Who are the Uninsured?

Nurses Activism

Published

Who are the Uninsured? October 16, 2003

Numbers Point to Problem Created When Legislation Driven by Headlines

By Chris Patterson

Another horrifying announcement from our newspapers a few weeks ago - millions of Americans are uninsured. It's so often repeated, we no longer have to ask what people are going without. This is about health insurance.

Most articles began with alarming statistics, as the Austin American-Statesman did: "The number of Americans who lack health insurance climbed by nearly 6 percent in 2002, to 43.6 million, the largest single increase in a decade, according to figures to be released today by the Census Bureau."

Such stories, and agitated editorials that followed, are geared to evoke cries of outrage for the victims. We are led to believe that this "crisis" is "growing" and, like random urban violence, not one of us may be spared.

Editorial pages have been calling on legislators - state and federal - to do something, and do it quickly. They call for more laws, more spending, more taxes, more government.

We need to breath deeply, calm down and look at the facts.

The National Center for Policy Analysis, based in Dallas, recently examined the numbers of "uninsured."

Almost three-fourths of the newly "uninsured" are people who are making over $50,000, according to the NCPA report, and simply choose not to purchase health insurance. While this decision says many things about the cost of medicine, it does not mean that people without health insurance are poor and desperate for help.

Since 1993 the number of uninsured in households with annual incomes above $75,000 increased 114 percent, according to the NCPA. On the other side of the economic divide, the study finds the number of uninsured with annual incomes below $25,000 fell by 17 percent.

The NCPA uncovered some facts that don't make it to the newspapers. For example, young adults are less likely than other age groups to have health insurance, while those over 65 are almost all insured. Americans between the ages of 18 and 34 make up some 41 percent of the "uninsured." This makes sense. We all remember the invincible years of the twenties - that is a healthy age and most young people are making the economic decision not to waste their money for insurance they do not need at the time.

Most interesting of NCPA's findings is the length of time people remain uninsured: just under a year in 75 percent of the cases.

The shrillness of many press releases and news stories disguise the fact that many without health insurance are making a rational choice. Trumping feelings over fact, the uninsured are portrayed as hapless victims of hard employers and greedy insurers.

While passing legislation to create more programs that spend more money might make for good politics, they do no good in the long run and often deflect resources from the truly needy.

Perhaps the only accurate conclusion we can draw from headlines is that a great many Americans are opting to take care of themselves in ways not reflected in insurance headcounts. Instead of creating more programs, lawmakers should search for ways to make it easier for us all to plan and pay for our individual health care needs. Rather than raising taxes to slay an illusionary dragon, legislators could reduce the mandates making health care - and health insurance - so expensive for every one.

Chris Patterson is director of research for the Texas Public Policy Foundation, a non-profit, non-partisan research institution.

TexasPolicy.com

Come on don't just say "oh no there goes the conventional wisdom again." Does this not make sense. health care costs money, no matter how you set it up.

If I am not mistaken most systems outside the US have long wait periods to test if you have just had an MI. Then another wait list to have the commonplace operation to fix it. This is why many Canadians who can afford it receive MRIs in Detroit or Seattle.

Does someone out there know of an example. Am I wrong here?

"We have no government armed with power capable of contending with human passions unbridled by morality and religion... Our Constitution is designed only for a moral and religious people. It is wholly inadequate for any other. "

John Adams (1735 - 1826)

How is denying healthcare to children, the poor, elderly, or disabled moral or religious?

Specializes in ICU.
Originally posted by dudenurse

Come on don't just say "oh no there goes the conventional wisdom again." Does this not make sense. health care costs money, no matter how you set it up.

If I am not mistaken most systems outside the US have long wait periods to test if you have just had an MI. Then another wait list to have the commonplace operation to fix it. This is why many Canadians who can afford it receive MRIs in Detroit or Seattle.

Does someone out there know of an example. Am I wrong here?

