The Uninsured

[Apparition]

I'm completely uninformed about the healtcare system so I was looking into buying a book called Uninsured in America and I came across a review (below). What do you guys think about his opinion? http://www.amazon.com/exec/obidos/tg/detail/-/0520244427/103-7043511-0712659?v=glance

The overall notion that Americans are on a "death spiral" because of the lack of health insurance is totally bogus. Let me elaborate. Let's start by taking the author's number of 40 million uninsured and break it down. Approximately 15 million are probably young individuals who are healthy and lead healthy lives and who don't think they need insurance. Approximately 10 million are probably wealthy individuals who can pay for their own healthcare and medicine. You can probably add to the previous group another 5 million that are self-employed and are not concerned. Approximately 5 million are individuals who just don't care about insurance. As hard as it is to believe, there are people out there that think this way. This leaves approximately 5 million that are probably truly uninsured.

Let's take this down a little bit further. Do you honestly believe that there is NO health care for these individuals? By law, all hospitals are obliged to treat those who come in for any type of health related problem. This is, of course, generally only for emergency type treatments and not for every day regular check-ups. But there are FREE clinics all over the country who provide some type of health assistance to those who are poor.

If you take all of this into consideration, America has the best health care system in the world which is why there are a lot of people who are trying to immigrate to this country. This also happens to be the best country in the world for opportunities, which will naturally include getting some good healthcare.

It's all about YOU and how YOU will improve and provide for yourself. Don't blame others and don't look to leech off the hard work of others who have paid with their sweat and time (and yes sometimes blood) to create a better lifestyle for themselves.

One thing that does pop up is the rising costs of healthcare. Most of this can be debunked by the rise in frivolous lawsuits on the medical industry by trial-shysters (I won't denigrate true lawyers) who only care about that one (or two) big payoff. Look at the high malpractice insurance rates for doctors. It's outrageous. All because of greedy and selfish individuals who don't see the bigger picture.

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[Minion677]

seems like hes just pulling those numbers out of his ***. however, he has a point that 46 million uninsured are not A LOT. there are a lot of people out there who could pay for insurance just prefer not to. the problem with these uninsured is that they often come into ERs and receive free care.

 

[lyn2006]

I'm completely uninformed about the healtcare system so I was looking into buying a book called Uninsured in America and I came across a review (below). What do you guys think about his opinion? http://www.amazon.com/exec/obidos/tg/detail/-/0520244427/103-7043511-0712659?v=glance

The overall notion that Americans are on a "death spiral" because of the lack of health insurance is totally bogus. Let me elaborate. Let's start by taking the author's number of 40 million uninsured and break it down. Approximately 15 million are probably young individuals who are healthy and lead healthy lives and who don't think they need insurance. Approximately 10 million are probably wealthy individuals who can pay for their own healthcare and medicine. You can probably add to the previous group another 5 million that are self-employed and are not concerned. Approximately 5 million are individuals who just don't care about insurance. As hard as it is to believe, there are people out there that think this way. This leaves approximately 5 million that are probably truly uninsured.

Let's take this down a little bit further. Do you honestly believe that there is NO health care for these individuals? By law, all hospitals are obliged to treat those who come in for any type of health related problem. This is, of course, generally only for emergency type treatments and not for every day regular check-ups. But there are FREE clinics all over the country who provide some type of health assistance to those who are poor.

If you take all of this into consideration, America has the best health care system in the world which is why there are a lot of people who are trying to immigrate to this country. This also happens to be the best country in the world for opportunities, which will naturally include getting some good healthcare.

It's all about YOU and how YOU will improve and provide for yourself. Don't blame others and don't look to leech off the hard work of others who have paid with their sweat and time (and yes sometimes blood) to create a better lifestyle for themselves.

One thing that does pop up is the rising costs of healthcare. Most of this can be debunked by the rise in frivolous lawsuits on the medical industry by trial-shysters (I won't denigrate true lawyers) who only care about that one (or two) big payoff. Look at the high malpractice insurance rates for doctors. It's outrageous. All because of greedy and selfish individuals who don't see the bigger picture.

I don't have lots of in-depth knowledge about the healthcare system here, but I wouldn't say this review is entirely accurate. People who can't afford health insurance don't have access to the type of care that people with it have. I am from a small, rural, poor town and know people who have gone to the ER to get treatment without insurance so the hospital pays... but they can't afford follow-up visits, medications, etc.

