Thinking back to my first experiences with health insurance as a welfare recipient in West Philadelphia in 1971 and more recently as a single working mother with a “pre-existing condition,” I have wondered, how do people afford health insurance?

In an effort to better understand what insurance is all about, I looked up “insure” in Webster’s Dictionary. The three synonyms are ensure, assure and secure. The definition: “to make an outcome clear.” Unfortunately for myself and for the millions of Americans who cannot afford health insurance, there are no clear outcomes.

An ad put out by a coalition of thirteen groups, including the United States Chamber of Commerce, the Health Insurance Association of America, and the AFL-CIO, shows the face of a pensive woman. On one side the test reads, “She has diabetes. She gets the insulin she needs. Her life goes on.” In the center there is a big “”OR,” and on the other side are the ominous words: “She has diabetes. When her job disappears, her medical coverage does too. Her life is threatened.”

According to the Institute of Medicine, more than 18,000 people die prematurely every year as a result of being uninsured, and women with breast cancer are 49% more likely to die if they are uninsured. Currently, more people are uninsured in the United States than the populations of Texas, Florida and Connecticut combined.

Kate Sullivan, health care policy director of the U.S, Chamber of Commerce, noted that the high cost of health care causes more than 1/2 of all personal bankruptcies in the United States.

According to the World Health Organization, the U.S. ranks thirty-seventh in the world for healthcare quality (and fifty-fifth for fairness), behind Chile, Saudi Arabia, Singapore, Morocco and other nations. France ranks first.

So why, in a country as powerful and as technologically advanced as ours, wouldn’t we be number one in quality health care?

Ronald Glaser, M.D., a Minneapolis specialist in pediatric nephrology and rheumatology wrote in Harpers Magazine in July 2004, “Americans pay too much for their health care,” and “compared with other countries we receive a very poor return on our investment. The reasons are many, but they are not hard to understand: in essence, we have tended historically to view health care as a commodity like any other. But health is not a product; it is a public good. The evidence is clear that even when viewed through the reductive lens of purely economic self-interest, market-based, entrepreneurial medicine is a failure. Healing people after they fall ill is vastly more expensive than preventing the illness in the first place…Yet policymakers have consistently prefered the most expensive and least efficient models of health care, proving once again that the apostles of privitization are motivated not by hard-nosed economics but by an incoherent ideology that is little more than a brittle mask concealing the most irrational species of self-interest.”

A quote from the Physicians for a National Health Program sadly sums up our plight: “Our current national health care system is simple: don’t get sick.”

Advertisements