August 10, 2000
Onus falls on Texas to be “laboratory for change” for uninsured
AUSTIN, TX – Two reports released nationally by Consumers Union today document the failure of our nation’s healthcare system in alleviating the plight of the uninsured and point to the dilemma faced by Texas and other states in closing the gaps through a loose patchwork of programs.
The reports conclude that U.S. taxpayers are not getting their money’s worth for a failed system that features 44 million uninsured Americans and many more millions who are underinsured. While the U.S. spends more money on healthcare than any other country (13.7 percent of its Gross Domestic Product, or GDP), all German consumers are covered for 10.5 percent of their GDP and French consumers are covered effectively for 9.8 of their GDP. Both countries’ healthcare systems rated higher in performance in a recent World Health Organization report.
“Basic healthcare is a right in every other industrialized nation … not a commodity to be bought by those lucky enough to have money,” says Consumer Reports in a September article resulting from a special six-month investigation, which includes Texas. A report by CU’s Washington office also released Thursday says the nation faces a “healthcare divide,” where the financial burden of healthcare is much greater for the sick and the poor than for the healthy and the relatively well-off. The report finds that the sickest 10 percent of Americans spend nearly seven times as much as the average American spends on healthcare.
Lisa McGiffert, senior policy analyst for the Southwest Regional Office of Consumers Union, said Congress’ failure to implement a national solution means states must “act as laboratories for change, a solution that is far from ideal and at best yields mixed results.”
Texas typifies what ails the rest of the country, but its problem is more severe. Despite a booming economy, the state tops the list of states with the highest percentage of uninsured: 27 percent of the population, or 4.7 million Texans. Even the allegorical safety net for the uninsured – comprised mostly of emergency rooms and community health clinics — is showing signs of strain due to managed-care cost cutting and low-income consumers leaving the welfare rolls for jobs.
“It is pure fantasy to believe that healthcare clinics and emergency rooms provide healthcare for all,” said McGiffert. Consumer Reports says the number of people seeking care from federally funded clinics is up 45 percent over the past decade. But it also notes the 3,000 federally funded clinics can meet only 6 percent of the need for dental care. “The emergency room is not the place to get primary care, follow-up care after emergencies, and care for chronic conditions. And local clinics have to beg for specialty care and borrow unused drugs to try to meet their patients’ needs,” McGiffert said.
In Austin, according to Consumer Reports, the People’s Community Clinic turned away 153 children and 184 women who needed checkups in the month of February 2000 alone, and told 94 pregnant women they would have to wait eight weeks for their first prenatal visit. “For an uninsured person, healthcare means the emergency room at Brackenridge Hospital in Austin … where the price of treating a sore throat may be three to five times as high as in a doctor’s office,” the report says.
If patchwork solutions are inevitable for the time being, Consumers Union believes we should start by finishing the job of ensuring that all children in the U.S. have comprehensive health coverage. CU supports legislation in Congress that would do so. In the absence of true national healthcare reform, CU also is urging Congress to expand Medicare to people between 55 and 64 and to approve a prescription drug plan that covers everyone in Medicare.
In Texas, numerous legislative committees and agencies are grappling with similar issues. CU is pushing for a simplified Medicaid application process for children. The cumbersome process currently in place creates significant barriers to the approximately 600,000 Texas children, mostly of working parents, who are currently eligible for healthcare under Medicaid but do not receive it. The Texas Blue Ribbon Task Force on the Uninsured is also considering the Medicaid simplification issue along with market based solutions to the uninsured problem.
Many proposed market-based solutions either diminish the quality of health insurance products by bypassing mandated benefits, or divide the healthy from the sick. For example, Medical Savings Accounts, high-deductible insurance policies combined with a tax-deferred savings account, move us away from pooling risks, the fundamental principle of keeping health insurance affordable. Consumer Reports calls it “bad public policy” in its investigation. “They give a tax break to people more likely to be healthy, and if they were to become widespread they would help wipe out what subsidies are left in the insurance system to help care for the uninsured as well as for people who are more likely to be sick.”
“Patchwork solutions can never substitute for the real deal,” said McGiffert. “Every few years one of the patches falls off and we have to come back and sew it back on. In the meantime, at a time of great prosperity, second-class medicine is the fate of the swelling numbers of uninsured and underinsured in the U.S. and Texas.”
The principal recommendation of “The Healthcare Divide” report echoes this sentiment. “At a time of unprecedented budget surpluses, Congress should establish, as a matter of law, that all people in this country have a right to comprehensive, affordable, quality healthcare coverage,” the reports states. “If Congress will not undertake a comprehensive approach, it must address the most important needs of targeted populations, while guarding against market mechanisms that divide the healthy from the sick.”
For more information contact:
Lisa McGiffert (512) 477-4431