You are very wrong here - we do NOT have long wait times to "test if you just had an MI". Yes there are wait times but these are accelerated as the patient condition dictates. You might have to wait sometimes up to 10 weeks for a FREE angio IF and only IF you are stable and have NO further chest pain - just one further episode of chest pain and BOOOM!!! you get your angio then and there!!!!!!

Please understand it is not now and never has been about denial of service but there is and always has been a priority allocation of that service. You Triage patients in ED - well we simply do it on a larger scale is all.

However if you have private health insurance there is no wait.

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What premiums pay for

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U.S. Urged on Universal Health Insurance

http://www.sjs-vitamins-shop.com/li...ancy_stats.html

World Health Organization Reports Life Expectancy By Country

One of the biggest surprises with DALE was the relatively low position of the United States, which was 24 on the list.

This link describes many factors that influence life expectancy

http://www.worldbank.org/depweb/eng...es/social/life/

The 11 countries where people on average live one or more years longer than the USA have two things in common:

1. High per capita average income.

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2. Universal Healthcare.

http://www.studentsoftheworld.info/...nk/espvie2.html

Comment: The Committee has provided a great service by demonstrating, in previous reports, the severe deficiencies in our system related to uninsurance, and now by providing an unqualified recommendation for universal coverage.

The State of California's recent health care study, the Health Care Options Project (HCOP), conducted by the California Health and Human Services Agency (CHHS), demonstrated that a publicly funded and administered universal health insurance program (also knows as single payer) will save billions of health care dollars and provide the necessary funding for universal health care.

"They" are U.S. consumers and, more and more, they are becoming disenchanted, distrustful and disgusted by the state of health care in the wealthiest nation in the world. "

Now is the time ... 'The nurses' proposal for Universal Healthcare & a single standard of care'

http://www.studentsoftheworld.info/...nk/espvie2.html> http://www.studentsoftheworld.info/...nk/espvie2.html >

LIST OF THE HEALTHIEST COUNTRIES

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What premiums pay for

David Lazarus

Friday, January 16, 2004

©2004 San Francisco Chronicle

The United States squanders more money every year on health care bureaucracy than it would cost to provide medical coverage for the 43 million Americans now lacking insurance.

gwenith,'Some one asked me the other day if health care was important to Australians and my answer was YES!!!!

Elections are won and lost here on health care issues. We have a free health care service - not ideal - not perfect but about 100,1000 kilometers ahead of where the USA is. '

check this out

So, when it comes to universal health care all I can say is "don't knock it till you trY it!"

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http://news.bbc.co.uk/2/hi/middle_east/3459703.stm

Like it or not, you can have socialism - or you can have liberty - but you can't have both. As far as I am concerned, you either support and defend the Constitution (an American) - or you don't (anti-American). It is that simple.

Moreover, when talking about this issue, it seems that other factors need to be discussed such as the trade agreements like NAFTA. At one time, companies were proud to say they were an American company; but not anymore. "To promote the general welfare" means the government should take the necessary steps to ensure that now only American jobs are safe, but that they pay adequately to support the necessities of life such as medical costs.

As an American, I am totally against socialism - period. I am however for the Constitution and the government doing its job (obligations) as is mandated. By allowing high paying jobs to go to other countries, lax immigration laws and poor trade policies, the government is doing everything it can to for American into socialism. Wake up people. See how it all ties together. Look at the bigger picture.

Originally posted by WyomingRN

Like it or not, you can have socialism - or you can have liberty - but you can't have both. As far as I am concerned, you either support and defend the Constitution (an American) - or you don't (anti-American). It is that simple.

Moreover, when talking about this issue, it seems that other factors need to be discussed such as the trade agreements like NAFTA. At one time, companies were proud to say they were an American company; but not anymore. "To promote the general welfare" means the government should take the necessary steps to ensure that now only American jobs are safe, but that they pay adequately to support the necessities of life such as medical costs.

