The Social Stigma of No Health Insurance
By Randall | February 26th, 2008 | Category: Health and Money | 15 comments 21,750 views | 15 Comments » |
When did health insurance become a social status symbol in America? Why is is that people without health care are treated differently, even if they can pay immediately for service/treatment?
I and my family have lived without medical care on and off in years past, sometimes due to job (or lack thereof), sometimes due to the cost of the healthcare itself. In either case, We’ve had enough money to pay for doctor’s visits, emergency care, and other non-catastrophic incidents out of our emergency fund. Even with that, the attitude I and my wife have continually received from all the doctor’s offices, hospitals, and other health organizations was that even though we could pay immediately, and up-front, that we were somehow deadbeats and were treated like we should be on welfare or some other government assistance program. It’s gone so far as one doctor refusing to see my wife because she didn’t have health insurance, even if we could pay IN CASH, THAT DAY for the service!
Why is Health Insurance REQUIRED
I’m not saying private health insurance isn’t a necessity, quite the contrary nowadays. But like car insurance, more and more people (and legislators) are looking at this from the point of view that it should be REQUIRED BY LAW to have private health insurance, rather than optional. I believe this is more a push by the insurance companies to increase their revenue streams than any real interest in helping the country. Whatever the reason, there are multiple reasons why an estimated 47 million people DON’T have insurance today.
Health care costs have SOARED out of control, and over the past 7-8 years particularly.
Some Health Care Statistics
National Health Care Spending
- Health care spending is 4.3 times the amount spent on national defense.
- Although nearly 47 million Americans are uninsured, the United States spends more on health care than other industrialized nations, and those countries provide health insurance to all their citizens.
- Health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France, according to the Organization for Economic Cooperation and Development.
Employer and Employee Health Insurance Costs
- Premiums for employer-based health insurance rose by 7.7 percent in 2006. Small employers saw their premiums, on average, increase 8.8 percent. Firms with less than 24 workers, experienced an increase of 10.5 percent.
- The annual premium that a health insurer charges an employer for a health plan covering a family of four averaged $11,500 in 2006. Workers contributed nearly $3,000, or 10 percent more than they did in 2005.The annual premiums for family coverage significantly eclipsed the gross earnings for a full-time, minimum-wage worker ($10,712).
- Since 2000, employment-based health insurance premiums have increased 87 percent, compared to cumulative inflation of 18 percent and cumulative wage growth of 20 percent during the same period.
- According to the Kaiser Family Foundation and the Health Research and Educational Trust, premiums for employer-sponsored health insurance in the United States have been rising four times faster on average than workers’ earnings since 2000.
- The average employee contribution to company-provided health insurance has increased more than 143 percent since 2000. Average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits rose 115 percent during the same period.
The Impact of Rising Health Care Costs
- National surveys show that the primary reason people are uninsured is the high cost of health insurance coverage.
- One in four Americans say their family has had a problem paying for medical care during the past year, up 7 percentage points over the past nine years. Nearly 30 percent say someone in their family has delayed medical care in the past year, a new high based on recent polling. Most say the medical condition was at least somewhat serious.
- One half of workers in the lowest-compensation jobs and one-half of workers in mid-range-compensation jobs either had problems with medical bills in a 12-month period or were paying off accrued debt. One-quarter of workers in higher-compensated positions also reported problems with medical bills or were paying off accrued debt.
- If one member of a family is uninsured and has an accident, a hospital stay, or a costly medical treatment, the resulting medical bills can affect the economic stability of the whole family.
- A new survey shows that more than 25 percent said that housing problems resulted from medical debt, including the inability to make rent or mortgage payments and the development of bad credit ratings.
- A survey of Iowa consumers found that in order to cope with rising health insurance costs, 86 percent said they had cut back on how much they could save, and 44 percent said that they have cut back on food and heating expenses.
From the National Coalition on Healthcare web site
With the costs rising, and the out-of-pocket expenses eating at families even WITH health insurance, what is the average American to do about the situation??
An Extreme Example
One particularly egregious example of the situation cites an increase for entertainment workers in California and New Jersey to more than $44,000/year for family coverage. That’s the median income for the average American, and an average 82% INCREASE from the year before. This is an extreme example, but by no means the only example of rate increases. The breaker for me was when my OWN company sponsored health insurance increased 42% one year (following a 37% increase the year before). That was when I decided I couldn’t afford to pay more for my family’s health insurance than I did for my mortgage.
Is it any wonder that 47 million people in the United States don’t have health insurance today??
So, with all these examples of spiraling health costs, why the attitude??
Is There a Solution in Sight?
Short answer, No.
Little longer answer, Not yet. Maybe.
The American people are at odds with the Insurance industry, Healthcare industry and other Big Business companies that have a vested interest in maintaining the health care industry as status-quo. High costs equate to high profit for many of these companies and they don’t want to see a move towards Universal Health Care (UHC), so they have made it a political and PR issue. Many myths about the ‘evils’ of Socialized Medicine exist (using the word Socialized, is supposed to remind the American public that Socialized = Socialism = Communism = Evil Russian Enemies/bad things/bogeymen).
