Paying with their Lives: The High Cost of No Health Care

Medical advances are making it possible for people to live longer and healthier lives. New diagnostic techniques are catching cancer, heart disease, and other potentially fatal diseases earlier, sometimes with the result that lives are saved which would be lost otherwise; in other instances a disease process can be slowed and symptoms treated to provide a longer life, with greater quality, than would otherwise be possible.

That's the good news. The bad news is that at least 40 million Americans have either limited or no access to all these advanced technologies. Forty million Americans have no health insurance at all, and many of these people choose to delay or entirely avoid visits to doctors because of the burden medical treatment would become on their limited income. Some doctors actually refuse to treat uninsured individuals. And when these people do get into a doctor's office, often they're billed for doctor's visits and tests at many times the rate that hospitals and clinics bill insurance companies. One common blood test, for instance, is billed at the rate of $25 for insured patients; uninsured patients are billed $250. The reasoning? According to hospital financial managers, many people without insurance "don't bother" to pay their bills, so when people do pay their bills, they need to be charged more for those who don't pay at all, and to make up for insurance companies and Medicare and Medicaid patients whose plans also pay too little.

In other words, the most vulnerable people, the ones who cannot afford health insurance coverage, are the ones who are forced to subsidize health care for everyone else.

An example of how devastating a delay in diagnosis can be: A colonoscopy, recommended periodically for individuals over the age of forty, uses a thin tube with an electronic camera assembly to explore and take photographic images of the colon for signs of precancerous and cancerous conditions. Early detection of colon cancer makes the disease easily curable, with cure rates of up to 90 percent. However, if not detected in time, the fatality rate for colon cancer is very high. A colonoscopy could catch many cases of colon cancer at a very early stage, but it costs an average of $2000 - a fee that could devastate the finances of many people without insurance. For many people, at least in the case of colon cancer, if you have insurance you live; if you don't, you die.

The fact is, if you add up the money spent on Medicare and Medicaid recipients, plus all the federal, state, and local government employees, two-thirds of health care expenses are already paid for by the government. The bitter irony is that much of this health care money comes from income and Medicare taxes paid by workers in this country - including those with no health care coverage, who are being overcharged for the health care they do get, and who often have no access to health care at all. These individuals with no health care coverage are paying plenty; they're paying with their money, and they're paying with their lives.