Guaranteed Healthcare

Sixteen million. For the past several years, healthcare activists have been making consistent reference to the same number. By now, it’s become a standard, one of those statistics you can hang your hat on, a number that’s seared into the brains of anyone who works as a care provider, or, for that matter, anyone who’s seen Michael Moore’s SiCKO. It was a steadfast reminder that we need to do something, now: sixteen million.  That’s how many people live with inadequate health insurance in America.  

Or rather, that’s how many Americans lived with inadequate health insurance in the year 2003. On June 10, 2008, the Commonwealth Fund released an updated report on the problem of America’s under-insured, with data current to the year 2007. Now we have a new number to remember: 25 million.

Twenty-five million people. That’s the same number of people who died in Europe’s black plague, nearly decimating the continent. That’s more than the entire population of Australia. That’s two Pennsylvanias. Can you imagine such a vast number of people being invisible?

And yet invisible is exactly what they are. They don’t count towards the even larger number of people without health insurance altogether (nearly 50 million at last count), and they are overlooked by most pundits promising healthcare “reform.” Healthcare theorists often see in black and white instead of grayscale: because those 25 million people have “coverage,” the degree, efficacy, or reliability of that coverage is all too often considered irrelevant.

It may be the mantra of GuaranteedHealthcare.org, but once again, it’s worth repeating: coverage is in no way a guarantee of care. The underinsured are just as vulnerable as the uninsured when it comes to prioritizing health and financial stability. The San Francisco Chronicle relayed the story of one middle-aged woman in San Mateo County (median household income in 2006: $77,900) who, despite continuous insurance coverage, estimates that her out-of-pocket health costs over the past six years total a staggering $35,000.

“We’re moving in a direction where you can be insured all year and still face medical bankruptcy,” the study’s lead author, Cathy Schoen, told the New York Times. As a result, many insured Americans are choosing to forgo prescription drugs, scheduled checkups, and preventive treatment for fear of digging into their deductibles, driving up their premiums, or shelling out for co-pays. So basically, they receive the same amount of care (little to none) as the uninsured do, but with the added bonus of paying yearly or monthly premiums for the privilege of “coverage.”

What’s even more sobering about this new number, however, is the fact that these are only the people who know they’re underinsured. For the rest of us, it could come as a nasty surprise—that ten-dollar-a-pill prescription is only covered for the first ten days of a 21-day course; that hospital where the ambulance took you while you were unconscious is out-of-network; that sinus headache you had in 1982 constitutes a pre-existing condition and your MRI will not be covered by your policy.  

As unpredictable as life is, so is the insurance industry fickle. Health insurance by its very nature is not comprehensive: denying care is business and giving care is charity, and a business is exactly what insurance is. Every single one of us could become one of the ‘invisible’ at any given moment, and without the courtesy of a warning.

Perhaps it might be more accurate to say that the real number of underinsured in America is closer to 255 million. That number includes all of us who have health insurance in the United States, minus the two million government employees who enjoy ‘CheneyCare.’

I’ll leave you with one last number: 304,282,000. That’s the number of people living in the United States, and the number of healthy people who would enjoy a decent quality of life if we were merely to allow equal access to medical care for all Americans. That’s the number of people in our country who are being denied a human right to access healthcare. That’s the number, not one less, that we are fighting for today.