Universal Health Care, a major issue in the upcoming elections, has been in the works for over a decade now, without being implemented. This is in no small part due to the myths perpetuated by the UHC opponents.
A few of my favorite myths.
Myth: Universal Health Care Would Be Too Expensive – Federal studies by the Congressional Budget Office and the General Accounting office show that single payer universal health care would save 100 to 200 Billion dollars per year despite covering all the uninsured and increasing health care benefits. (*1)
Myth: Universal Health Care is Socialized Medicine – Universal healthcare itself is not socialized medicine, which refers to medicine that is both financed and delivered by the government. In other words, the government pays for and owns the healthcare system. That is the case for so-called “national health services” such as the healthcare systems of the U.K. and Spain, but it is not the case for other health care systems in Japan, Canada, and the rest of Europe. Single-payer systems such as Canada are not socialized medicine in the sense that the mechanisms of delivery are mostly private (i.e. physicians exist mostly in the private sector) (*2).
Myth:The Problems With The US Health Care System Are Being Solved and Are Best Solved By Private Corporate Managed Care Medicine because they are the most efficient –
Fact: Private for profit corporation are the least efficient deliverer of health care. They spend between 20 and 30% of premiums on administration and profits. The public sector is the most efficient. Medicare spends 3% on administration.
Fact: The same procedure in the same hospital the year after conversion from not-for profit to for-profit costs in between 20 to 35% more
Fact: Health care costs in the United States grew more in the United States under managed care in 1990 to 1996 than any other industrialized nation with single payer universal health care
So What Can You Do?
For those without insurance, there are other options, including free clinics, hospitals with ‘required admittance’ statutes, and other avenues out there to get needed healthcare. They’re not easy, and they’re not as publicized, but they are out there. Doing some homework with your phone book may be able to dig up local resources for assistance.
For those with insurance that are just getting by, keep itemizing health expenses (they can be tax deductible) and talk to your employer about cheaper insurance alternatives (like joining a co-op organization for small businesses, or going with HSA plans that can double as an investment).
Stay healthy by taking care of yourself. Even moderate additional exercise can have effects on overall health. Take a walk, play with your kids. Try eating a little less or try to quit smoking.
Until the system gets fixed by our leaders, there’s not that much that individuals can do to change things. Vote for the leaders that have put forth a solution you believe works. Talk to others about their views and try to get others to get involved.
To the health care industry out there.
We know that you have stressful jobs, and you deal with lots of patients without health insurance, but please, PLEASE, the next time you talk to someone without health insurance, TREAT US BETTER! Many of us don’t CHOOSE not to have health insurance, it’s just a financial impossibility to us. Be understanding, it could be you that gets fired and can’t afford health insurance tomorrow.
Do you have viewpoints on Universal Health Care?? What do you think needs to be done? Let Us Know!
Sources

At the moment, my family is among the uninsured (that will be changing in April, thank goodness). While a agree something needs to be done, I’m not in favor of the government taking over our healthcare system.
Oregon has the Oregon Health Plan, which is supposed to provide insurance for those who can’t get it otherwise, and it’s a huge drain on our budget, and quite frankly, the program isn’t effective. You can’t find a doctor who can afford to take on OHP patients, because the reimbursement rate isn’t enough to cover the doctor’s malpractice insurance. This is especially true for OB/Gyns.
It seems that the government screws up just about everything they get their hands on. I really don’t want to trust them with my health!
Lynnae @ Being Frugal.net’s last blog post..Psalm 27
The existing system isn’t working either. With so many people not covered, and it being job dependent, you’re perpetually at the mercy of your employer. It’s getting to the point where people will never move from a job, even if they can’t stand it, because they can’t take their healthcare with them.
We’re working on getting a HSA. Anything else is just crazy without an employer’s help. *sigh* And we’re trying to keep healthy. We do have catastrophe insurance in case something terrible happens.
I love the question about House.
no matter what plan we choose to help the problem, it will not be perfect and wont change things instantly.
its a sad state of affairs when the richest country has one of the worst health care systems
and our rich politicians are not effected by this directly so dont expect them to do much
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I’m paying for my own health insurance out of pocket and it’s too much. But it’s one of those things I believe I can’t afford not to have.
I don’t know much about Universal Health Care to really have an opinion about it but I know that I want health care to be more affordable to all of us.
Frugalchick’s last blog post..Oh, happy day
I’m with Lynnae on being pretty skeptical of the government doing a decent job if they got more control over the healthcare system.
I love HSA’s and think they’re a great option for healthy people like myself. They’ve decreased my health insurance costs by a lot over the last couple of years.
I think another good idea would be to limit the dollar amount that can be awarded in a malpractice suit. I’ve read that this has become a *huge* cost to doctors. If their premiums go down, they can (and better) pass that savings onto the consumer.
Just a thought!
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That seems to be a common thread, the distrust of the government. But there’s a lot of things the government DOES get right (Military, Transportation system, to a point, Food and Drug Administration, Federal Banking system, etc).
