Wednesday, August 8, 2001
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Wednesday, August 8, 2001 |
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Uninsured still face problems I share Dr. Rückl's concern about the 42.5 million Americans without health insurance and thus with inadequate access to health care services. However, the "Patient's Bill of Rights" legislation will do nothing to expand coverage to uninsured Americans. It addresses access to additional specialists, liability for health plans and employers, and a few other issues of concern to the approximately 160 million Americans with employer-sponsored, usually managed health care coverage. Of course, health plan liability and lack of access to a preferred specialist are of little concern to those without any health insurance. Even supporters of the legislation in its present form acknowledge that it will increase the cost of coverage, although there is little agreement about the extent of that increase. And, since health care purchases are voluntary in this country, anything that increases price will necessarily decrease the extent of coverage. Therefore, the legislation is likely to increase rather than decrease the number of uninsured. Health Insurance Association of America (www.hiaa.org) in conjunction with the American Academy of Actuaries estimates that the Dingle/Norwood version of the Patient's Bill of Rights [would have] caused an additional 6.5 million Americans and almost 200 thousand Georgians to lose their health coverage. Even if this estimate proves to be high, there is no evidence that the legislation will expand coverage. The only ways to expand coverage are to reduce the cost (in a voluntary system) or make coverage mandatory for some or all of the population. The benefits of each of these approaches are good topics for future debate. The legislation Dr. Rückl supports may be legitimate to address problems in the managed care industry. However, it is likely that the public attention given to the problems with managed care reflects the size of the constituency concerned with those issues and the potential for votes from that constituency, especially when compared to the power and size of the uninsured constituency. I also agree with Dr. Rückl that it is shameful that many children remain uninsured in our country. The March Current Population Survey (CPS) data published by the Census Bureau is the most common source for information about the uninsured. Nationwide 10.7 million and in Georgia approximately 279,000 children are without any health insurance. Fortunately, well over half of these children are eligible for the Children's Health Insurance Program (PeachCare in Georgia). If your children are uninsured and your annual family income is less than $35,000 for a family of three or $42,000 for a family of four, your children are probably eligible for this comprehensive coverage. There is no cost for this coverage for children up to 5 years of age. The monthly premium for children 6 to 18 is $7.50 and two or more children can be enrolled for $15 per month. This premium does not reflect the full cost of coverage. The remainder is paid out of state and federal funds. You can find more information about this program at www.peachcare.org or call 1-877-GA-PEACH. Given the heat of the debate in the past few issues of this newspaper, anyone who jumps into the fray risks being called anything from a "Bible belching fascist" to a "communist" by those on either side. However, it is worth the risk if even one child in Fayette County gains access to coverage through this information. Patricia G. Ketsche, Ph.D. Assistant Professor, Health Administration Georgia State University
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