P o rtla n d COb&eruer
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O pinion
|uly 22. 2009
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Underinsurance: Health Care Costs Not Covered
have.” But w hat is it that we
have?
F o r g ro w in g n u m b e rs o f
A m ericans, ou r health in su r­
ance is com pletely inadequate.
U nfortunately, we don't leam
this until we actually get sick.
by L eonard R odberg
Only when a seri­
U n d e r in s u r a n c e -
ous illness or in ­
the failure o f insurance
jury hits us do we
p la n s to p r o te c t us
find our plans re­
from the cost of needed
ally tested. O nly
medical care - is a grow­
th e n do w e d is ­
ing p ro b lem for m il­
cover that co-pay-
lions o f m iddle- and
m e n t s ,
low er-incom e A m eri­
deductibles, exclu­
sions, and denials
cans.
As the national debate over leave us struggling to pay for
reform ing our costly and ineffi­ our needed medical care.
cient health care system heats
In a study of health insurance
up, recen t studies show that claim s just published in the re­
deficiencies in our private in­ spected policy journal Health
su rance system afflict m any A ffairs, researchers report that
more than the m illions who are between 2003 and 2007 average
uninsured.
out-of-pocket expenses paid by
Yes, it's true that the majority ad u lts w ith e m p lo y e r-sp o n ­
o f A m ericans report they are sored insurance grew by more
satisfied w ith their insurance than a third, to $729 per person
plans, and so politicians prom ­ each year. One in 10 adults faced
ise “ you can keep w hat you out-of-pocket costs that aver-
Insurance
plans that
can ruin you
JJortbnb (Obstruer
aged $3,364. This spending that
insurance didn't cover includes
deductibles (which the patient
m u st pay b e fo re in s u ra n c e
starts paying anything) and co­
paym ents (the p atien t’s share
o f the remaining bill).
T he stu d y 's au th o rs a ttrib ­
uted the increase in co sts to
the overall rise in h ealth care
co sts, along w ith a declin e in
th e c o v e r a g e p r o v id e d by
e m p lo y e r - s p o n s o r e d in s u r ­
ance. In fact, the research ers
co n clu d ed that “ in the U nited
States, if you are sick and earn
a m o d e s t in c o m e , y o u are
p robably u n d erin su red - even
if you have em p lo y er-b ased
c o v e ra g e .”
In an o th er study ju s t p u b ­
lished in the A m erican Journal
o f M edicine, researchers from
Harvard found that in 2007 ill­
ness and medical bills contrib­
uted to nearly tw o-thirds o f all
personal bankruptcies. This is
a 50 percent increase from the
num ber o f sim ilar bankruptcies
found in 2001.
T he m ajority o f m edically
bankrupt families w ere middle
class and ow ned their homes.
M ost su rp risin g , m o re th an
three-quarters o f them were in­
sured at the start o f their illness.
T h ese in su red in d iv id u als
and families were unable to pay
out-of-pocket expenses that av­
eraged $17,749. Severe illness
caused many to lose their jobs,
w hich in turn caused them to
way we pay for health care is
not protecting us from heavy
financial burdens, nor is it as­
su rin g us a c c e ss to n e e d e d
medical care. In spite o f this, the
health reform plans currently
being considered in Congress
w ould require that we purchase
the very health insurance that
is failing us. They do nothing
The health reform plans
currently being considered in
Congress would require that we
purchase the very health
insurance that is failing us.
lose their coverage. The authors
conclude that "the U.S. health
care financing system is broken,
and not only for the poor and
uninsured. M iddle-class fam i­
lies frequently collapse under
the strain o f a health care sys­
te m th a t tr e a ts p h y s ic a l
w ounds, but often inflicts fis­
cal ones.”
As this research reveals, the
have com prehensive coverage
o f the care we need. We would
also save hundreds o f billions
o f dollars in w asteful adm inis­
trative spending an d contain
c o sts g o in g in to th e fu tu re.
Such a plan, as embodied in Rep.
John C o n y ers' U .S. N ational
H ealth C are A ct (H R. 676),
would create a secure financ­
ing m echanism , elim inate the
burden o f out-of-pocket spend­
ing, and protect those o f us who
become ill from financial ruin.
