COVERAGE: Ask Your Doctor, Insurance Matters

We have blogged and written before about the importance of health insurance coverage when it comes to access to care and treatment. For example, the uninsured:

• Remain sick longer and die prematurely
• Are more likely than the insured to forgo preventive screening, which leads to a higher probability of late stage, untreatable diagnoses
• Are more likely than the insured to go without medical care because of cost.

Yet, a piece in the Washington Post today brought us a new take on why health insurance really matters...from a physician's point of view. Dr. Manoj Jain detailed first and second hand accounts of patients who suffered life and death consequences because they did not have access to the care that health insurance affords. In addition to the real-life examples, however, a couple of comments in the article hit home:

There may be a few among the uninsured who prefer to buy $149.99 sneakers than health insurance. Far more common are stories of preexisting conditions that make insurance unaffordable or jobs that offer none.

Translation: Most people are uninsured simply because they cannot afford or access health coverage, not because they are choosing to spend their money on something else. And this number is growing. About half of Americans would need to spend more than 17 percent of their income to secure health insurance for their family. Meanwhile, fewer and fewer employers are providing health insurance and those that do are offering less generous coverage.

To compensate for the cost of treating uninsured patients (about 10 percent of my practice), I inflate my charges for all patients, thus increasing my income from commercial insurance.

Translation: Uncompensated care for the uninsured forces providers to raise rates for services. Insurers then raise premiums. This vicious cycle inextricably links the uninsured to health care costs and by extension premium rates. While estimates vary, the hidden tax is likely between three and 11 percent of health care premiums. In terms of premium costs, this adds between $360 and $1300 to the price of a family's health insurance coverage per year.

Covering all Americans is the right thing to do, but it is also the smart thing to do. The cost to the economy of the poor health and shorter lifespan of the uninsured is greater than the cost of covering all Americans. Sick workers are less productive and U.S. businesses are shipping more and more jobs overseas because of the employer health care burden.

The current economic crisis has cast a shadow of doubt over our nation's ability to embark upon new domestic initiatives. But as Len Nichols points out on the National Journal's new health blog, "We must take action not in spite of our current economic crisis but precisely because of health care's financial impact on American families and businesses."