As an American, I am totally against socialism - period. I am however for the Constitution and the government doing its job (obligations) as is mandated. By allowing high paying jobs to go to other countries, lax immigration laws and poor trade policies, the government is doing everything it can to for American into socialism. Wake up people. See how it all ties together. Look at the bigger picture.

Amen, and Amen !

My point with the post from your Senate (?), is that these are problems currently identified in your system in Australia. You guys haven't worked out all the problems. How long have you had socialized medicine? Why trade our problems, which do not seem to be as bad, for socialized medicine problems?

The point is to have your tonsils removed is a problem in Australia. It is not here in the US. They would not treat you with antibiotics for a year (so you don't die of sepsis) while you wait on a list because your tonsils are not a priority.

I know that the post was because your country is trying to fix their PROBLEMS. It was actually an exerpt from a more liberal state of mind (Liberal in the US meaning left wing and not conservative), yet it still IDENTIFIES problems in your system.

The next step is they say, "MORE MONEY WILL FIX IT". So, more tax dollars get put into the system and it never does get fixed. More money never fixes the problem, yet liberals sream for more more more and more money.

kitkat

Australia's Public Health Care System

The following 'typical' patient case descriptions

By your Senates OWN admission this is a TYPICAL patient case description:

Joan's throat

Joan, a nineteen year old young adult is suffering from a sore throat and after a number of days of discomfort and aspirins discover she cannot swallow and goes to the Emergency department of a public hospital for treatment. She is admitted for two days and treated with antibiotics for swollen tonsils and suspected Quinsy as a public patient at no resulting cost to her. Before being released she is seen by the hospital specialist who warns that if her tonsils again become swollen or infected again she will need to have them removed.

Several weeks later while visiting another city, Joan's tonsils again become swollen and so visits a medical clinic where the general practitioner (GP) prescribes a course of antibiotics to control the infection until she can visit her own local GP. The GP refers Joan to an Ear Nose and Throat (ENT) specialist who prescribes another course of antibiotics. After the course of antibiotics her tonsils become inflamed again causing the specialist to recommend surgical removal of the tonsils while classifying the patient as Non-Urgent (category 3).

Wait times for category 3 public patient awaiting tonsil removal in a public hospital was estimated between 12 and 24 months. Alternatively, Joan has the option of paying around $2000 to have the specialist remove the tonsils in a private hospital within the next four weeks.

Joan began to evaluate her options of risking any side effects of drugs and antibiotics treatment for over a year, or borrowing money for an early operation knowing the private hospital cost and extra billing and balance of the Medicare benefits amounted to an patient out-of-pocket expense (the gap) would amount to approximately $1000.

So, Australia separates those who can pay privately and those who cannot and get STUCK waiting. This really is a good respresentation of my point. This does not happen here. We don't have lists to wait that determine whether or not your condition is a priority.....

Perception is everything... Why does the same surgery cost twice as much in the private sector than in the state run facility. By the same surgeon?

I just can't believe people don't think that Americans have to wait for surgery (if they aren't denied it outright). I also can't believe that people are still posting that I can't choose my doctor. I will say it one more time I GET TO PICK MY DOCTOR AND FIRE HER IF I WANT. It's clear that some people are so closeminded that they can't admit what they are saying isn't the case.

Don, we had the same problems in Canada. Private clinics operate on the lucrative cases, charge a lot more and leave the costly cases for the public system, thus putting a bigger drain on the public system.

Originally posted by kitkat24

The point is to have your tonsils removed is a problem in Australia. It is not here in the US. They would not treat you with antibiotics for a year (so you don't die of sepsis) while you wait on a list because your tonsils are not a priority.

kitkat

First may I respectfully suggest the possibility that members of this BB who live in the UK, Canada, and Australia are honest nurses who know more about their system than a publication?

