Lack of Health Insurance Looms Large

More than 5,560,000 people in California have no health insurance--about 20% of the state’s total population. It would be nice to think that a growing economy and a tight labor market would solve much of the problem. Yet, in the midst of the most prosperous economy in American history, the problem is getting worse, not better. Nationwide, more than 100,000 people a month lose their health insurance, and the problem shows no sign of abating in the near future.

The 1999 Orange County Health Needs assessment survey found that more than 335,000 adults and almost 90,000 children are uninsured in Orange County. And 9% of respondents reported needing to see a physician, but could not do so because of cost. This, coupled with the fact that Orange County spends far less per capita than any other county in California, leaves many of our residents on a high wire with no safety net.

I am a doctor, not a politician or a policy-maker. For that reason, I have no grand prescription for solving this problem. I can assert with great confidence, however, that the growth of the uninsured population represents a public health problem that deserves the same sense of urgency as cigarette smoking, alcohol abuse, or wearing seat belts.

People without health insurance are much more likely to live sicker and die younger than their insured counterparts. A recent report by the American College of Physicians-American Society of Internal Medicine found that uninsured Americans are up to four times as likely as insured patients to require both avoidable hospitalizations and emergency hospital care. Furthermore, uninsured children, compared to their insured counterparts, are up to 40% less likely to receive medical attention for a serious illness.

Considering what’s at stake, it is important that California’s voters ask some key questions of any politician seeking our votes. Are you aware of the evidence showing that people without health insurance coverage are at a greater risk of unnecessary suffering and even premature death? If so, how do you propose to expand coverage? Are you willing to support a plan to provide health insurance to all Americans? How long will it take to reach this goal? If you are proposing an incremental strategy for expanding coverage, what will the next steps be to get everyone covered, and how long will it take?

Ideally, all presidential candidates should commit either to creating or supporting a plan to give health insurance to all Americans within their first year in office. Otherwise, the number of uninsured will continue to grow and eventually become a menace that threatens us all.