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U.S. health care system in crisis

October 17, 2003 | Pages 6 and 7

NICOLE COLSON looks at the deepening crisis in the U.S. health care system.

NICK MIGHT need to go to the emergency room this month--again. But if he does, he doesn't know how he'll be able to pay for it. At age 25, Nick was diagnosed with neurofibromatosis--a genetic disorder that causes tumors to grow anywhere on or inside his body--in November 2002.

The disorder caused him to miss so many days of work that he lost his job--and his health benefits. But as a single, childless adult, he doesn't qualify for government assistance under the government's Medicare or Medicaid program.

According to Families USA--a nonprofit advocacy group that keeps a database of hundreds of health care horror stories like his--Nick tries to work at least one day a week. But he doesn't know how long he'll be able to keep it up with his illness.

He's now $20,000 in debt from multiple trips to the emergency room, and he was forced to change his telephone number--because of the number of debt collectors calling. Yet because he has gone without regular medical care, Nick's condition is getting worse.

He has lost 50 pounds in the past two months and has blackouts that last for up to six hours at a time. Nick told Families USA that he is "losing hope of getting anything done."

Nick is just one of the 43.6 million people in the U.S. who live without health insurance, according to the U.S. Census Bureau. Literally thousands more lose their insurance each day, as good-paying jobs with benefits continue to disappear.

Plus companies that do provide insurance are increasingly shifting the cost onto workers, and cutting back on the benefits that they do pay for--leaving another 50 million Americans with inadequate insurance, according to supporters of health care reform.

The ranks of the uninsured are growing fast. According to the government, another 2.4 million Americans lost their insurance last year--bringing the total number to more than one in every seven people in the U.S.

It was the largest jump in the number of uninsured in a decade. Actually, the 2002 increase in the uninsured would have been at least twice as large--except for the fact that Medicaid, the public health program for the poor, and the State Children's Health Insurance Program for low-income children picked up the slack. Together, the programs added a total of 4 million people last year.

But because of huge state and federal budget deficits, these "safety net" programs are facing more and more cutbacks. With every cut, more and more people end up falling through the system--left without any health care at all.

One consequence of the growing numbers of people who lose insurance--or have poor coverage--is that the sick delay seeking treatment until health problems become health emergencies. But when emergencies do arise, there may be nowhere left to go--since the same budget ax that's chopping low-income health programs is also falling on public hospitals that are supposed to treat all patients, regardless of insurance coverage.

A typical case is Harbor-UCLA Medical Center in Los Angeles, which serves mainly uninsured patients. The hospital has dropped from 2,600 inpatient beds in 1995 to 1,800 today because of budget cuts and rising costs.

"The county intends to close more beds if the court system will allow it," Robert Hockberger, the chief of emergency medicine at the facility, told Knight-Ridder news. Hockberger said that as medical bills for uninsured families accumulate, he sees children leaving school to work--and support sick loved ones.

"One by one, they drop out to get jobs to pay for food, clothing and medical care, as mama and grandpa, who don't have insurance or regular medical care, get sick," Hockberger said. "It creates a vicious cycle, and their attempts at the American dream are thwarted."

Secretary of Health and Human Services Tommy Thompson told reporters that the recent census numbers show "the nation must do more" to help the uninsured. But the real solution to the crisis--a single-payer national health care system--won't be mentioned by the Bush gang, or by Democrats, for that matter.

Instead, the best "solution" that Thompson and his bosses in the White House can come up with is for Congress to provide tax credits for the purchase of private insurance. It's a paltry measure that will do next to nothing to fix the problem. And it means more health care horror stories to come.

Horror stories like the one that played out last month, in Dyersburg, Tenn., where Harold Kilpatrick Jr., a 26-year-old man suffering from schizophrenia, tried to get treatment for his mental illness from a counseling service. Harold was told that he would need health insurance, but he had lost his job at FedEx, and his health care coverage along with it.

When he applied to TennCare, the state's low-income medical program, he was denied--repeatedly. Harold's schizophrenia worsened, and last month, he took a room full of college students hostage--injuring two people before he was shot to death by police.

"In a small town, everyone is affected by a tragedy like this," retired Tennessee pediatrician Dr. Jim Hudson told Physicians for a National Health Program. "This is criminal, that in the wealthiest country in the world, we don't assure access to basic life-saving care."

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