How Uninsured Americans Affect Your Care

ByABC News via logo

Oct. 24, 2003 -- Phillip Dahl moved back to Colorado last year, in part to take care of his ailing parents, when his own health crisis hit. He started seeing spots in his right eye.

"I started seeing weird colors," Dahl, 42, of Bennett, Colo. said. "I was scared, I mean it was like, my dad is now blind from glaucoma."

With no insurance and not much money, Dahl put off seeing a doctor, but after a few weeks he wound up at the emergency room. Doctors explained that he had a detached retina, nearly torn all the way off, and only immediate surgery could save his vision.

"I think it is the most serious eye surgery that is done," said Dr. Naresh Mandava at Rocky Mountain Lions Eye Institute at the University of Colorado in Aurora, Colo.

In Glenelg, Md., 31-year-old Josh Eyre, a laid-off Web designer, also suffered from this "delayed care" syndrome. A victim of high blood pressure since his teens, Eyre couldn't afford his own insurance, or the $150 a month for his medication. But when he went to a doctor last May, things had reached a crisis point:

The nurse called the doctor in immediately after finding his blood pressure was a shockingly high 276 over 174. Eyre said he passed out cold for about 15 minutes. After being rushed to a nearby emergency room, he was in the hospital for more than two weeks. When it was all over, he had no answers to what was causing his disease, but he did have some $30,000 in medical bills. Dahl and Eyre had two different circumstances, but both faced the same fears and problems and both are classic examples of how all Americans are affected by the uninsured. Millions of uninsured Americans wind up seeking treatment in our over-stressed, under-staffed emergency rooms, where, by law, the uninsured must get treated. Ultimately, everyone who uses the health care system feels the consequences.

"The next time an ambulance that you are in gets diverted from your hospital to another hospital, the next time that you have to wait six or eight hours to get admitted to an inpatient bed," said Dr. Arthur Kellerman, chairman of emergency medicine at Emory University School of Medicine in Atlanta. "When the system itself begins to crumble under the strain of trying to care for so many people without health insurance — everyone's access to care is impaired."

The Institute of Medicine found that 18,000 Americans die each year because they don't have health insurance. Many more suffer serious health problems. There is universal access to treatment via hospital emergency rooms, but a trip to the E.R. doesn't come cheap.

"It costs dramatically more to treat someone in this way," ABCNEWS' Medical Editor Tim Johnson said. "For instance, someone with insurance who has a cold can go see their doctor and get early treatment. Someone without insurance has to wait until he has pneumonia before he gets treatment. That can cost thousands of dollars to treat."

Plus, such treatment means more lasting health problems in the long run, as compared to someone who had a simple cold, Johnson said.

Even after the surgery, Dahl's vision is still impaired. Seeing through his right eye is like looking through a fishbowl, he says. If he had gotten treatment earlier a simple laser procedure may have been able to give him normal sight.

"We see people like this every day and every night, who have medical problems, cannot get access to care and often wind up turning to the emergency department, often too late," Kellerman said.

An Extra $28,000

The Institute of Medicine estimates that $65 billion to $130 billion is lost every year in wages and benefits because of the uninsured, but if insurance was provided to the estimated 46 million Americans who do not have it, it would cost $39 billion-$69 billion a year.

Eyre's monthly medication would have only cost about $1,800 for the year. Because of the delayed care, it cost $28,000 more.

"I am thinking about money 95 percent of the time — which I don't want to," Eyre said. "It's very stressful."

Eyre has applied to social services for help with his bills — but, months later, he still doesn't know how much he may have to pay out of his own pocket.

Grateful for Coverage

Back in Denver, Dahl's bills were absorbed by the hospital, but that absorption affects the insured population as well.

"Entire communities are being destabilized. Their health care systems, their hospitals, their doctors' practices are being affected by the cost of providing a lot of care that doesn't get compensated due to un-insurance," Kellerman said.

Eyre is now running his own tea shop in College Park, Md. He is covered by a new state insurance plan, but says, so far, it's barely helped.

"It's scary," Eyre said. "I don't really know what is going to happen."

Meanwhile, Dahl is working as a dispatcher for Avis. He has full health coverage now, and is grateful for it.

"When you don't have insurance, you are thinking about it all the time," Dahl said. "Now when I go to my doctor's office, I like flipping out my insurance card."