When you live in the wealthiest nation in the world but can still claim over 40 million people without health insurance–despite spending more than twice as much per capita on health care as any other nation–you might have a problem. Nowhere is this more apparent than in my home state, Texas, which leads the nation with 24.5% of its population uninsured.
Since the state government has done little to address the situation (often making things worse, by significantly defunding the Children’s Health Insurance Program (CHIPS), for example), others are taking up the slack. Yesterday’s New York Times reported on one way that local hospitals are using to ease the financial strain of a broken health care system: offering free primary medical care for the uninsured.
On the surface, it’s a nice story about organizations helping out those whom the system has left behind. Although the U.S. health care system is fundamentally flawed and will remain so without universal coverage for all Americans, it’s clear that by offering free medical care, these organizations are making a big difference in a few people’s lives.
But, this isn’t a story about altruism in action. This is a story about hospitals trying to save money… by giving out free health care, specifically to individuals without health insurance who have repeatedly end up in the emergency room due to a lack of primary medical care:
“For most preventive efforts there is an upfront expense,” said Alan D. Aviles, president of the corporation. “But over the long term it saves money.”
Denver’s public system, Denver Health, has 41,000 uninsured patients enrolled in its clinics. Officials there calculate that for every dollar they spend on prenatal care for uninsured women, they save more than $7 in newborn and child care.
The “safety net” plan of the Seton system in Central Texas accepts people making 150 percent to 250 percent of the federal poverty limit and has resources to support 5,000 patients. (People below the poverty line, which is $13,200 a year for a family of two in the contiguous states, can obtain care through the public clinic system.)
Officials scrutinize the records of plan members to see who is still overusing the emergency room or being repeatedly hospitalized — these high-cost patients total some 40 each month — then assign them caseworkers to help improve care and bring down costs.
A special effort to educate 631 asthma patients saved the plan $475,000 in one year, Seton officials said.
This article illustrates two important points about health care: preventative care saves money, and private market-based health care systems are incredibly wasteful, especially when compared to government or other “free” or “universal” systems. More significantly, though, every day that the U.S. maintains its current system is another day that people needlessly suffer, endearing the physical pain and financial difficulty of health problems that should have been preventable. That alone is enough reason to switch to a universal health care model. However, we all know that money talks, and as more and more businesses realize that the current system is bad for the bottom line, our chances of seeing real change improve dramatically.