By Jennifer L. Boen
Fort Wayne News-Sentinel
Thu, Mar. 08, 2007
The stories told by the uninsured and underinsured reverberate in the mind of emergency room doctor Robert Stone, who works in Bloomington: People delay care because they don’t have health insurance or skip or stop taking medications because they can’t afford them. A less serious medical problem becomes catastrophic because of the delays or lack of medication.
Nationally, 46.6 million people are uninsured, according to 2005 U.S. census data; 860,000 of those are Hoosiers. Many health-care providers, consumers and their families are calling for a change and will address the problem at a public forum on Monday titled “Citizen’s Hearing on Healthcare for All.”
Stone, who co-founded Hoosiers for a Commonsense Health Plan, is keynote speaker at the event. The organization is promoting the health-care reform agenda laid out by Physicians for a National Health Program. The groups seek universal, comprehensive coverage for everyone through a single-payer health insurance system that is publicly financed but privately delivered. Rather than employer-based health insurance, all people would participate in a plan that would give access to all — similar to the way Medicare works for people 65 and older.
“This is not socialized medicine,” with doctors and hospitals government-owned, Stone said.
A Medicare-like system for all would require raising taxes, but those taxes would take the price of premiums, which continue to escalate for employers and employees, he said.
A 2003 study by Harvard Medical School and the Canadian Institute for Health Information found 31 percent of U.S. health-care dollars are spent on administration and overhead, compared to 17 percent in Canada.
“Medicare runs about 3 percent overhead,” compared to insurance companies’ 20 percent to 30 percent overhead, Stone said.
Park Center President/CEO Paul Wilson calls U.S. health care a “non-system.” “The confusion and fragmentation is so expensive and so wasteful. It’s a real tragedy we spend so much money on health care, and we leave so many people out.
“We see huge numbers of people who don’t have any insurance or don’t have mental-health coverage,” Wilson said about the community mental health center. “What we’ve developed in this country is all kinds of stopgap measures. People in their most vulnerable time running across town to the (township) trustee’s office, or to a church for help.”
The ASK clinic is one of several free clinics in Allen County.
“The numbers here just keep going up,” said ASK director Eve Bratton. “It used to be the generational poor we saw. Then it became people laid off from their jobs. Now we’re seeing people still in college and people among the middle class. We’re seeing sicker people. It’s not uncommon for me to see blood pressures of 260/120 (normal pressure is 120/80), because people can’t take their medicine, and they delay care.
“The health-care system is absolutely collapsing, and people are falling through the safety net,” Bratton said.
Dr. Matthew Farber is an ophthalmologist and surgeon with Allen County Retinal Surgeons. “In talking with physicians, some say things such as, Ć¢ā¬ĖI don’t know if people are going to be happy waiting for care as in Canada,’ which has a single-payer system.
But the reality, Farber says, is even though U.S. health-care spending was nearly $2 trillion in 2004 and is expected to reach $4 trillion by 2015, “In the end, it’s not as if people live longer here,” compared to Canada.
Americans want new medicines and life-saving technologies, yet also want to preserve the free-market system and competition. For example, three medicines are used to treat glaucoma, Farber said. All are costly, and the companies who make them “don’t compete by trying to get a bigger (sales) share by lowering the price. Sure we want the pharmaceutical industry to come up with new therapies, but in the end, there can be only so much spent on pharmaceuticals.”
For too long, the health-care system has not promoted or reimbursed doctors for preventive medicine. Now a growing epidemic of diabetes, chronic lung disease, high blood pressure and other conditions, along with the largest segment of the population entering their senior years, is overwhelming the system.
“There aren’t any easy answers,” Farber said, “but the current system isn’t working. We have to get Congress to be willing to stand up and try and improve things.”
The economic ramifications of health-care costs are far-reaching, Stone said. Big industries wanting to compete internationally find themselves at a disadvantage because of American health insurance costs. People running small businesses cannot afford to pay premiums. Wilson says he has found 7,200 health insurance plans exist in the United States. “It’s bizarre, craziness. I suppose we could have a more wasteful system — but I don’t know how.”