The government is a LARGE bureaucracy, and all bureaucracies have problems of one sort or another. Universal Health Care isn’t necessarily going to be COMPLETELY controlled by the government anyway, private contractors and companies will do most of the heavy lifting. Having the government GAO watching costs and verifying the numbers will go a long way to reducing administrative and overage costs.
I love HSA’s too. I’d prefer one since I’m relatively healthy too, but for those that have chronic (read: expensive) conditions, even THAT will be drained dry fairly soon.
I think malpractice suits are out of control too, but we have to be careful of erring in the other direction too. Could you imagine a case where a Gynecologist delivers a child and through their mistake, the child becomes developmentally challenged to the point that they will need special care for the rest of their lives?? Awarding TOO LITTLE, will saddle the parents with a crushing, recurring cost for the rest of their lives. (This actually happened to a friend of mine in Germany, with a military doctor, who CAN’T be sued for malpractice BTW)
There are clearly cases where the amounts are too much, but sometimes, even too much isn’t enough.
I definitely see both sides of the malpractice issue. In the case of a doctor being at fault for developmental disabilities in a baby, it’s going to take a lot of money to give that child proper care throughout his life.
On the other hand, I lost my OB when I was pregnant with my son, because she couldn’t afford to keep delivering babies, due to the high cost of malpractice insurance. The problem? There was one doctor in our county who had two multi-million dollar judgments against him. He wasn’t even in the same practice as my OB, but because our small, rural county was looked at as one that would deliver high dollar judgments, the malpractice insurance of every single OB in our county tripled in price.
A handful of doctors quit delivering babies, and the entire county was down to 3 OBs at one point. There’s something wrong with that.
Lynnae @ Being Frugal.net’s last blog post..Painfully Slow Progress is Still Progress
Why don’t we have government oversite over other types of insurance? Car, Life, Homeowner’s insurance is getting cheaper. . . why?
I am in favor of the government requiring a minimal amount of health insurance, but not having any of the money cycled through the gov’t beauracracy. Let people purchase the insurance product that they feel is best – and then spend the money as they see fit.
No program run by the federal government has ever saved money. “Government” and “frugality” are antonyms. Remember when Medicaid was only going to cost 9 billion a year?
It is ludicrous that we can’t pay cash for health care. We went through the same problem when my wife needed her wisdom teeth removed.
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We do have oversight, it’s called the National Association of Insurance Commissioners (I used to work there coincidentally) It’s state-by-state, not federal, but still a government oversight system.
As for Car Life and Homeowners’s insurance getting cheaper, I can’t say I’ve seen that anywhere. I’d have to see examples. In fact, I’ve had a couple of unilateral increases in insurance over the years (even w/o an accident or repair)
Medicaid is trying to pay for private health care at a fixed price per procedure, but private health agencies always crank up the price over that to what they ’say’ is the going rate. Even with the overrun, the payment levels are lower than private insurance payouts, so there is a cost savings involved (to the recipient, who would otherwise have to have the insurance pay more, or pay out-of-pocket, the difference).
Requiring insurance, w/o providing the funds necessary for that insurance will only exacerbate the existing problem.
An example of government savings (bad example, but the first I could think of) is the practice of hiring Blackwater ’security’ vs. military personnel. While a typical military member may make $30k/year, a private contractor may make $250k/year doing EXACTLY the same job. Military savings in action. (I’d rather pay our military more however, as the job they are doing is exemplary.)
Every other industrialised country has managed to find a more equitable solution. I’m sure you could manage to do the same if you put your minds to it. More equitable, does not have to mean government run, just as it doesn’t in many countries.
There’s a reason why no one else does it your way, just as there’s a reason that no one else has instituted a British style National Health System.
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As a health insurance agent myself, I feel torn between what we should have and what we have all gotten. Everyone deserves the best health treatment no matter what. Even though nobody likes it, most people can afford it and that seems to be the only real reason that private health insurance is so dominant. If the tables were turned, and most people couldn’t afford some kind of health coverage, I believe we would see government sponsored health plans in a snap. Personally, I would like to see American do something more like what Canada and/or France is doing for their citizens.
I agree with Randall. I just lost my job and now have no health insurance and was in a car accident and even with my 3rd party auto insurance paying my medical bills, the doctors want me to sign practically in blood that I will pay the balance of the bill if my auto insurance medical does not. I never even carried a co-pay balance with this physician and today I was treated like a total low life. The government controls practically everything, and yeah, it does screw things up. However, I would rather pay higher taxes to make sure we are ALL TAKEN CARE OF. I have a friend in Canada and I have visited her and have been with her to see her Dr. just to see, firsthand, how their medical system works and it is fine. Not perfect, but fine. Just like anything else.
And Jeff, I hate to tell you this, wake up and take a whiff of reality, but I really doubt that there are people out there who can afford healthcare but opt not to get it. That would be just insane and counter to their own interests, so I don’t know where you got that piece of information. “Even though nobody likes it, most people can afford it and that seems to be the only real reason that private health insurance is so dominant.”
great post(why i keep getting an error when i try to subscribe to your feed)?thanks
Mine? : o