Guest Column

Time to consider the vast uninsured

By DR. MARC J. YACHT
Published October 3, 2007

I remember participating on a Primary Care Committee that met in Tallahassee. At that time Hillary Clinton was pushing her health care proposals through community forums around the country. I naively thought the United States would finally get universal health care.

The late Wendell Rollason served on the committee. Wendell had a colorful history but was best noted for his successful efforts to address the needs of Florida's migrant children through the Redlands Christian Migrant Association (RCMA). The group and its members are active in the Dade City area and across the state. They don't beat a loud drum; they just do good work for migrant kids.

I might have skipped later meetings except for the opportunity to rub shoulders with Wendell, a true Florida icon, who received enormous respect wherever he appeared. Being the fairly new bureaucrat to this committee, I expressed my optimism that much of what we were discussing would be moot with the implementation of Hillary's universal health care plan. Wendell didn't say much and let me ramble on. When he did speak, he made it quite clear that he doubted such a plan would be successful and suggested that it would take another 10 years before this country would be ready to support a health plan for all. I defended my position though somewhat deflated and told Wendell we would celebrate Hillary's successful effort at lunch together.

Sadly, Wendell and I never had a lunch that would celebrate universal health access for all Americans before his death in 1997. Wendell would never say, "I told you so," but would walk along with his shock of white hair, stooped over a bit with his cane, appearing saddened by what Americans refused to do for each other.

Looking back, Wendell was wrong; he predicted that it would take 10 years for universal health coverage. It has been almost 20 years since my first meeting with the Primary Care Group and we're not even close to a plan that would scratch the surface of universal health care.

Quite the opposite, for it appears that the small gain accomplished by State Children's Health Insurance Program (S-CHIP), the 1997 health insurance program reaching out to uninsured low-income children who do not qualify for Medicaid, may be cut again or possibly abandoned.

The president bellows that expansion is a step toward federalized health care. That's an interesting stretch. Even organized medical associations are having trouble with that rhetoric. S-CHIP has been a highly successful program of which the major criticism has been that too many children are left out.

Florida lost millions of dollars in federal match by increasing the barriers for applications to qualify children. The state went from a high of 360,000 children covered to fewer than 200,000 of the almost 800,000 that could quality under current federal guidelines.

Of course the need for S-CHIP and so many other programs that target specific populations would go away with a sane universal health care policy.

Gov. Charlie Crist recently announced that one in four Floridians under the age of 65 have no health insurance. A recent article suggests that although the official number of uninsured in the nation tops 47-million, if you consider any American uninsured during the course of the year, that number could top 90-million. There are only 302-million Americans and about 37-million of those are older than 65 and have Medicare. If there is any truth to the 90-million uninsured, that means almost 34 percent of Americans younger than 65 may find themselves unprotected by health care insurance at some time during the year.

As for Pasco County, we are due for a reassessment of our uninsured. I would estimate the number at 25 percent younger than 65. That percentage does not consider the homeless population, which remains largely invisible to our census, or people who have insurance only part of the year.

It is very difficult to defend our current nonsystem of health care that seeks to protect private insurance and reject a national health care program based on a tax. If you don't believe it is a dysfunctional system, just ask executives from General Motors or Ford. By the way, House Resolution 676 suggests expanding Medicare to all. It has been around a couple of years. There appears to be more interest now. It will work and get Americans the health care they deserve.

Dr. Marc J. Yacht of Hudson is the retired director of the Pasco Health Department.

[Last modified October 3, 2007, 00:37:54]