If anyone IS interested in written reports our union, registered nurses of all political opinions, have cillected more than a quarter million stories like these:

http://www.calnurse.org/cna/patient/

Patient Watch Stories

The following are excerpts from letters received from patients, their families, and Registered Nurses in the US state of California during the 1990s.

A four-year-old girl ran a high fever following a five hour hospital stay for a tonsillectomy (considered an outpatient operation by HMOs). Her mother took the girl to her HMO pediatrician, who didn't take the girl's temperature, didn't examine her throat, and didn't refer the girl back to the surgeon-- a routine procedure for post operative problems. The girl died of a hemmorhage at the surgical site.

"My grandfather survived brain surgery but died three months later, from the effects of malnutrition, dehydration and an infected bedsore. All of this could have been prevented if a registered nurse was at his side. He was a dignified elderly gentleman, a loving husband and the strong center of a family...In the hospital he had become just another dollar sign who was being manipulated to meet the greed of hospital revenue."

My wife entered ----- hospital recently and received very poor service. Every time she called for a registered nurse, she got a "nursing assistant" or "patient care assistant" instead. It took 30 to 45 minutes to actually see a registered nurse.

Our baby died after we were pushed out of the hospital too soon by ------ Health care. The coroner's report said our baby died of meningitis or streptococcus B, and would have lived if we had spent just 6-10 more hours in the hospital. Our child was born with a cleft palate that was not detected. She was then misdiagnosed as developmentally disabled. While we were in the hospital, we rarely saw an RN. When we went home, the baby was not feeding properly. The hospital where she was born was unresponsive and of no help to us. We finally took her to ---- Hospital in -----, where she was found to be dehydrated and had to be put on an IV.

"I provide HIV antibody testing and counseling services. One of the clients I counseled required HIV antibody testing because she had cared for a relative who died of HIV disease and had given the relative several injections, during which she had sustained needle sticks. This client had no previous medical training or experience prior to caring for the ill relative. She told me she was awkward and nervous while giving the injections, and that was why she had sustained the needle sticks."

A 27 year-year-old man from Central California was given a heart transplant, and was discharged from the hospital after only 4 days because his HMO wouldn't pay for additional hospitalization. Nor would the HMO pay for the bandages needed to treat the man's infected surgical wound. The patient died.

.

When a 23-year-old diabetic asked her California HMO why it wouldn't cover the cost of blood sugar testing supplies, the company's chief executive told a newspaper reporter that the company provides all benefits required by the state. He suggested that the patient "try to get a law passed requiring the kind of coverage she wants."

A former HMO medical reviewer is still haunted by decisions she made to deny care to patients. She was quoted in a special report published in U.S. News & World Report: "If there was any way at all to claim that something requested was experimental or nonstandard, we took it. We looked for ways not to cover treatment" she said.

Late last year a three-member arbitration panel awarded over $1 million to the family of a 34 year-year-old schoolteacher who died of breast cancer. A California HMO was the defendant. Testimony given during arbitration hearings showed that the HMO tried to "influence or intimidate" the woman's oncologist and his superior with "argumentative" phone calls. In the opinion of the panel, "(the) HMO's actions, which were designed and intended to interfere with an existing doctor/patient relationship, constitute extreme and outrageous behavior, exceeding all bounds usually tolerated in a civilized society."

Very good post Spacenurse. It should be noted that every country in the world has a different system, both governmental and health care. Countries like Canada or Australia have their way, but America is suppose to be a unique country based upon individual sovereignty. In other words, the individual is suppose to matter. While it has always been true to an extent, over the last few decade, it seems that all businesses in general - and health companies in particular, are far more concerned with $$ and the bottom line than with employees or patient care. And unfortunately, the U.S. government for the last two decades has been supporting rather than discouraging this practice.

I think that socialized medicine may be just fine for other countries - and it is their choice. But such would be totally contrary to the Constitution in America. HMO's are the stepping stone to total socialized medicine in America. That is why the government is so supportive of them. And as has already been established, it is going to be a disaster and nightmare.

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