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Searching For The Shovel In Texas: The Young Are Digging Themselves Out Of The Healthcare Crisis

Aug 17, 2007
Perhaps it shouldn't feel like suffering a personal wound when learning about the state of health care coverage in Dallas, Houston and throughout Texas, or anywhere else in this country - but it does. In fact, for most of us, it really does.

It tends to shatter the ideals we were taught as American children - that everyone is equal, no one suffers unwillingly, and working hard will get you somewhere - when we learn that approximately 18,000 uninsured individuals ages 25 to 64 suffer "excess" deaths annually.

Health insurance premiums have increased by 15% per year over the past five years, more than triple that of the inflation rate, 2.5% . Medical costs are through the roof, quality of it often below sewage level, and an average citizen might feel that he/she has to overwork him or herself into a coronary just to get it.

One third of firms did not even offer health insurance coverage to their employees in 2004 , most of them citing high premium costs. It does not seem a coincidence then, that one-third of uninsured adults did not fill at least one prescription, and/or receive at least one recommended test, due to cost .

In Texas alone, 9,787 deaths in 2002 were attributed to lung and bronchus cancers, arguably the most preventable cancers with proper screening and smoking cessation programs. Perhaps it shouldn't be personal, but when young adults consider the reality of an impending personal health crisis, or their children not receiving the absolute highest quality of care available because of poor or non-existent coverage - and perhaps not even knowing the difference - yes, it tends to chafe. This is a biologically-based life, after all, and those lungs and hearts keep us in the game.

In order to address the problem, it is important to attempt to understand why this is happening. It's not just that premiums are increasing; it's that the economy is shifting. Texas and the rest of the United States is no longer manufacturing-based; it's service-based, and small businesses which cannot afford large, corporate healthcare packages - in turn, cannot offer coverage to their employees. Three-fifths of all workers provide their labor to small businesses, and less than two-thirds of these companies offer health benefits .

Even if they could, their employees might not be able to afford group health insurance; employee spending for health care coverage increased 143% between 2000 and 2005 . To many, it's simply unrealistic. So what we have, without exaggeration, is a health care crisis -lack of or inadequate coverage, which leads to lack of or inadequate health care.

But let's not be entirely gloom and doom about this, shall we? After all, whiners with no solutions are a bit like well diggers in the desert with no shovels. We can analyze the situation for days at a time ("yep, that's a lot of sand") but then, of course, we die of dehydration. There are, in fact, solutions, and perfectly logical options at that.

(1) Introduce revamped, affordable health insurance plans addressing the uninsured's actual needs.

Sounds obvious, right? Well, evidently not. Approximately 58% of uninsured adults in 2004 reported having changed or lost their jobs in 2003 , while only 7% of the unemployed could afford COBRA insurance (an extension of former employers' health plans), at an average of $700 per month, per family. While it's also easy to blame insurance companies for high premiums, they, too, are absorbing higher hospital and clinic bills, the consequences of malpractice suits, and a surge of baby boomers growing older. It may be more productive, for now, for the public to demand new plans that are reflective of today's needs, than to try to tear apart the industry as a whole. This is not at all unrealistic, and pushing for such changes could make a big difference.

Many of us, for instance, need affordable interim or basic coverage while we build our careers, and would gladly pay a reasonable premium for a reasonable policy. We need these policies to cover the millions slipping through the cracks: students, entry-level workers, those in between jobs, on leave of absence, or those just starting out in their professions (and who may not be able to afford buying into group health insurance). Similarly-crafted policies need to also address the growing number of workers in contract, freelance, self-employed, and full-time positions, in which benefits are self-provided through individual health insurance plans.

These plans need to be accessible and affordable to the increasingly independent, young individual with middle and lower-middle class budget constraints. Obviously, the market is there.

(2) Purchase "portable" individual health insurance plans.

Considering the majority of the uninsured in 2004 had changed or
lost their jobs, and considering that there are many who stay in their current
positions simply for the health insurance coverage, individual health insurance may make more sense, as they are "portable," that is, they can follow a worker from job to job. With individual health insurance policies, workers are no longer tied to a position just for the sake of health insurance, nor do they need to worry about the exorbitant cost of COBRA in the case of job loss. Many companies, in fact, are willing to offer an allotment to cover all of their employees for the purpose of purchasing individual health insurance. In this way, insured individuals can relax, knowing they will still have coverage if they switch, or lose their jobs, even with pre-existing conditions.

(3) Increase coverage of preventative care.

According to the American Cancer Society, an individual's risk of getting, or dying from, cancer greatly decreases with prevention, early detection, and proper screening programs. Smoking alone causes 30% of all cancer deaths, and lifestyle changes can also dramatically reduce cancer risks . Yet, those lacking insurance receive less preventative care, are diagnosed at more advanced stages of disease, and tend to have higher mortality rates than the insured . Even many of the insured do not have access to these programs. Obviously, standardizing affordable packages that offer preventative services would not only reduce incidences of disease, but also dramatically reduce treatment costs. Even basic plans need to include an allotment for preventative care, in addition to some version of basic dental and eye coverage - like annual exams.

So, yes, my sense of good citizenship has been a bit wounded by the current state
of healthcare coverage. We used to worry about the retirees and children who could not provide their own health coverage; now we worry about almost everyone. Most of us are hard-working, helpful members of society who would pay a reasonable premium if we had access to it. But, if this system is to be revamped, citizens must speak louder for the necessary changes. We may be in the desert of healthcare, after all, but we are not without shovels.
About the Author
Pat Carpenter writes for Precedent Insurance Company. Precedent puts a new spin on health insurance. Learn more at Precedent.com
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