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Insurance Crisis

Discriminating against the sick and elderly

By PAM BERNS
When a black man was denied a seat and a cup of coffee at the local diner in the 1950s, we all knew what it was--discrimination--and we knew it was wrong. Our government stood behind those who were denied their civil rights. Today, however, our government supports the discriminatory practices by numerous corporations. Today, it's not the owners of local diners who are denying service to Americans, and it's not only discrimination based on race. Today, discrimination is against the poor and the sick. And a lot of people in Washington think this is just good business.

No individual or corporation should interfere with the life, liberty or the pursuit of happiness of our citizens. We're not talking about hitting the glass ceiling or failing to be served coffee at the diner counter. We're talking about life and death.

Most of us would recognize the discriminatory practice of offering  coffee to the black man for a price of $10,000 a cup. But many people are effectively being denied health insurance because of the prohibitively high rates that insurance companies are charging them--if they're accepted at all. Only the very wealthy can afford these rates.

In this case, hard-working poor and those who are middle class or have had the misfortune of having allergies, diabetes, asthma or acne are being denied service by the health insurance industry.

And, as reported in Cure, if you have the misfortune of having had cancer, you will not be able to buy individual health insurance except in New York and New Jersey. According to Karen Politz, project director at the Georgetown University Institute for Health Care Research and Policy, "If you are within five years, [the top health insurance firms] just won't sell to you," even it you are considered cancer-free. "Once you reach five years, only some companies will consider selling you a policy. Others won't issue a policy until you have been cancer-free 10 or 15 years." And yet, cancer strikes one out of every three people.

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Jonathan Cohn's new release, Sick: The Untold Story of America's Health Care Crisis--And the People Who Pay the Price, tells the story of how we got into the precarious place where 47 million Americans are without health insurance and where we go from here.

Cohn traces the concept and the fascinating history of health insurance and HMOs. He writes about real life stories of regular people who were let down by our health system. Some of these stories echo others: middle class workers who have jobs and health insurance until they're laid off or their companies default on their benefits, or sickness or disabilities force them to leave jobs that had offered insurance. When they try to buy their own health insurance, they are turned down. The price these people paid was life and the pursuit of happiness.

Sick describes Chicago's St. Elizabeth's Hospital as being typical of American hospitals started by faith-based groups. Founded by a German order, it was serving 40 percent of its patients as charity cases in 1897. Cohn tells of what has happened to a number of Chicago hospitals that were non-profit until their donations dried up as their patrons moved to the suburbs. Cohn writes about Michael Reese Hospital on Chicago's South Side, which converted to a profit entity and then was sold to Humana, which then sold it to Columbia/HCA. Cohn also writes about our city's Lutheran and Evangelical Hospitals, which merged in the 1990s and formed Advocate Health Care, one of the largest hospital networks in the United States. He says that Chicago's Catholic hospitals also began to merge into Resurrection. Rather than hospitals being headed by a nun or minister, professional hospital administrators began to run the hospitals. With all the mergers, groups of hospitals were finally able to successfully negotiate with the insurance companies for better reimbursement rates.

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Hospitals in some cities have increasingly been unable to keep up with treating the skyrocketing number of sick patients without health insurance. In cities like Boston and Atlanta, even a person with health insurance who has a heart attack can be at great risk because the ambulance cannot find a nearby hospital with facilities or availability to treat the patient. Emergency rooms in some cities are simply too full of people seeking treatment for non-emergencies because they need to be treated for serious chronic ailments and have no physician. Cohn describes emergency rooms in Los Angeles with a 66-hour wait, and after being admitted to the hospital, some patients are waiting up to 7 days for a bed. How many people like the ones profiled by Cohn die and suffer unnecessarily? Where do we go from here?

George Bush has praised Health Savings Accounts (HSAs) as the answer. HSAs "are available to people who forgo traditional health benefits and opt, instead, to buy high-deductible insurance that covers only catastrophic expenses," writes Cohn. Not only will HSA consumers most likely put off checkups for chronic conditions, HSAs will have the "pernicious" effect of narrowing the pools of people with more serious health conditions as young, healthy people opt out of the large insurance pools, and "the overall burden of financing health care in the country will shift from the healthy to the sick," writes Cohn.

And HSAs do not address the millions of sick patients denied health insurance or the exorbitant rates charged to those who have had the misfortune of past health problems. The United States should not endorse a health insurance system where the sicker you are, the harder you have to work to stay alive. We need security.

In stark contrast to Bush's 2003 State of the Union speech, where he said, "Problems will not be solved with a nationalized health care system that dictates coverage and rations care," Cohn's solution to the dire health crisis is one of optimism and security: universal health insurance similar to France's system. He writes, "It is possible to do all this for everybody, not just an economically or medically privileged few, in a way we can all find affordable."

Published: May 28, 2007
Issue: Summer 2007 Urban Living

Comments

"Cure"
What is "cure" as noted in the article by Pam Bern? jbecker17@earthlink.net
JoAnn Becker, Jun-03-2007
"Cure" Information
Cure is the name of a magazine for cancer patients, survivors and caregivers. They can be reached at 3500 Maple Ave., Suite 750, Callasa TX 75219. To subscribe visit www.curetoday.com.
Pam Berns, Jun-05-2007