Doctors Describe Human Toll, Especially for Children and Minorities As Employers Drop Coverage and Incremental Reforms Fail
SEPTEMBER 30, 2003, CHICAGO, IL�The number of Americans without health insurance jumped sharply for the second year in a row, up 2.4 million to 43.6 million,15.2% of the population, according to a report released by the U.S. Census Bureau today. Members of Physicians for a National Health Program offered graphic descriptions of the human toll behind these numbers.
This month in Dyersburg, Tennessee, a 26 year old patient was turned down for coverage by the state�s TennCare program after losing his job and workplace-based insurance. Denied access to mental health care, his psychiatric condition worsened and he took a room full of college students hostage, severely injuring two classmates before being killed by police.
�In a small town, everyone is affected by a tragedy like this,� said retired Tennessee pediatrician Dr. Jim Hudson. �This is criminal, that in the wealthiest country in the world, we don�t assure access to basic life-saving care.�
Minorities have been particularly hard hit. One-in-three Latinos are uninsured (32.4%, including 25% of Latinos who were born in the US), as are one-in-five blacks (20.2%). �Latinos suffer staggering health consequences from being uninsured,� said Dr. Olveen Carrasquillo, a leading academic researcher on the uninsured at Columbia University in New York. �Diabetes is 2-3 times more common in Latinos, which can cause blindness, kidney failure, and leg amputation if untreated. Asthma is 3-5 times more common in Latino kids.�
The proportion of all children who are uninsured held steady at 11.6%. 8.5 million children remain uninsured, a graphic illustration of the failure of incremental reforms, such as the Children�s Health Insurance Program which is supposed to sharply reduce the number of uninsured children.
Texas residents are the worst insured in the nation, with one in four (24.1%) lacking any health coverage. �Over 50% of my young patients are uninsured,� said Houston pediatrician Dr. Ana Malinow, who easily recalls a half-dozen patients with terrible complications from being uninsured, including a two year old with a chronic ear infection and perforated eardrum whose family can�t afford the $1,000 deposit required for surgery. �In Texas, a simple ear infection in a child may not be properly treated for years, causing preventable hearing loss, speech deficits, and lifelong learning problems. The �leave no child behind� state is frighteningly callous when it comes to children�s health, and it�s no better for the adults I see in my volunteer work at a local shelter. The health care system in Texas is failing everybody.�
In Chicago, Dr. Claudia Fegan (who is also incoming president of Physicians for a National Health Program) runs the outpatient clinics for one of the city�s busiest safety-net hospitals. �People who thought they�d never be here find themselves begging for care. Yesterday a woman who had recently suffered a stroke sat crying outside my office in a wheelchair. Another hospital had discharged her and brought her here via ambulance. They told her she had to come here to receive her medications and follow-up care. We took care of her but we do not have any more available appointments for new patients until 2004. Where are people supposed to go?�
In Massachusetts, Dr. Steffie Woolhandler is in charge of quality reviews for the Department of Medicine at Cambridge Hospital. �I review the cases of people who should not have died to find out what went wrong. Too often the problem was that the patient didn�t have insurance and delayed care,� said Dr. Woolhandler. She cited the case of an uninsured health care professional who died of a treatable cancer before her biopsy results had even come back from the laboratory. �She correctly diagnosed herself with a liver problem based on her symptoms. She thought if she quit drinking she�d improve on her own. If she�d come in sooner, we could have treated the lymphoma we found in her liver.�
�The incremental reforms of the past two decades have failed,� said Dr. Carrasquillo. �The economic boom of the 1990�s barely dented the number of uninsured. The last three years of recession has exposed the cracks in our unsound health system. The number of people without insurance is skyrocketing, while benefits for people who still have coverage are shrinking rapidly. This should be a wake-up call to all political and health care leaders, including Latino leaders, that the time for bold solutions is now.�
Physicians for a National Health Program has more than 11,000 members across the country which advocates national health insurance for the U.S. PNHP members take care of the uninsured in every state and medical specialty. To interview a PNHP physician about the problems of lacking health insurance and options for reform, contact Ida Hellander at (312) 782-6006 or
pnhp@aol.com .