From January to August of 2008, over 2 million homeowners received foreclosure notices. What health insurance coverage do they have? How many of them have children? How many of them are pregnant women? If you are uninsured in my state, Colorado, the average expense for prenatal care and delivery is $15,000. The amount increases for any complications or for cesarean delivery. In this economy, how many people can afford to pay that amount?

America is a nation that takes care of the world. We fight disease and malnutrition in other countries. So, I wondered how we ranked with the rest of the world when it comes to providing for our own citizens.

According to the 2007/2008 Human Development Report, the United States ranked 36th in commitment to health, which includes resources, access, and services. How do our pregnant women fare? The same report reveals that the U.S. shares ranking 39th with three other countries for maternal mortality. That means that 38 other countries have less maternal deaths than us. I previously wrote that when there is a lack of medical care for the mother and child, death rates increase. The Human Development Report supports this conclusion.

We are the United States of America. Why are we in 36th and 39th place in this report? Why are we not leading in less maternal deaths? Why are we not united in the endeavor of health care for all?

America’s Uninsured Statistics

The Census Bureau last reported in 2007 that over 47 million people lack health insurance. The new statistic is an increase from 2005 Census numbers showing America’s uninsured at 44.8 million. It correlates the U.S population now lacking health insurance at 15.8%, which is the highest level since 1998.

The Census also shows that there are 19.3% of American children in poverty whom lack insurance. Hispanics are the race with the highest rate of no insurance with over 15.3 million uninsured in 2006. Blacks with no insurance increased to 20.5% from 19%, while the rate of whites without insurance statistically remained the same at 10.8%. Asians are the only ones whom statistics show improved with the rate falling to 15.5% from 17.2%.

Low-income households obviously have the highest uninsured rates as many of the low-wage jobs don’t offer insurance. However, 1.3 million more workers (full and part-time) also went uninsured according to the previous 2005 Census records.

Workers are going without or declining coverage for several reasons, according to the Employee Benefit Research Institute, a non-partisan group in Washington. D.C. Insurance premiums, which are rising faster than wages, are causing workers to struggle with the cost, so they’re declining coverage. Employers are also offering fewer options.

A typical family plan offered by employers is approximately $11,480.00. Consequently, fewer workers are enrolling, even when employers do provide insurance. The most surprising–and scary–statistic that the Census Bureau provided is that the uninsured rate rose fastest among households with annual incomes above $75,000, going from 7.7% in 2005 to 8.5%.

Health insurance deductions come out of your check before taxes, which makes it more valuable per dollar than the same amount in taxable pay. Generally, health insurance companies pay lower prices to doctors and hospitals than you would pay on your own.

The Cost of America’s Uninsured

• America spends nearly $100 billion per year to provide health services for uninsured residents. Most often treated are preventable diseases or diseases that physicians could treat more efficiently with earlier diagnosis.1Hospitals donate approximately $34 billion worth of uncompensated care a year.1
• Private and public payers provide another $37 billion for health services for the uninsured.1
• Those who lack coverage pay out-of-pocket $26 billion.1
• Those who lack coverage are 30 to 50 percent more likely to be hospitalized for an avoidable condition. The average cost of an avoidable hospital stay is estimated around $3,300.1
• The uninsured increasingly rely on the emergency department, which has serious economic implications. The cost of treating patients is higher in the emergency department than in other outpatient clinics and medical practices.2
• A new study found that 29 percent of people who had health insurance were “underinsured”. Their coverage is so meager that medical care is often postponed or avoided because of costs.3
• Nearly 50 percent overall, and 43 percent of people WITH health coverage, said they were “somewhat” to “completely” unprepared to cope with a costly medical emergency over the coming year.3

The effects of being one of the millions without affordable health coverage are clearly severe. Many uninsured individuals postpone needed medical care, which creates increased mortality and billions of dollars lost in productivity, besides the increased expenses to the health care system. Plus, the American citizens who have managed to retain coverage have an increased sense of vulnerability to the possible loss of the health insurance coverage.

There are no easy answers to this epidemic problem. Some have the opinion that every American should have health care coverage, and that participation should be mandatory.4 Others promote that only America’s children be required to have mandatory health care.5

Yet others proclaim that health care should be available to all and not limited by where one works or how much one makes. They endorse that families be in charge of their health care dollars and have more control over care.6

There seems to be no obvious right or wrong answer to the question of how to better insure the American population. However, the U.S.’s past actions of doing nothing about the problem has proven detrimental. The solution at this point might be that it’s just better to do something than nothing at all.

1. Institute of Medicine. Hidden Costs, Values Lost: Uninsurance in America. The National Academies Press. 17 June 2003 http://www.iom.edu/Report.asp?id=12313
2. Institute of Medicine. Care Without Coverage – Too Little, Too Late. The National Academies Press, 2002.
3. Consumer Reports. Are You Really Covered? September 2007.
4. Clinton’s Mandatory Health Care Insurance plans. http://www.cnn.com/2007/POLITICS/09/17/health.care/index.html
5. Obama’08 Healthcare. http://www.barackobama.com/issues/healthcare/
6. http://www.johnmccain.com/Informing/Issues/19ba2f1c-c03f-4ac2-8cd5-5cf2edb527cf.htm

America’s Lack of Health Insurance

Here are more statistics about those lacking Insurance and its effects.

