The growing ranks of the uninsured

Dear Medical Staff Leader:

Over the years, some health care "experts" have belittled the plight of the uninsured by asserting that most choose not to insure. However, hospital leaders know this assertion is incorrect and the situation is poised to become substantially worse.

It's no wonder that some small businesses drop their health insurance coverage. The cost of such coverage averages just under $8,000.00 per family per year, and on top of this cost they must pay $1,217.00 in Social Security taxes on the money earned to pay the premium. (This is not the case for larger businesses that are permitted to deduct the premium as a cost of doing business.)
It's no wonder that many people with jobs that offer insurance to employees and permit them to buy into the plan for their families choose not to do so. They earn barely enough to cover living expenses and simply cannot afford the cost of coverage.

It's no wonder that early retiring baby boomers (often laid off or unemployed as a result of an early retirement incentive) find the cost of private health insurance so restrictive that they attempt to "ride it out" until they become Medicare-eligible.

It's no wonder that millions of part-time employees are uninsured--current federal and state laws do not require employers to provide health care coverage to full-time employees, never mind part-timers. (However, Hawaii does require coverage, and Maine and California may follow suit.)

It's no wonder that more than 44 million Americans are uninsured and it is likely the situation will get worse before it gets better. Recent reports indicate that physicians are more reluctant to provide charity care and indicate that the nation is facing a shortfall of 150,000 physicians by the year 2020.

Uninsured patients will likely impact the organized medical staff. Medical staff leaders should therefore encourage the board and management to carefully study the plight of the uninsured and identify its effect on the emergency department, private physicians, local business, and the community. Once such a study is completed, leaders can begin to research how to solve the problem.

Other medical staffs have tackled this enormous problem and have achieved great success. Perhaps, with concerted community and hospital effort, you too will find the means to provide high quality primary care to the uninsured in a way that reduces use of the ED, takes some burden off private physicians, and creates a healthier community.

That's all for this week.

All the best,

Hugh Greeley