10-28-05, 8:23 am

America's health care system – or rather lack of a system – has created a state of emergency for the country. With 46 million people without coverage and up to 100 million without adequate coverage, this emergency costs lives, financial stability, and threatens to unravel our social fabric.

Unfortunately this is a crisis ignored by the big media and one which we can expect the Bush administration and Republicans to continue to ignore.

A recent study published by the Economic Policy Institute titled 'Prognosis Worsens for Workers’ Health Care' shows the extent of this disaster. Elise Gould, the report's author, writes that even as the population grew between 2000 and 2004, the rate of coverage provided by employer-paid health insurance declined from 63.6 percent to 59.8 percent of workers.

Over the same time frame, about 3.7 million fewer people had employer-provided health insurance, while Medicaid, including the State Children’s Health Insurance Program (SCHIP), increased by nearly eight million. This is a significant shift from private sector coverage to public sector coverage, especially in the case of children.

Gould's report also exposes the decline of employer coverage by state. From 1999 to 2004, Maryland, Maine, Missouri, North Carolina, and Wisconsin all experienced losses in coverage rates in excess of six percentage points. Not a single state experienced much of an increase in coverage.

Gould doesn't focus on the reasons for the loss of employer-based coverage, but does give the grim statistics showing the decline in health insurance coverage by age, sex, race, education, or family income. The numbers show that class and race play a large role in who is hurt by the loss of insurance. 49.9 percent of African Americans and 41.1 percent of Hispanics had employer-provided coverage, compared to 65.7 percent of whites. Only about 1 in 5 individuals in families in the lowest income group had employer provided health insurance, yet 4 in 5 individuals in families at the highest income groups had such coverage. Only 42.5 percent of workers with a high school education were covered, compared to 68.8 percent of those college-educated. Workers among the bottom 20 percent of hourly wage earners were the least likely to have employer coverage; 24.4 percent of workers in the bottom one-fifth of income earners were covered, compared to 77.5 percent in the highest wage quintile. Prime working-age, middle-income Americans experienced declines in employer-provided coverage from 80.6 percent in 2000 to 75.8 percent in 2004 – a drop of 4.8 percentage points. Although 2.5 million youth lost employer-provided health coverage between 2000 and 2004, many were caught by the public sector safety net as indicated by the enrollment of an additional 4.8 million more children in both Medicaid and the State Children’s Health Insurance Program (SCHIP) over that same time period.

As employer-provided insurance continues to decline, Bush-appointed tax policy advisers are discussing ways to reduce the tax incentives for employers to provide such coverage in order to pay for tax cuts targeted to the very rich.

Additionally, a number of states are cutting Medicaid coverage. The Republican Party, though it recently postponed legislation to gut Medicaid and other health care programs due to lack of support within its own party ranks, continues to push for legislation at the federal level that would substantially cut the very programs, Medicaid and SCHIP, that have kept millions of children from losing coverage altogether. There is no similar safety net for non-senior adults.

While this new report adequately examines today's severe health care crisis, pointing to continuing inequalities by race and class, and highlighting the Republicans' policy of cutting back the much needed programs that minimally cover the loss of private-sector coverage, the report doesn't address existing proposed solutions.

It is plainly evident that many private sector employers cannot afford to pay ballooning premiums sparked by out-of-control medical care inflation and skyrocketing drug prices. Many employers can afford it, but simply don’t want (e.g. Wal-Mart).

It is also clear that the Republican solution of gutting public programs and turning a blind eye to the problem simply isn't a desirable or viable solution. Republican ideology, almost across the board, puts profits before people’s needs. Public programs are more efficient and less expensive than private insurance. Compare a three percent administrative overhead under Medicare to a 30 percent overhead/profit margin cost imposed by private insurers. This means that private insurers automatically markup costs to the consumer by 30 percent, and for what?

One proposal that is catching some attention across the country is a bill introduced by Rep. John Conyers (D-MI) called the National Health Insurance Program (H.R. 676). This bill would expand Medicare to cover everybody for all types of medical needs: dental, vision, mental health, long-term, and so on. It would use the government's buying power to effectively control the cost of prescription drugs. Expert agree that it would save literally hundreds of billions of dollars across the economy each year for health care.

Most importantly everyone would have equal and complete access to the basic human right of health care.



--Contact Joel Wendland at jwendland@politicalaffairs.net.