Date: Fri 19-Feb-1999

Publication: Bee

Author: DONNAM

Quick Words:

Commentary-uninsured-Collins

Full Text:

COMMENTARY: I Told You Not To Get Sick!

Jack and Jill,

Are injured still;

With no insurance,

To pay their bill.

The upcoming annual tussle in the General Assembly over an HMO "Bill of

Rights" doesn't mean much to my cousin, Mary. Mary is 58 and single. She's

also a skilled executive secretary. But then, who is hiring 58-year-old

executive secretaries these days? Thus she is reduced to working three

part-time jobs to make ends meet. You won't be surprised to learn that none of

them offers health care. So Mary pays through the nose for private insurance,

and probably will until she's 65. With three jobs, there's little time to

worry about her HMO rights. Her crisis is paying the premium.

But other Americans make even Mary's situation look blessed. There are 41

million of them with no health insurance at all. And they're growing by one

million a year. If they have a heart attack, or can't breathe, the hospital

emergency room will stabilize them. For preventive medicine, there may or may

not be a free clinic offering, say, mammograms. It is very unlikely, though,

to find a free PSA test for prostate cancer, or any ob/gyn care.

Some of those 41 million thought the Kennedy-Kassebaum Act would save them. It

prohibited insurance companies from dropping them simply because they changed

jobs. Nice try. What it didn't do was set price limits. Thus if they move from

one job to another, and their insurer wants to drop them, it simply sets an

exorbitant premium. Voila! No coverage.

Others of the 41 million used to get charity treatment from private doctors.

Some, of course, still do, but that number is shrinking. It turns out that the

falling HMO reimbursement rate for doctors is pressuring them to take on more

paying customers, and fewer freebies. That's bad news for your basic

threadbare diabetic. Where does he turn now?

And from the breakdown of the health care clippings on my desk, that's not a

question most of the legislature is eager to acknowledge. One set of headlines

describes the pitched battle between Republicans and Democrats over how much

protection to give HMO patients. Another set concerns how much of a killing

the trial lawyers will make from any new reform. A third details the debate

over Medicare.

The smallest set of clippings, by far, deals with the uninsured. They are like

non-people. Many don't vote, and there is no business interest hungry for

their trade. They don't contribute to candidates either, and there are few

lobbyists to fight for their rights.

One category of poor Americans, though, gets care even without insurance, and

moderately good care at that. They visit 49 public hospitals and 190 public

health centers. We're referring to Native Americans.

They enjoy socialized medicine much as do the British. Also much as do our

veterans. In fact, much as do most Western nations. No HMOs and no insurance

companies to fuss with. Their system works pretty well, as long as Congress

doesn't muck with its budget. But a better system still, some think, and

surely cheaper, is Canada's. There the government itself is the insurance

company, while doctors are still private. State Rep Chris Donovan has offered

such a bill this year. And Senate Health Chair Toni Harp has some other ideas.

Bless them.

They might help my other cousin, the one with heart trouble. He lives in

Westchester but wants to move to Stamford. Sorry. Oxford says that if he

crosses the county line, they'll drop him.

(Bill Collins, a former mayor of Norwalk, is a syndicated columnist.)