By Amanda J. Crawford
The Arizona Republic
Jan. 4, 2006
Jessa Johnson was sick for a couple of weeks. She figured it was probably some kind of virus. But without health insurance, the 23-year-old Gilbert resident could not afford to see a doctor and find out.
“I need to be healthy,” Johnson said as she recovered by spending a pleasant afternoon at the Phoenix Zoo with her boyfriend. “But I need money to live.”
Johnson is not alone in her concerns about the cost of health care and the American health care system. The Arizona Republic poll completed in mid-December indicated that 39 percent of registered voters surveyed statewide worry about their ability to afford the health care or prescription drugs they need this year. Many more, 81 percent, believe it is time that the state or federal government step in and create a universal health care system that ensures everyone has access to medical care.
Chris Philbin, 26, of southeast Phoenix, like many of the voters surveyed, is not concerned about his ability to afford health care in the next year because he has health insurance through his job at Lowe’s Home Improvement. But Philbin strongly believes the nation needs to find a way to insure everyone even if it means he would personally have to chip in for it.
“I would gladly give up 10 percent of my paycheck to have free health care like they do in Canada – free prescriptions, everything,” Philbin said as he strolled through the zoo with his fiancĆ©e and their 2-year-old son. Philbin, a registered Republican, said it’s not right that Americans without insurance sometimes have to skip care and could die due to not having access to medical care. “We should take care of them,” he said.
In Arizona, nearly 1 million residents were without health insurance in 2004, according to the Census Bureau. And more than 1 million residents now get their health insurance through the Arizona Health Care Cost Containment System, or AHCCCS, the state Medicaid program that provides free or low-cost health insurance to low-income families at a cost to state and federal taxpayers of more than $5 billion per year.
With health care costs soaring and many employers scaling back job-based benefits, health insurance has, by many accounts, become one of the most significant issues facing Arizona and the nation as a whole. When the Arizona Legislature reconvenes next week, health care is anticipated to be the subject of several bills.
Rep. Phil Lopes, a Tucson Democrat, for example, plans to introduce a bill to create a universal health care system in Arizona. The legislation would lay out a plan to provide public insurance coverage for all residents who have been here longer than a year, funded by employers, Medicaid, Medicare and other payers in the current system. Modeled after a plan that has been pursued in New Mexico for more than a decade, the legislation would lay out the basic structure of the program, which would keep doctors, hospitals and other providers private, Lopes said. And it would establish a commission to iron out the details and implement the program.
“I think it is government’s role to step in when the private market fails to provide basic necessities that our residents need,” Lopes said. He said that many health insurance innovations that relied on the private market over the past few decades, including the move toward managed care, have failed to keep costs in check in the long run or expand coverage. Lopes, House minority leader, acknowledges that such an unusual and ambitious plan could be hard sell to Arizona’s conservative Legislature.
Still, he said: “I am committed to doing what I can. And I am convinced this is the best way to go.” Noting the support for universal coverage in The Republic’s poll, he added, “How often is it that 81 percent of people say that we need to do something?”
On the other side of the aisle, Rep. Russell Pearce, a Mesa Republican who is chairman of the House Appropriations Committee, said he wants to curb the amount of money that the state spends on health care. He wants to eliminate some public programs that provide low-cost insurance for the working poor, such as KidsCare Parents, and make all AHCCCS recipients pay significant co-pays to get care, which he said would put accountability in the system. He also wants to lower the income limits so that fewer people qualify for AHCCCS. That would require a ballot referendum to overturn Proposition 204, the measure passed by voters in 2000 to open AHCCCS to all residents below the poverty line.
“(Medicaid) is a runaway train and absolutely cannot be sustained the way it is going. It is a drain on taxpayers,” Pearce said, noting that the program eats away at the state’s General Fund. “I was raised poor, and we never took a penny from government. . . . This is not about being coldhearted but recognizing that moms and dads that work hard are paying for someone else’s health care. These bleeding-heart socialists have no respect for taxpayers.”
But Pearce may have trouble finding voter support for his plans. Only 8 percent of poll respondents agreed that the state should save money by lowering the income limits of AHCCCS and excluding more families from coverage.
On the contrary, nearly half (46 percent) of respondents said they thought that the state should spend more money on AHCCCS, raise the income limits and open up the program to more families without insurance. One-third of respondents thought it should be left as it is.
Carnelina Vaccaro, 62, of Tucson, has good benefits herself because she is a federal government retiree. But she says that she knows many people aren’t so lucky, and she worries about people who are uninsured or have trouble affording health care.
“There are so many people who need assistance,” Vaccaro said while having lunch at La Cocina restaurant in downtown Tucson. She said she thinks the United States needs to “take a look at the kind of coverage they have in Europe.”
In the meantime, she thinks expanding existing programs like AHCCCS to more low-income workers could help, especially because the state is anticipating a budget surplus this year.
“I think it should be expanded,” she said. “There are too many people who don’t have health care. Help out Arizona families.”
