No Health Insurance = No Political Power

Despite Growing Numbers, People Who Lose Coverage Often Struggle Alone

(AP)  If the uninsured were a political lobbying group, they'd have more members than AARP. The National Mall couldn't hold them if they decided to march on Washington.

But going without health insurance is still seen as a personal issue, a misfortune for many and a choice for some. People who lose coverage often struggle alone instead of turning their frustration into political action.

Illegal immigrants rallied in Washington during past immigration debates, but the uninsured linger in the background as Congress struggles with a health care overhaul that seems to have the best odds in years of passing.

That isolation could have profound repercussions.

Lawmakers already face tough choices to come up with the hundreds of billions it would cost to guarantee coverage for all. The lack of a vocal constituency won't help. Congress might decide to cover the uninsured slowly, in stages.

The uninsured "do not provide political benefit for the aid you give them," said Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health. "That's one of the dilemmas in getting all this money. If I'm in Congress, and I help out farmers, they'll help me out politically. But if I help out the uninsured, they are not likely to help members of Congress get re-elected."

The number of uninsured has grown to an estimated 50 million people because of the recession. Even so, advocates in the halls of Congress are rarely the uninsured themselves. The most visible are groups that represent people who have insurance, usually union members and older people. In the last election, only 10 percent of registered voters said they were uninsured.

The grass-roots group Health Care for America Now plans to bring as many as 15,000 people to Washington this year to lobby Congress for guaranteed coverage. Campaign director Richard Kirsch expects most to have health insurance.

"We would never want to organize the uninsured by themselves because Americans see the problem as affordability, and that is the key thing," he said.

Besides, added Kirsch, the uninsured are too busy scrambling to make ends meet. Many are self-employed; others are holding two or three part-time jobs. "They may not have a lot of time to be activists," he said.

Vicki and Lyle White of Summerfield, Fla., know about such predicaments. They lost their health insurance because Lyle had to retire early after a heart attack left him unable to do his job as a custodian at Disney World. Vicki, 60, sells real estate. Her income has plunged due to the housing collapse.

"We didn't realize that after he had the heart attack no one would want to insure him," said Vicki. The one bright spot is that Lyle, 64, has qualified for Medicare disability benefits and expects to be getting his card in July.

But for now, the Whites have to pay out of pocket for Lyle's visits to the cardiologist and his medications. The bills came to about $5,000 last year. That put a strain on their limited budget because they are still making payments on their house and car.

"I never thought when we got to this age that we would be in such a mess," said Vicki, who has been married to Lyle for 43 years. "We didn't think we would have a heart attack and it would change our life forever."

While her own health is "pretty good," Vicki said she suffers chronic sinus infections and hasn't had a checkup since 2007. "I have just learned to live with it," she said.

The Whites' example shows how the lack of guaranteed health care access undermines middle-class families and puts them at risk, but that many of the uninsured eventually do find coverage. Lyle White has qualified for Medicare, even if the couple must still find a plan for Vicki.

Research shows that nearly half of those who lose coverage find other health insurance in four months or less. That may be another reason the uninsured have not organized an advocacy group. At least until this recession, many have been able to fix the situation themselves.

"The uninsured are a moving target," said Cathy Schoen, a vice president of the Commonwealth Fund, a research group that studies the problems of health care costs and coverage.

But even if gaps in coverage are only temporary, they can be dangerous. "Whenever you are uninsured, you are at risk," said Schoen. "People don't plan very well when they are going to get sick or injured."

Indeed, the Institute of Medicine, which provides scientific advice to the government, has found that a lack of health insurance increases the chances of bad outcomes for people with a range of common ailments, from diabetes and high blood pressure to cancer and stroke. Uninsured patients don't get needed follow-up care, skip taking prescription medicines and put off seeking help when they develop new symptoms.

Such evidence strengthens the case for getting everybody covered right away, Schoen said. But she acknowledges the politics may get tough. "It certainly has been a concern out of our history that unorganized voices aren't heard," she said.

[Yes_ABWH_Fan]

ubrew12, the entire Medical/Legal field has similar high charges far above actual costs, from OEM medical supply and pharmaceutical subcontractors, clear up through holding companies of insurers, government subsidies, and trumped up liability costs. All in this "supply chain" need overhauled on a "Cost+" basis. If each step would be true-cost + 5% (profit) analyzed, we'd easily find that what's supplied is not at all worth the costs being charged. THAT, and getting rid of non-value-add steps, is what the Obama administration needs to do to get coverage for all, and bring down medical costs. Government subsidies are a large contributor to the overcharge mindset & feeding-greeding frenzy.

[mgkonyx]

Conservatives can squawk about socialism until they turn blue in the face; however Congress should just be honest and say that there is no universal healthcare because the health insurance industry's lobby is so powerful. Congresspersons are afraid to lose those fat donations to their political war chests.

The truth remains that even those of us who are insured cannot be assured that a catastrophic illness will not begger us. Until the present housing debacle, the primary cause of foreclosures in the US was people who became ill and couldn't afford their medical bills. As more and more people struggle to keep their homes and their jobs, more and more Americans will sacrifice their health care insurance to keep food on the table and a roof over their heads. These struggles are a condemnation of the present state of health care.

[Solarrays247]

The "Gospel of Wealth" again rears its ugly head saying "I have mine, you get your own" We pay for the health care of every politician elected and very good health care at that. If we can afford it for them, why not for everyone?
Posted by debinok1 at 3:08 PM : Apr 13, 2009

Imagine the screaming in the halls of Congress if we should tell our representatives and senators that we can no longer afford to pay the premiums for their health care?

[debinok1]

The "Gospel of Wealth" again rears its ugly head saying "I have mine, you get your own" We pay for the health care of every politician elected and very good health care at that. If we can afford it for them, why not for everyone?

[tincup356]

What needs to be addressed is the cost of the actual health care,,,,,,,ant trip to the doctor for even minor needs such as colds or flu,,,,your looking at several hundred dollars,,,from there it skyrockets,,,,,I try to avoid going to the doctor unless it is absolutely needed,,,one small trip makes you think you have just paid that doctors Mercedes payment and half his mortgage for that month.Funy how the take an oath to save lives,,,,,IF you can afford it.

[ddaryl1]

FULL health care is the RIGHJT of any Ameircan citizen. if we cannot provide helath care for al lcitizens then Ameirca is and has been a failure.

Why don't we all ha ve dependable health care = it costs to much

Why don't we have mass transit in every major city and its suburbs = it costs too much

Why don't we manufacure goods in the USA enough to employ all citizens = it costs too much

this list goes on.

basically capitalism costs too much... what is good for humanity is not good for capitalism. Capitalism is not the future of humanity, and it will collapse upon itself. There is no scenario in which capitalism survives. It may get stretched out for a few more decades, but eventually the piper is going to call

[ubrew12]

By 2005, fully 40 percent of all corporate profits in the US came from the financial services sector - a group of people who didn't produce anything at all of value, nothing edible or usable, nothing that would survive into future generations.

What they produced was debt, the ability to claim 'profits' today and leave the 'losses' for someone else to own up to tomorrow.