Uninsured could use some help

By Patricia Hunt
Published: October 17, 2008

Thousands of bankers are already out of work or soon will be. The rest of us suspect they will land on their feet, but I am wondering what they will do about health insurance. They can keep their old insurance for eighteen months if they can pay for it, but then they join the Main Street entrepreneurs who have never had health insurance. I wonder if this threat of joining the uninsured will have any effect on how they regard health care problems in the United States. For many this is an issue they never imagined having to face.

I can’t even count the number of young people I know who are uninsured. Some work for employers who allow them to purchase it through their workplace, but the cost is so high and the salaries so low they can’t afford it. Some own their own small businesses, demonstrating initiative and responsibility, but we don’t reward such self-starters by making it possible for them to get health insurance. A lot of people my age are paying for insurance for their grown children long after the college tuition payments are behind them. Parents are a little embarrassed that they have to do this and speak of it only to their closest friends and in hushed tones.

Maybe rising unemployment among people in a higher income group will give the problem more urgency that it has had when it was mainly lower paid people who were affected.

We do have “socialized medicine” in the United States. It is the VA. The Veterans Administration owns and operates the health-care delivery system, and no one is excluded because they are high risk.

Medicare is considered “social insurance.” The government regulates the risk pools, and individuals pay premiums based on their ability to pay, not on the risk that they will need care. The sickest patients are not kept out of the pool. This involves a mix of private for-profit and not-for-profit institutions.

Then there is the private and commercial system. Employers have to use this system if they want to provide their employees with insurance. About 40 percent of them are declining to do this. Individuals have to use this system directly if they can’t get insurance through their employer and indirectly if they can. People who are high risk for needing care but can’t get insurance at work may find that they cannot purchase coverage at any price, certainly not at a price they can afford.

Finally, there are the uninsured whom the system will care for if they show up at the ER with a heart attack, but they will be billed even if everyone knows they can never pay.

What I hear from veterans is enormous relief that they can get care. I don’t hear them complaining about socialized medicine. What I hear from young people with no insurance is that they are paying for the VA and Medicare through their taxes, but they are getting no benefits. This seems unfair to them. Young people, however, are not organized. They have no AARP. There is no lobbyist in Washington working the halls of power on their behalf.

Are they going to find allies in laid-off Wachovia employees and former Lehman Brothers bankers? I don’t know, but they and legions of other uninsured working people could use some friends in high places.

Patricia Hunt, of Staunton, is chaplain at Mary Baldwin College.