One issue bound to be in the forefront of the upcoming elections is healthcare coverage. Over 47 million Americans are without health insurance. While many of these individuals are young, healthy, and may not think about the potential for ailing health, the reality is that anyone can fall ill, be injured, or need healthcare services in one capacity or another. The cost of healthcare services can be staggering- consider that a simple x-ray can run you a few hundred dollars and a routine stress test or echocardiogram can set you back over $1000 if you are uninsured! - And that's if they're normal. Should one need further diagnostic testing, treatment, medication and hospitalization, it's not hard to fathom a 5 figure bill.
Hence, it's no wonder that many Americans list healthcare coverage as a number one concern. In addition, failing to pay medical bills is a leading cause of bankruptcy declaration in the U.S. Certainly, in both finding and maintaining employment, what type, if any, healthcare benefits an employer offers can be the deciding factor in taking or rejecting a job. Moreover, the uninsured can wind up costing society more than the insured. The uninsured are more likely to defer testing, doctor visits and preventive care due to cost. These individuals usually find themselves in the nation's many understaffed, overworked and over utilized Emergency Departments, where the cost of care is far beyond that of their local primary care physicians' offices. Moreover, the cost of healthcare premiums for those who have insurance has continued to outpace the rate of inflation, though the double digit increases seen earlier in this decade have begun to moderate. Many of us who work for large employers take little notice of the premium hikes. Large corporations and other sizeable entities with more than several hundred employees are able to exert leverage in the health insurance marketplace, negotiating deeper discounts from insurers than smaller businesses. Furthermore, large employers "spread the risk" for insurance companies.
If one person in a one thousand employee firm gets cancer, there will theoretically be 999 other employee premiums to help defray the cost of care. If, on the other hand, one employee gets cancer in a 10 person firm, the cost of care may still far outweigh the premiums of the other 9 employees. Hence, many small and medium sized businesses find it difficult to insure their employees. They have less bargaining power with insurance companies on both a size and risk level. Trying to provide coverage becomes prohibitively expensive. As a result many of these working Americans go uninsured or face spending considerable cost in buying health coverage on an individual basis. Some newer forms of health insurance such as high deductible insurance or health savings accounts (where individuals pay considerably lower premiums but are responsible for the first $2000 of expenses) have gained in popularity to a select group of mainly young and healthy workers.
For the world's most powerful, richest, and developed nation, we can do better. The candidates in the upcoming election, be they from either side of the aisle, need to address this issue and devise a plan that guarantees affordable health coverage for all Americans. It will not only be beneficial to the millions of uninsured, but to the millions of small and medium size businesses struggling to provide coverage for their workers.
Published On: January 14, 2008