With Liberty and Health Care for All: With 44 Million Uninsured and Just about Everybody Else Unhappy with Annual Cost Hikes and HMO Runarounds, It's Fair to Wonder If Americans Are Getting Their Money's Worth from the World's Costliest Health Care System

By Clarke, Kevin | U.S. Catholic, March 2004 | Go to article overview

With Liberty and Health Care for All: With 44 Million Uninsured and Just about Everybody Else Unhappy with Annual Cost Hikes and HMO Runarounds, It's Fair to Wonder If Americans Are Getting Their Money's Worth from the World's Costliest Health Care System


Clarke, Kevin, U.S. Catholic


Chris and Lisa Wilson were living a just-about picture-perfect middle-class life in New York's Duchess County when America's health care crisis came pounding on their front door last spring. Chris had a mid-level management job with an IT services firm; the couple had recently purchased their own home; and Lisa was a stay-at-home mom to 10-year-old Max. But in May, his company battered by three years of a high-tech slowdown, Chris was laid off.

In addition to the normal problems and anxieties that accompany any job loss, the Wilsons found themselves facing a wholly new worry: finding affordable health insurance now that Chris had lost his company benefits. Like millions of other suddenly tenuously middle-class Americans, they tried to balance their monthly expenses against the security of a costly private health plan, but the nearly $700 they would have had to set aside each month just for basic coverage was too much. The Wilsons opted to hold their collective breath and hope for the best--or at least for a new full-time job with benefits.

"We had a 'choice'--we could pay the COBRA [the federally mandated group rate 'bridge' insurance for laid-off workers] or pay the mortgage," says Lisa Wilson.

Going without health insurance is a risk being accepted by an increasing number of Americans. Last year 44 million--more than 15 percent of the population--did not have health coverage, and an estimated additional 40 million were underinsured.

Those are shocking figures for a nation that spends more on health care than any other country in the world--almost $1.6 trillion in 2002, 15 percent of the nation's gross domestic product and an astounding $5,400 per capita. That's well over twice the per capita median of other Western economies and almost three times the per capita spending run up by the much-maligned Canadian system. In fact, our northern neighbor's single-payer network, long the foil of conservative pundits, is now fast becoming the pharmaceutical provider of choice for the U.S.'s cash-strapped seniors and state governments looking to trim costs.

At the same time record numbers went without health coverage of any sort, white- and blue-collar workers in the U.S. fortunate enough to have company-provided health packages have been forced to make record contributions to their plans, coughing up anywhere between 10 and 45 percent of their monthly premiums. At the high end of that scale it's little wonder that more low-paid, full-time workers are "choosing" to leave their health benefits on the table.

But making ever higher co-payments for health insurance premiums is becoming the lesser of two evils for many working Americans. As businesses confront double-digit increases in insurance rates for three straight years, many have simply dropped coverage altogether. Two years ago 65 percent of firms employing 200 or fewer workers provided health insurance. Today that number is down to 61 percent and falling. By some estimates, half of all labor disputes, like the ongoing grocery workers' strike in California, are centered around health care.

In the near future more companies will be forced to juggle plans, eliminate levels of care, shift costs to workers, or drop health benefits altogether, says Tom Hadrych, a vice president in compensation, benefits, and corporate services for DaimlerChrysler. "The trend is that fewer companies are providing fewer benefits, and that trend is going to continue." As more workers lose benefits, they will end up in the gentle embrace of the public system on the public nickel.

His company may have a vested interest in fixing health care since each increase reduces competitiveness and cuts into profits, but Hadrych says the problem is much bigger than its impact on U.S. corporations. The health care industry is on track to eventually lay claim to as much as 25 percent of the total U.S. economy.

"That means that you and I and anyone else who is on the bill-paying side of this has an interest in [resolving] the health care crisis," says Hadrych. …

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