As Rose Ann D eM oro, ex ­
ecutive director o f the C alifor­
nia N u rses A sso c ia tio n , has
said, "The trouble for most fami­
lies is not the lack o f insurance,
it's the insurance they already
have.” Unless we change how
the c o u n try p ay s fo r h ea lth
care, we w on't have the reform
we really need.
to reduce the incidence o f un­
d e rin s u r a n c e ; in fa c t, th e y
spread it. They leave health in­
Leonard Rodberg is profes­
surance ju st the way it is now
and would require even more sor and chair o f Urban Studies
at Queens College, City Uni­
people to buy it.
A dvocates o f a single-payer versity o f New York, and re­
national health program point search director o f the N.Y.
out that there is an alternative. Metro Chapter o f Physicians
With a public insurance pro­ fo r a National Health Pro­
gram like M edicare, we could gram.
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Affordability Key to Real Reform
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D is t r ib u t io n M a n a g e r : M ark W a shington
C r e a t iv e D ir e c t o r : P aul N e u fe ld t
E d it o r - I n -C h ie f , P u b lis h e r :
E d it o k
Health care
based on
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History is unfolding before
o u r ey es as C o n g re ss o v e r­
hauls our health care system so
that, at long last, it covers all
Americans. Maybe.
W h ile th e r e 's a g o o d
chance that C o n g ress w ill e n ­
act som e type o f h ealth care
reform this year, all will be for
n a u g h t i f th e n e w s y s te m
leaves the cost o f care out o f
reach for m any A m ericans. If
a f f o r d a b i l i t y is n o t a d ­
eq u ately ad d ressed , the p ro g ­
n o sis fo r the n atio n w ill be
poor.
There's no great medical mys­
tery as to why millions of Ameri­
cans today lack health cover­
age. They can't afford it.
To address the problem o f
a f f o rd a b ility , C o n g r e s s is
rightly exploring a system that
would base the cost o f health
care on people's ability to pay.
Creating a sliding-scale subsidy
to help low er-incom e A m eri­
cans afford the cost o f health
insurance is essential.
Good investment
in the future
J udge M athis
In recent months, the federal
g o v e rn m e n t h a s b a ile d o ut
banks, auto companies and, to a
THE
SPINACOLUMN
An ongoing series oi questions and answers about Americas natural healing profession
Dt. Billy R. Flowers
Part 30. Genuine Benefits of Chiropractic Help
/
"V
C a n a ch iro p racto r
really help my problems?
\ : You have no doubt heard
how chiropractors helped
a friend's headaches, neck pain,
neck stiffness, back pain or fa­
tigue?
But, it is perfectly normal for
you to wonder whether a chi­
ropractor can really your par­
ticular problems. Your head­
aches. Your neck pain and/or
stiffness. Your back pain or
other symptoms. Problems you
may have had for some time.
The truth is, doctors o f chi­
i
ropractic are extremely success­
ful at eliminating many symp­
toms. Often more quickly and ef­
fe c tiv e ly than o th e r h ealin g
methods.
But, your doctor of chiroprac­
tic can do so much more for you
than ju st treating sym ptom s.
Your chiropractor is concerned
w ith m aking sure your entire
body is functioning properly
For low-income families, Con­
gress should set the scale at a
low enough level so they can
still meet other basic needs from
their m odest paychecks.
A nd for m o d e ra te-in c o m e
fam ilies, the cost o f health care
should also be m uch low er than
it is today.
To get there, Congress m ust
There's no great medical
mystery as to why millions o f
Americans today lack health
coverage. They can't afford it.
at today's prices is sim ply out
o f reach.
The key question in im ple­
m enting a sliding scale is how
to c a lib r a te it. H ow m u c h
should fam ilies at different in­
com e levels be expected to pay
for prem ium s and other costs
o f care?
If moderate- and low-income
fam ilies are asked to pay more
than they can afford, the reform
effort will fail. We'll be back at
square one, w ith m illio n s o f
A m ericans uninsured and the
econom y still ham pered by a
costly health care system.
ad d ress the co st o f m o nthly
premiums. Right now, for a fam­
ily o f four earning $77,000 with­
out em ploym ent-based health
care, the typical health care pre­
m ium in the private insurance
market costs over $ 12,600 a year
- about 16 percent o f their in­
com e. From a practical stand­
point, that's unaffordable.
A re a so n a b le a m o u n t fo r
such a fam ily to spend on pre­
m ium s is no more than about 8
percent o f their incom e. That's
the level C ongress should set
for middle-income families.
Securing reasonably priced
insurance, however, is only half
the cure. H ealth reform legisla­
tion m ust also limit deductibles
and co-p ay m en ts, w hich can
deter people from getting the
care they need.
