07 May 2009

What does 1 in 7 really mean?

We've all heard the statistic: 1 in 7 Americans is not covered by health insurance. Then comes the inevitable follow up: and millions more are underinsured . . . The harder question, as we try to tackle this problem is, who are the uninsured? The Christian Science Monitor's patchwork nation blog divides America demographically into 11 community types by county. This week they're exploring who's being hit by the healthcare crisis the most?

Comprehensive healthcare and insurance reform has been tried countless times before, and the same pitfalls descend each time: one side says Tort Reform will solve the crisis the other says that only single payer health care will get anything done. In reality both sides are naïve. Medical malpractice is less than 1% of American health care spending and limiting the right to recover violates one of the basic tenants of Tort law, the right to be made whole, a tenant which is a basic foundation of civil justice long before America came to be. On the other hand single payer isn't going to happen, America hates socialism. Getting burnt to the ground in World War II changed Europe forever; market fundamentalism had no choice but to get out of the way when state-centered rebuilding (much of which funded by American dollars) brought Europe back to life. America has never faced such an identity crisis.

Nevertheless, healthcare reform isn't discretionary. We already have universal healthcare. We should recognize that we have the least efficient universal healthcare plan in the world, and maybe we can put some of that American ingenuity to work to change that. What am I talking about? Emergency Rooms; if you are experiencing a medical emergency, they can't turn you away. This means medical indigents don't get basic care when healthcare is cheap, but wait until a cough becomes pneumonia. And when they can't pay for expensive inpatient care, who pays for it? You and I already do. Sometimes its Medicaid, sometimes the Hospital itself absorbs the cost. Either way, the cost already comes back to you, in taxes or insurance premiums.