American Crisis: The Working Uninsured
Dec. 15, 2005 — -- An estimated 46 million Americans don't have health insurance -- but most of them do have jobs -- everything from doggie day-care provider to freelance writer and editor.
The uninsured often don't get necessary medical care and, as a result, are in poorer health and more likely to die prematurely than those with insurance. There are six million more uninsured Americans today than in 2000, and that is creating another crisis -- a crisis in emergency medicine.
In his last documentary, Peter Jennings focused on this national problem.
Nearly one-third of Houston residents -- 1.1 million people -- have no insurance. And that's not even counting the recent evacuees from Hurricane Katrina. When people without insurance need to see a doctor -- for anything from a cold to a serious illness -- they often go to the emergency room. By federal law, emergency rooms cannot turn anyone away if they have space.
Dr. Guy Clifton, of Houston's Memorial Hermann Hospital, says on a busy night, patients can wait five or six hours to see a doctor. When its emergency room is filled to capacity, the hospital must often turn away patients and ambulances. He said "from time to time" people died because the hospital simply didn't have the medical capacity.
It costs more to treat someone in an emergency room than just about anywhere else. The ER is also where more bills go unpaid. In 2003, U.S. hospitals delivered $25 billion worth of health care to patients who didn't pay.
"The problem is, when you have 25, 30 percent uninsured in your community, the hospitals that perform these functions lose so much money that they can't afford to expand capacity," Clifton said.
That's one reason why emergency rooms in Houston -- and around the country -- are shutting down. And may be why some of the newer hospitals have actually been built without ERs.
One of the problems with health insurance today is how hard it can be to get. In 2004, about 174 million people got insurance through work. Nearly 79 million were covered by the government -- including the elderly, the poor, and those in the military. Everyone else who wanted insurance had to buy an individual policy. Only about 27 million people got insurance that way, and it can be extremely expensive.
Even people who can afford individual insurance can't always get it. In 45 states, insurance companies are allowed to deny people coverage. So those with certain medical conditions can find it impossible to buy health insurance.
Penny Baldwin sells health insurance to individuals. It's something, however, she can't buy herself. She's a cancer survivor, and many insurers are increasingly reluctant to write policies for people with even minor health problems.
"I'm seeing more and more problems with the younger people, also," she said. "So, they're not doing people that have acne … because of the medication. They're scared to death of even seasonal allergies. Asthma is just like, 'forget it, we don't want it.'"
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