The reviewer's comment about the self-employed people who don't have health insurance and aren't concerned isn't right either. My parents are self-employed and have to spend ~1/6 of their yearly earnings to provide health insurance for my family. They have many friends who are in this same type of situation. Self-employed people may choose not to have health insurance but it is probably because they can't afford it- not because they aren't concerned.

 

[jamesrd]

What is this 'review' you speak of? All I see is a poorly sourced rant masquerading as fact.

 

[Apparition]

What is this 'review' you speak of? All I see is a poorly sourced rant masquerading as fact.

Well it was "book review" on Amazon, though it doesn't really address a book it attempts to rip apart. I'm just trying to find out more about the actual situation.

 

[medicomel]

you're right; uninsured people have access to medical care via the ER or community clinics, but are left out in the cold once they're treated. this is pretty bad when you assess the need for preventative medicine, rehabilitation/PT, or mental disorders

 

[medicomel]

oh yeah, my dad has been self-employed for many years, but is a two-time cancer survivor. his insurance has shot through the roof, and has become a major concern over the years.

 

[jbrice1639]

first off, yes, that was more a rant than a review. however, there are some valid points (and some pretty dumb points.) the notion that 46 million uninsured is not a HUGE number is, in some ways, true...especially considering that, as the reviewer stated, several of those uninsured people are uninsured by choice, considering it a wasted expense because they are "healthy." I would, however, argue that the estimate of 10 million of those people being wealthy and paying out of pocket sounds a little out there...for the most part, the wealthy are the tightest with their money (possibly the reason they ARE wealthy) and would be very unlikely to "throw away" money on health care that could be paid for by insurance that they could easily afford (or would be provided by an employer/corporation since i'm assuming these wealthy folks have jobs).

while i don't really think this reviewer has any authority to make most/any of these claims, it is interesting to think about the number of unisured people and how they are truly broken down since they immediate image is of the poor and destitute relying on free clinics for basic health care, and this only represents one part of this unisured population...

 

[Shredder]

I'm completely uninformed about the healtcare system so I was looking into buying a book called Uninsured in America and I came across a review (below). What do you guys think about his opinion? http://www.amazon.com/exec/obidos/tg/detail/-/0520244427/103-7043511-0712659?v=glance

The overall notion that Americans are on a "death spiral" because of the lack of health insurance is totally bogus. Let me elaborate. Let's start by taking the author's number of 40 million uninsured and break it down. Approximately 15 million are probably young individuals who are healthy and lead healthy lives and who don't think they need insurance. Approximately 10 million are probably wealthy individuals who can pay for their own healthcare and medicine. You can probably add to the previous group another 5 million that are self-employed and are not concerned. Approximately 5 million are individuals who just don't care about insurance. As hard as it is to believe, there are people out there that think this way. This leaves approximately 5 million that are probably truly uninsured.

Let's take this down a little bit further. Do you honestly believe that there is NO health care for these individuals? By law, all hospitals are obliged to treat those who come in for any type of health related problem. This is, of course, generally only for emergency type treatments and not for every day regular check-ups. But there are FREE clinics all over the country who provide some type of health assistance to those who are poor.

If you take all of this into consideration, America has the best health care system in the world which is why there are a lot of people who are trying to immigrate to this country. This also happens to be the best country in the world for opportunities, which will naturally include getting some good healthcare.

It's all about YOU and how YOU will improve and provide for yourself. Don't blame others and don't look to leech off the hard work of others who have paid with their sweat and time (and yes sometimes blood) to create a better lifestyle for themselves.

One thing that does pop up is the rising costs of healthcare. Most of this can be debunked by the rise in frivolous lawsuits on the medical industry by trial-shysters (I won't denigrate true lawyers) who only care about that one (or two) big payoff. Look at the high malpractice insurance rates for doctors. It's outrageous. All because of greedy and selfish individuals who don't see the bigger picture.

excellent review, where are other people like this. the whole uninsured problem is blown up as a social issue

 

[Suppuration]

His opinion is garbage. The Census Bureau published data from its 2003 survey in August 2004 demonstrating that 45 million people were uninsured, and the number had increased by 1.4 million from the previous year. In addition, 82 million people under 65 had spent a portion of 2002-2003 without insurance.

