County, one of the richest counties in the nation, some women with breast cancer will get state of the art treatment and access to the latest life-saving advances. And some women who can't afford it will go without the first and cheapest step, a mammogram - maybe until it's too late.
According to the Institute of Medicine, which advises the government on health policy, uninsured women with breast cancer have a 30 percent to 50 percent greater risk of death than women who are insured.
As of now, America's uninsured - 44 million people - equal the entire population of 14 states, as authors Donald Barlett and James Steele point out in their new book, 'Critical Condition.' They say no other industrialized nation would - or does - tolerate this injustice.
How much longer will we?
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Mary Ellen Schoonmaker is a Record editorial writer. Contact her at schoonmaker@northjersey.com. Send comments about this column to oped@northjersey.com.
Keywords: USA, HEALTH, INSURANCE
Copyright 2004 Bergen Record Corp. All rights reserved.