A nd health plans m ust pro­
vide a basic level o f com prehen­
sive co v erag e to en su re true
access. Too often people with
inadequate coverage find them ­
selves facing exorbitant hospi­
tal b ills o r ev en b an k ru p tc y
w hen they contract an illness
or condition that their insurance
doesn't cover.
Just as when you buy a car
you know it com es with an en­
gine, fo u r w heels and safety
belts, A m ericans need to know
that their health plans come with
all the basics. T hat's som ething
that real health care reform must
ensure.
M aking health care truly af­
fordable for all may not be po­
litically easy, but failure to do
so w ould be disastrous. Should
C ongress fail to seize this his­
toric opportunity to enact real
reform , the cost o f health care
will continue to debilitate the
health and finances o f m illions
o f fam ilies and our economy.
Janet Bauer is a policy ana­
lyst with the Oregon Center for
Public Policy.
A Helping Hand for College Students
by
www.emeraldforestherbarium.net
503-249-0047
Bob.em eraldforest@ integra.net
A sliding scale recognizes the
great disparities o f income. E x­
cept for the wealthiest o f house­
holds, A m erican fam ilies are
finding it increasingly difficult
to afford health care. For some,
p ay in g fo r h e a lth in su ran c e
means not saving for retirement
or for their kids' college educa­
tion. And for others, health care
Therefore, your chiropractor
goes beyond treating your im­
m ediate sym ptom s to m ake
sure your body is still function­
ing efficiently. That is the only
w ay tru e h e a lth can be
achieved.
But we aren't the only ones
who have said it. Chiropractic
has been accepted by the ulti­
mate authority; you the people.
Flowers' Chiropractic Office
2124 N E. Hancock Street. Portland Oregon97212
Phone: (5 0 3 ) 2 8 7 *5 5 0 4
lesser extent, families
and individuals via pro­
grams built into its eco­
nom ic stim ulus pack­
age. College students
are now in need o f a
helping hand. And the
govern m en t needs to
step up.
O rg an izatio n s that provide
p riv a te c o lle g e sc h o la rsh ip
have cut back on the m oney
they give to students, thanks
in part to the econom ic dow n-
made things difficult
for num erous indus­
tries, now is not the
tim e for scholarship
cutbacks.
D u rin g an e c o ­
n o m ic d o w n tu rn ,
Am ericans should be
encouraged to return
to school to obtain training, in­
crease their skills or to develop
n ew o n e s. T h is w ay, w h en
things im prove - and they al­
ways do - these individuals will
r Even in an economic crisis it is
important to invest in the future.
tum . Funding sources have ei­
ther been reduced or completely
elim inated, to the detrim ent o f
those w anting to further their
education.
These cuts, com bined with a
difficult econom ic clim ate that
m akes it even harder for fam i­
lies to afford college tuition, are
dashing the college dreams o f
num erous students across the
country, m ost o f whom com e
from w orking and middle class
families.
Even though the economy has
p o te n tia lly h e lp g ro w th ese
sectors in the future.
T h e fe d e ra l g o v e rn m e n t
should either expand the eco­
nomic stimulus package to in­
clude funds for college scholar­
ships or create a new funding
source specifically for this pur­
pose.
A dditionally, federal grants
to students need to be further
ex te n d e d an d p ro g ra m s d e ­
signed to eliminate student loan
debt in exchange for w ork - i.e.
teaching for a year, w orking in
new industries in city ’s hit by
urban blight - need to be re­
searched and im plem ented.
Som e have argued that the
current adm inistration is on a
spending frenzy an d w ill a t­
tem pt to block the allocation of
additional funds for college stu­
dents. However, even in an eco­
nomic crisis it is im portant to
invest in the future. A nd there
is nothing more important to the
c o n tin u e d g ro w th o f th is
c o u n try 's ec o n o m y th an its
workforce.
be better prepared for the job
market. The quality o f w orkers
available to employers will have
improved and companies will be
m o tiv a te d to r e f ra in fro m
outsourcing key jobs.
The financial coffers o f the
foundations and other organi­
zations that offer scholarships
are drained. So the governm ent
Judge Greg Mathis is vice
m ust step in. G iven the assis­
tance that has been extended president o f Rainbow PUSH
to other industries, it is not too and a board member o f the
m uch to ask that the g overn­ Southern Christian Leadership
ment help the workers w ho may Conference.