March 15, 2006


Researchers have estimated that as many as 18,000 Americans die prematurely each year due to lack of quality health care. For a good look into this situation, check out the book Uninsured in America: Life and Death in the Land of Opportunity by Susan Starr Sered and Rushika Fernandopulle. Despite the apparent wonkiness of a book on health care, it’s actually a page turner, with hard data combined with profiles of uninsured people across the country. (It would have been cooler if there were goats in it though.)

While there is a tendency today to blame lack of health care (and poverty) on individual choices, the authors argue that “The inability of a large portion of the U.S. population to access health care services in a systematic and medically competent manner is a consequence of social and economic developments that predate and underpin individual life histories.”

Instead of following the path of most industrialized nations in providing universal health care—which presidents Franklin Roosevelt and Harry Truman supported—health care in the United States was often linked to employment. That worked pretty well for a while, but globalization and the switch to a low wage service economy has weakened or severed the link for millions of Americans, including retirees who were promised care for life.

Despite the delusions of the true believers in the cult of the market god, health care is more like a public good, such as public education or fire protection, than a commodity like iceberg lettuce or even alfalfa cubes for goats. (And remember, the same people who are now pushing Health Savings Accounts are the ones who thought starting the war in Iraq was a good idea: see Goat Rope archives).

The authors of Uninsured in America say that the only approach to the problem is “to make the provision of basic, comprehensive health care for all Americans a public rather than a private responsibility.” Far from a radical idea, this is acknowledging a reality. In West Virginia, for example, the vast majority of those with health insurance—over 70 percent--get it from some public program, whether it is Medicaid, Medicare, CHIP, or the Public Employees Insurance Agency.

There is some local good news. The legislature passed HB 4021, which expands CHIP coverage to children in families up to 300 percent of the poverty level, provides pilot primary health care programs, and allows insurance companies to see bare bones policies. The bill also created a panel to explore ways of achieving universal coverage here. These are positive incremental steps, but as a nation we are still not heading in the right direction.


No comments: