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Guest Commentary July 13, 2002
The Crisis of the Uninsured
The Honorable Charles Rangel
Today America faces a crisis that affects more than 40 million people. This is the number of Americans who are currently without health insurance. Additionally, if we account for the number of people who have insurance but are underinsured, then we arrive at a far more disturbing number. Let's face it. The health care system as we know it is falling far short of its goals.
During a time in which the economy is lagging and health care prices are rising, companies are having to make cutbacks and consumers are having to choose between health coverage and meeting their daily needs. For example, when faced with the choice of paying for a vehicle needed to get to work each day or for expensive health care coverage, millions opt to forgo their health in favor of a much needed paycheck.
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On the other hand as business profits have been decreasing substantially, employers can no longer afford to offer employees lower prices for health insurance. This means that businesses feel the pressure to pass the health care bill on to employees. Since 74% of the U.S. population is covered by private health care insurers, mostly provided by the workplace, this means that most consumers will feel the squeeze of skyrocketing health care premiums.
Why is it so important that we insure all Americans? Lack of health care drastically affects access to proper medical treatment. Since the uninsured are less likely to have regular health care treatment, their level of health is lower on average compared to the insured. People without health insurance tend to allow medical problems to go untreated because they cannot afford doctor visits or recommended medications. More that a third of uninsured adults say they have not filled a drug prescription in the past year due to cost. More than a third did not get a medical test or treatment that had been recommended.
The uninsured do not normally have access to preventative care, which may mean the difference between catching cancer in its early, treatable stages as opposed to a stage in which the cancer is incurable. For example, uninsured women diagnosed with breast cancer are more likely to die from it because they have a much greater chance of being diagnosed with late-stage cancer.
We must address the problem of the uninsured because this health care crisis also affects the decisions of health care providers. Under the current system of competitive managed care, physicians are often forced to choose between giving proper treatment to the uninsured (risking uncompensated care) and not providing adequate treatment (risking the life of the patient). To alleviate this problem, the uninsured are often required to pay for services "up front." This requirement causes uninsured individuals to either wait until they can afford treatment or charge their medical bills to credit cards, potentially building debt that may take years to pay.
Another problem evident in the current health care system is that minorities disproportionately represent the uninsured. Roughly a third of Hispanic and Native Americans are uninsured. About 20% of African Americans and Asians are uninsured compared to 11% of whites.
The poor and near-poor are also much more likely to be without health insurance. If it were not for Medicaid, many more of the poor would be uninsured and would have reduced access to medical care. Yet Medicaid does not cover a significant number of the near-poor. Since nearly 60% of the uninsured at or below the poverty level have at least one worker in the family, many near-poor individuals earn too much to qualify for Medicaid. It is evident that we must work to narrow the gaps of health care coverage disparities along racial and socioeconomic lines.
We can no longer sit back and hope that the problems within the current health care system correct themselves. It is imperative that we rise together in a bipartisan effort to address the health care crisis of the uninsured. We must find a solution before this crisis grows to affect additional millions of Americans.
Charles Rangel, a Democrat, represents the 15th Congressional District of New York in the U.S. House of Representatives. The above commentary has been adapted from a speech Rep. Rangel delivered on the floor of the House, July 11, 2002. To contact him, Click Here.
The above column has been distributed by PoliticsOL.com.