Also published in 2004 (separately) by the Henry J. Kaiser Family Foundation and Center on Budget and Policy Priorities was data showing that the percentage of workers with employer-based health insurance dropped from 70% in 1987 to 61% in 2004. The most frequently cited reasons were unavailability of coverage and excessive cost. A third of American firms did not offer coverage, and two thirds of the uninsured worked for firms that did not offer coverage.

Speaking of excessive cost, from 2000-2004 inflation has averaged 2.5% annually while health insurance premiums have increased 11.4% annually. Hewitt Associates LLC published data (also in 2004) showing that during this same period the average increase in employee contribution to his/her premiums has risen 126%. The percentage of workers who can afford COBRA is a whopping 7.

That last figure I can attest to personally. COBRA is one of the biggest financial reamings you'll ever lay eyes on.

So let's sum up, shall we?

Health insurance premiums: skyrocketing.
Number of people with employer coverage: shrinking.
Situation: sucking.

 

[Suppuration]

By law, all hospitals are obliged to treat those who come in for any type of health related problem. This is, of course, generally only for emergency type treatments and not for every day regular check-ups. But there are FREE clinics all over the country who provide some type of health assistance to those who are poor.

Actually, by law hospitals are only obliged to stabilize those in immediate need of critical care. Afterwards the patient punting begins.

If we look at the Institute of Medicine's "Hidden Costs, Values Lost: Uninsurance in America" (The National Academies Press, June 2003), their data shows that the uninsured are 30-50% more likely to be hospitalized for an "avoidable condition" (one which could have been prevented by earlier diagnosis/treatment), with the average bill coming in at $3,300.

While we spend about $100 billion a year providing care for the uninsured, they use the fewest healthcare resources. Providing coverage under the existing healthcare delivery system would tack on an estimated $34 to $69 billion a year, but this same report also estimated that the "dividends" in terms of improved health and developmental outcomes would run $65-$130 billion a year.

The brief version: http://www.iom.edu/Object.File/Master/12/327/0.pdf

 

[DrMike24]

His opinion is garbage.

Health insurance premiums: skyrocketing.
Number of people with employer coverage: shrinking.
Situation: sucking.

I second that. I think that the review is pretty exaggerated. 10 million that are wealthy and choose not to have it? Health insurance costs are rising rapidly, especially in the last few years. Some employers do not offer health insurance anymore due to these costs, or if they do, they are too expensive for the employee. I volunteer in a free clinic, and we get lots of people who used to have health insurance and cant afford it anymore, or their employer does not provide it. There are lots of those people out there. And how can anyone say that 46 million people w/o health insurance is not a huge number? Anybody not having some type of basic health care is significant. I'm talking basic health care, nothing special. We need to have some sort of basic health care/preventive care, where we treat simple conflictions/diseases so they do not turn into something huge that must be taken care of at an ER where the cost skyrockets, when the initial cost could have been small. Suppuration is right... its sucking. We are spending so much on healthcare, and its not necessarily better.

 

[MiesVanDerMom]

The OP presents absolutely no facts and his/her conclusions aren't even logical. PP Supparation presents actual research and I would welcome informed debate of this kind from other sides. SDN would benefit from more research and less ranting. I thought we were supposed to be scientists around here.

 

[Suppuration]

where are other people like this.

I'm betting they're sitting around on their parents' health insurance plans, never having spent a day working two dead end jobs to make rent while feeling their teeth slowly rot. Just a guess.

 

[willthatsall]

The OP presents absolutely no facts and his/her conclusions aren't even logical. PP Supparation presents actual research and I would welcome informed debate of this kind from other sides. SDN would benefit from more research and less ranting. I thought we were supposed to be scientists around here.

Just a point of information: the OP did not create that argument, he found it on an Amazon book review and wanted to know what other people thought.

 

[SeventhSon]

lol. He makes tons of unqualified statements:

If you take all of this into consideration, America has the best health care system in the world which is why there are a lot of people who are trying to immigrate to this country. This also happens to be the best country in the world for opportunities, which will naturally include getting some good healthcare.

One thing that does pop up is the rising costs of healthcare. Most of this can be debunked by the rise in frivolous lawsuits on the medical industry by trial-shysters (I won't denigrate true lawyers) who only care about that one (or two) big payoff.

