April 24, 2003
Health Care Requires Resuscitation
Eric Moore is frustrated. Within weeks after losing his computer consulting job, the 30-year-old UCLA graduate collapsed from a pulmonary embolism. He has since recovered, but faces a $14,000 hospital bill.
Dr. Alexandra Levine is frustrated. The head of the USC-Norris Cancer Center faces numerous barriers to providing the care she'd like to provide to her patients. One patient required a medication that could be taken at home via injection. Since Medicare doesn't cover prescription drugs, but will pay if the drug is administered in the hospital, Levine's 91-year-old patient was forced to make a thrice-weekly trek from the Valley to the center, and each time the tab to Medicare was twice as high as it would have been had the medication been taken at home.
Luis Jiminez is frustrated. The 29-year-old entrepreneur started an online marketing and Web business, which now boasts a staff of 11. But he can't afford to provide health insurance for his employees.
"We have a continuing crisis in this country of millions of Americans without health insurance, and that's just plain wrong," said Rep. Henry Waxman (D-Los Angeles), who will speak Friday, April 25 at Leo Baeck Temple as part of a series on health care.
In 2001, approximately 41 million Americans -- more than 14 percent of the nation's population -- went without health insurance for the entire year, and another 20 to 30 million lacked coverage for part of the year. With health care premiums increasing at about 11 percent a year, big companies are paying a smaller percentage of those premiums, and small businesses are finding they can no longer afford to provide health care at all. These factors, combined with job layoffs resulting from a weakened economy, have left a growing number of people without health insurance.
Meanwhile, health care costs are skyrocketing. In 2000, $1.3 trillion was spent on health care in the United States, a 7 percent increase from the prior year.
According to Rabbi David Saperstein, director of the Religious Action Center of Reform Judaism in Washington, D.C., the average family spends four times as much on health care today as it did in 1980.
"This country has yet to make a decision that every man, woman and child has a human right -- a civil right -- to health care," said Los Angeles County Supervisor Zev Yaroslavsky, speaking at Leo Baeck Temple last month. While implementing such a decision "may be complicated and expensive," he said, "it's not as expensive as not doing it -- not as expensive financially and not as expensive morally."
Because those without coverage tend to postpone seeing a doctor, preventable conditions become severe illnesses, needlessly harming patients and unnecessarily driving up health care costs. The uninsured also tend to use emergency rooms as their only source for medical treatment, limiting the ability of those facilities to provide more urgent care. And while many believe the majority of uninsured are unemployed, 80 percent of the uninsured come from working families.
In Los Angeles County, one out of every three residents lacks health insurance. More than 80,000 of the uninsured are children. Budget shortfalls spur continued cuts to county health services. Twelve public care centers and four school-based clinics have closed since June 2002, and High Desert Medical Center in Lancaster and Rancho Los Amigos National Rehabilitation Center in Downey are currently targeted for closure. These closures put an added burden on remaining facilities, raising the troubling specter that crucial services will be unavailable when we most need them.
"Whether you live in Bel Air or in Torrance or in Pomona ... you have a stake in providing health care to the maximum number of people," Yaroslavsky said. Otherwise, he said, you had better hope "that a mother who has a kid with an ear ache doesn't come to the ER ... and gobble up space ... while your heart attack is going on."
For those who consider the predominantly poor, immigrant patients who use county facilities somehow less deserving of care, USC's Levine had sharp words.
"Who we see at this hospital is you -- your mothers, your grandmothers, your great-grandmothers. All of us were immigrants in this country.... And what do these people do? They train every physician in the U.S. Did I learn how to do a spinal tap on you? No I did not. I learned on someone in the county hospital.... We owe them because of our roots and because of what they do for all of us on a daily basis."
As for the national picture, "reform must become a reality because we have no other choice," Saperstein said. "The question no longer is whether there will be health care reform, but what form these changes will take."
A number of proposals are on the table nationally and on the state level. Some aim to expand availability of health care coverage by pooling individuals or small employer groups into large groups. Others seek to expand Medicare, Medicaid and/or the State Children's Health Insurance Program. Still others propose use of tax credits to help families purchase insurance or tax incentives to encourage employer-sponsored plans and benefits.
Waxman is particularly critical of the Bush administration's approach to health care.
"The Bush administration is trying to undermine the programs we've got, and nowhere is this more obvious than Medicare. They refuse to add a meaningful prescription drug benefit to traditional Medicare.... Instead, they want to use a drug benefit ... to force people into private insurance plans or HMOs, where they won't have guaranteed benefits or assurance that they can see their own doctors."
Saperstein and Yaroslavsky say the way to get effective legislation passed is to make sure lawmakers know health care is a priority for voters. Politicians need to hear from their constituents about this issue, and to know that it drives contributions and votes.
"We have got to raise the political stakes nationally to make provision of health care a priority," Saperstein said.
Rep. Henry Waxman will speak about "The National Crisis in Health Care," on Friday, April 25, at Leo Baeck Temple, 1300 N. Sepulveda Blvd., Los Angeles. Services begin at 8 p.m. For more information, call (310) 476-2861.