Did You Know…

• …that the most recent government data available shows that 16% of the United States—almost 47 million Americans—were without health insurance in 2005?¹
• …the number of people lacking health insurance has increased by almost 9 million people since 2000, rising by 2.2 million between 2005 and 2006?¹
• …80% of the uninsured are native or naturalized citizens?²
• …in 2006 the increase in people was focused among working age adults? The percentage of working adults, ages 18-64, without health coverage climbed from 19.7% in 2005 to 20.2% in 2006.¹
• …nearly 1.3 million full-time workers lost their health insurance coverage in 2006?⁷
• …that in 2006 or 2007 one-third of the population below the age of 65–about 90 million people — spent a portion of either 2006 or 2007 without any health insurance?³
• …over 8 in 10 uninsured people come from working families? 70% are from families with one or more full-time workers; 11 %are from families with part-time workers?²
• …that those with employment-based health insurance (workers and dependents) has dropped from 70 percent in 1987 to 59 percent in 2006? This is the lowest level of employment-based insurance coverage in more than a decade.^{4, 5}
• …nearly 15 percent of employees had no employer-sponsored health coverage available to them (either through their own job or through a family member) in 2005?⁶
• …37.7 million workers were uninsured in 2006, because not all businesses offer health benefits? Also, not all workers qualify for coverage and many employees cannot afford their share of the health insurance premium even when coverage is offered and available.¹
• …that uninsured children in 2006 numbered 8.7 million (11.7 percent of all children in the U.S.)?1
• …that the number of uninsured children increased by nearly 610,000 in 2006, making it the second year that the number of uninsured children increased?¹
• …young adults, ages 18 to 24 years old, remained the least likely of any age group to have health insurance? 29.3% of this group did not have health insurance in 2005?¹
• …that the number of Hispanics without insurance increased to 34.1% in 2006, or 15.3 million people?¹
• …that people residing in households with the income of $50,000 or more was nearly 40 percent of the uninsured population?¹
• …that even when coverage is offered by their employers, an increasing number of middle-income families cannot afford health insurance payments?¹

1. DeNavas-Walt, C.B. Proctor, and J. Smith. Income, Poverty, and Health Insurance Coverage in the United States: 2006. U.S. Census Bureau., August 2007. http://www.census.gov/prod/2007pubs/p60-233.pdf
2. The Henry J. Kaiser Family Foundation. The Uninsured: A Primer, Key Facts About Americans without Health Insurance. October 2006. http://www.kff.org/uninsured/
3. Families USA. Wrong Direction: One Out of Three Americans are Uninsured. September 2007. http://familiesusa.org/assets/pdfs/wrong-direction.pdf
4. The Henry J. Kaiser Family Foundation. Employee Health Benefits: 2007 Annual Survey. 11 September 2006. http://www.kff.org/insurance/7672/index.cfm
5. Center on Budget and Policy Priorities. The Number of Uninsured Americans is at an All-Time High. 29 August 2006 http://www.cbpp.org/8-29-06health.pdf6.
6. Clemens-Cope, Lisa, et al, Changes in Employees’ Health Insurance Coverage, 2001-2005, Kaiser Commission on Medicaid and the Uninsured, October 2006.
7. Health Insurance Coverage, http://www.nchc.org/facts/coverage.shtml.

True Health Coverage Facts

The surmounting statistics of people without health insurance is alarming and has become one of the primary focuses during this election year. A recent Kaiser Commission Report discusses why in the U.S. lack health insurance and the detrimental affects on our society.

• 47 million Americans without health insurance (9 million are children) are in working families.

Eight in ten of Americans without Health insurance live in families with at least one worker. Uninsured workers typically are not offered employer sponsored insurance and cannot access it through a family member.

• More than eight in ten Americans without health insurance are in low or moderate-income families, with at least one worker.

About two-thirds of the uninsured Americans have incomes below 200% of the federal poverty level, which is roughly about $41,000 for a family of four in 2006. Approximately one in ten of those without health insurance are above 400% of poverty. Since the average annual cost of employer-sponsored family coverage in 2007 was $12,106. Only if they receive sizable employer contributions can the uninsured with lower incomes can only afford coverage.

• Most low- and moderate-income adults without Health Insurance are not eligible for Medicaid.

Medicaid coverage is primarily offered to low-income children, parents, pregnant women, people with disabilities, and the elderly. Regardless of income, most non-disabled adults under age 65 are not eligible for Medicaid unless they have dependent children.

About one-quarter of uninsured adults go without needed care due to cost each year. The uninsured are less likely to receive preventive care and services for major health conditions than those with insurance. Lack of timely care causes more than 20,000 uninsured adults to die prematurely each year.

• Medical bills are a burden for the uninsured and frequently leave them with debt.

The uninsured pay for more than one-third of their care out-of-pocket and are often charged higher amounts for their care than the insured pay. These bills often translate into excessive levels of medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.

Key Details:

• People without health insurance pay 35% of their care out-of-pocket.
• Children are more likely to be insured than non-elderly adults because of their eligibility to public coverage from Medicaid and SCHIP (the State Children’s Health Insurance Program).
• Uninsured people are typically billed for any care they receive, often paying higher charges than the insured.
• 23% of the uninsured adults report that they have borrowed money to pay their medical bills, a rate that is more than twice as high as the insured.
• These debts become burdensome for the uninsured since the average uninsured household has no net assets.
• People lacking health insurance often see their debts accumulate and their credit ratings compromised without sufficient income or assets to pay their medical bills
• Compared to 21% of insured adults, more than 37% of uninsured adults have been contacted by a collection agency about their about their medical debts in the past five years.
• Those without health insurance suffer from negative health consequences due to their lack of consistent necessary medical care. Approximately 20,000 adults without health care coverage die prematurely each year,