Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, May 24, 1990 TAG: 9005240516
SECTION: EDITORIAL PAGE: A16 EDITION: METRO
SOURCE: CAROLYN CLANCY
DATELINE: LENGTH: Medium
For 880,000 Virginians, no imagination is required; at least that many residents of the Old Dominion have no medical coverage whatever. Moreover, an additional million are underinsured; they would be financially ruined by a major illness.
All told, approximately one third of Virginia residents have either inadequate health insurance or none.
These Virginians live in a nation that spends more per capita on health care than any other. America has the most technologically advanced health system in the world, yet ours is the only industrialized nation besides South Africa that does not guarantee health care to all citizens regardless of ability to pay.
The proportion of uninsured Virginians has risen steadily in the past 10 years, as health costs have increased faster than inflation. Health-insurance premiums for state employees jumped by 20 percent on Jan. 1. Similar increases have become an annual affair for the majority of insured workers in the Old Dominion.
The misery that escalating health-insurance costs have created in the lives of Virginians was vividly revealed in a flood of calls to the Virginia Consumer Complaint Hotline, created by a coalition known as Virginians for Fair Rates and Fair Compensation.
One man said he would be dropping his own coverage in order to pay for his wife's premium. Many of the respondents were elderly persons struggling to pay rapidly escalating premiums.
The hotline also received calls from employees who now face significant out-of-pocket costs in the form of deductibles and co-payments, and find themselves without coverage they had previously taken for granted. As costs have continued to rise, many Virginia employers no longer offer any health-care benefits.
Ironically, many of the working poor in Virginia are deemed too affluent to be eligible for Medicaid, the federal health-care program for the indigent. That is because the state says an applicant is ineligible if his or her income is more than 40 percent of the poverty level.
Cost-containment practices such as mandatory second opinions, pre-admission certification and concurrent medical review have resulted in an avalanche of paperwork, a striking increase in administrative work and intrusion by insurers into the doctor-patient relationship.
As a result, the U.S. spends 23 percent of total health-care dollars on administration alone, compared with 13 percent in Canada and 8 percent in Great Britain.
Despite the high price of the controls, costs have not been controlled. So, a vicious spiral ensues. High costs result in more people without insurance, as the cost of premiums becomes prohibitive to both employers and individuals. The costs incurred by the uninsured then appear as higher premiums for the insured.
In short, restrictions in access to health care are not only inequitable but also fiscally disastrous. And further piecemeal reforms are likely to make the situation worse, not better.
Many observers, from both ends of the political spectrum, doubt that the current crisis can be resolved without major, systemwide reforms. While no solution is perfect, a national health program offers pragmatic, equitable solutions to many of our problems. We already have a model for such a program in the system used by Canada, a nation similar to the United States.
Such a program would provide universal, comprehensive care regardless of ability to pay. Financing would come from taxes on individual and corporate income. Total costs of would be far lower than what we currently pay, because a national health program would reduce administrative costs by simplifying all existing paperwork under one system.
A 1989 Harris poll found that a majority of Canadians were satisifed with their current health-care system, compared to 6 percent of Americans. Indeed, public-opinion polls have found that Americans overwhelmingly favor a national health plan even if it means higher taxes.
Surveys have found that a majority of physicians (56 percent in one large study) support a national health plan. The reason is simple: Physicians are increasingly disenchanted with their profession because of the time they must spend on paperwork.
Businesses, too, increasingly favor a national health program. They consider it an attractive option as the cost of health-care premiums becomes prohibitive.
Support for a national health program is growing in Virginia. A resolution of the 1990 General Assembly called on the Bush administration and Congress to develop and implement a national plan to provide universal access to health care. Co-patrons of the resolution included Senate Majority Leader Hunter Andrews of Hampton; Senate President Pro Tem Stanley Walker of Norfolk; and Del. Robert Ball of Henrico County, chairman of the House Appropriations Committee.
The message to Virginia's congressional delegation is clear: Every American should have adequate health care.
by CNB