Health Insurance issue only getting worse

Forty-five million Americans have no health insurance coverage; 45 million — a number equal to the combined population of 24 states. Nearly 20 percent are children.



The rapidly growing number of uninsured is one of America's greatest challenges. It impacts our entire economy and the future of our aging and growing nation.



This week, declared as Cover the Uninsured Week, is designed to provide national awareness and to help implore our nation's leaders to assure that all Americans have access to affordable and reliable health care coverage.



Risa Lavizzo-Mourey, M.D., MBA, president and CEO of the Robert Wood Johnson Foundation, organizer of Cover the Uninsured Week, states, "Individuals and families without coverage face the challenge of finding reliable, affordable, quality health care. Many go without annual check-ups, recommended health screenings, filling needed prescriptions and seeing specialists. This is simply unacceptable and we must keep the pressure up until the problem is solved."



The cost of health care and health insurance is a major concern for patients, employers and governments around the country.



WORSE IN SW Fla.



Health insurance premiums are escalating annually in excess of general inflation by five or six times. Thus, fewer individuals and families can afford to purchase coverage and fewer small businesses are able to provide coverage for their employees. Eight out of 10 people who are uninsured are in working families. Employees who still have coverage typically contribute more but have narrower benefits.



Meanwhile, state governments and the federal government are seeking ways to reduce Medicaid expenditures for those who do qualify, thereby increasing the spiral of uninsured and underinsured Americans.



This national trend is even more predominant in Florida and worse yet in Southwest Florida. Sadly, our region is now second only to Miami-Dade County in the percentage of uninsured. One-fourth of our residents under the age of 65 have no health insurance and do not qualify for any programs such as Medicaid.



Over the past 20 years, a perception existed that the more we increase competition in health care the more we will drive down the cost and improve efficiency. Unfortunately, while competition has many valuable effects, increasing competition has only widened the gap of the haves and have nots.



ACT NOW



Until this nation decides to cover the uninsured, the inflationary spiral will only escalate. Higher charges by providers of care to insurance carriers create higher premiums. More employers reduce coverage and shift costs to employees. Then more employees choose less or no coverage. The spiral continues. Solutions will take leadership at the national level and systemic redesign of the financing and delivery of health care for this nation.



In the interim, we should pursue:



• Quality, operations and safety improvement leadership by all health care providers.



• Many local health care providers have agreed to work with the Florida Legislature and Agency for Healthcare on innovative programs to better coordinate care for the uninsured.



• Tax incentives that increase health coverage.



• Government policies that assure health care providers and health insurers cannot skim only the most profitable patients and services while leaving the least profitable to underfunded providers or depend on emergency services for general health care.



• Encourage, actually implore, a national public policy debate as to the most efficient way to cover the uninsured.



The closer we get to universal coverage the more competitive market reforms will have a chance to succeed.



— Jim Nathan is president of Lee Memorial Health System.