This guy makes tons of explanations for phenomena while casually assuming that his explanation is the only one that makes sense, which is not at all the case and is not defended in any way. Who cares what some random clown posting on amazon.com thinks? From reading his review all i can conclude is that, based on the content of his argument and his method of argumentation, he watches "The O'Reilly Factor" too much.

 

[jonsir]

bump

 

[lyn2006]

I was just reading the New Yorker yesterday and came across this article, partly about the book Uninsured in America. Thought some people might be interested to see what they have to say, instead of some ranting reviewer...

http://www.newyorker.com/fact/content/articles/050829fa_fact

 

[medicomel]

Excellent article...thanks! I didn't even think about dental care, and how it is intimately related with this problem. Very sad situation.

 

[MedicallyBlond]

46 million is a huge number, and doesn't even take into account the even larger (and growing) number of people who are UNDER-insured (have insurance, but it does not even come close to meeting their needs) or who were uninsured for only part of the year. Some have projected that the number of people who were uninsured for at least part of the year is closer to 70 million.

Simply put, the main reasons why being uninsured is a problem (no matter how young and healthy you are) is that The Institute of Medicine (IOM) found that working-age Americans without health insurance are more likely to: (1) receive too little medical care and receive it too late (2) be sicker and die sooner (3) receive poorer care when they are in the hospital even for acute situations like a car crash.

It is actually MORE expensive for the government and the healthcare system to leave this many people uninsured (costs estimated around $60-80 billion ANNUALLY). The strain on emergency rooms, especially in inner-city hospitals, is enormous.

True, many of the people who are uninsured (also the fastest growing segment) are young, healthy people (early to mid twenties), many of them just out of college, who are no longer covered under their parents' plans.

But, the much more troubling demographic breakdown of the uninsured population looks something like this:

About two-thirds of the uninsured are people living below 200% of the Federal Poverty Level. About 20% of the uninsured are children. Many of these people DO qualify for state/public health insurance (Medicaid or SCHIP for children) but are not enrolled. However, many of these people are just above the cut-offs for Medicaid and SCHIP (150% of the FPL in some states), meaning they just barely don't qualify for public assistance, but most likely still can't afford health insurance unless their employer offers decent plans.

About half of the uninsured come from ethnic minority groups, hispanics being the most vulnerable group.

Most of the uninsured ARE employed, but cannot afford health insurance or choose to forgo insurance to set off other costs. Many are self-employed or work for small-businesses.

So, there is no single way to generalize the uninsured population. To say that 10 million of them are rich people who don't want health insurance is just silly. Rich people don't want to waste their $$$ paying for their surgery in full if they don't have to. They'd much rather buy a new Mercedes. Rich people work for rich companies who can afford great health coverage plans.

This IS a problem. My stats and facts come from my lectures on a course called Introduction to Health Care Policy, taken at the Kennedy School of Government at Harvard.

If you want to educate yourself a bit more on this topic. The websites for Families USA and The Commonwealth Fund have some great info and articles.

 

[DrMike24]

Wow, what a great article. It doesnt really solve anything, but puts things into perspective.

 

[mshheaddoc]

If you are interested in this topic I would suggest more than one book. Honestly most books on healthcare have a slant one way or another. Mostly political. There are a ton of books out there in reference to this topic. I had to read "Mama Might Be Better Off Dead" Laurie Abraham and "Sicker and Poorer: The Consequences of Being Uninsured" - Jack Hadley. Oh and "As Sick as it Gets: A Diagnosis and Treatment" - Rudolph Mueller.

Hmmmm ... here's a list of reading
"Mama Might Be Better Off Dead" Laurie Abraham
"Sicker and Poorer: The Consequences of Being Uninsured" - Jack Hadley.
"As Sick as it Gets: A Diagnosis and Treatment" - Rudolph Mueller.
Second Sickness: Contradictions of Capitalist Health Care - Howard Waitzkin
Dead on Arrival: The politics of Health Care in the 20th Century - Colin Gordon

Those were the main ones used on our section of origins and causes of inadequate health care. Also if You look up those authors they have other books as well.

Some books i didn't sample from but were suggested: Health Care of America: Can our ailing be healed - John Guyman and
Health Care meltdown - Bob Lebow.
Severed trust George D. Lundberg
Bleeding the patient - the conseuences of corp health care - Himmelstein, Woodlander, Hollander.

That's all I can list for now as I have to run. Enjoy