COVERAGE: Tough Choices for the Uninsured

Pierre Aterianus, 57, of Whitefish Bay, Wisconsin, has a problem, reports the Milwaukee Journal Sentinel. In January, he was laid off from his job. For seven years, he had been an engineer at the household garbage disposal manufacturer InSinkErator.

Aterianus didn't just lose his livelihood; he also lost his health insurance. Now Aterianus can't afford to visit the doctor. According to the Sentinel, his last doctor visit cost him $597.50 -- more than one-third of his monthly income and significantly more than the $150 he has left every month after paying his mortgage and real estate taxes. Every month, Aterianus has to choose between competing necessities -- food, utilities, or health care.

So Aterianus is forgoing his doctor visits and putting off  tests to monitor his high cholesterol. He knows that can increase his risk for serious health consequences, such as heart attack or stroke, but Aterianus feels that he doesn't have other options. For the next two months, Aterianus has catastrophic coverage. This means that he would have some assistance paying for a serious event, such as hospitalization for a heart attack, but does not have coverage for the cheaper, regular doctor visits that might help prevent such a crisis. He hopes that BadgerCare Plus, a recently expanded state public health insurance program, will cover him when his current insurance expires. BadgerCare Plus covers adults between the ages of 19 and 64, if they have no dependants under 19.

"If BadgerCare doesn't kick in, I'm just going to have to hope my diet is good and just hope for the best," he told the Sentinel. "I'm going to have to go without because of the cost of the tests and doctor visits."

As we've discussed before, the economic downturn has left many uninsured and unemployed. Since early this year, American families have reported forgoing or putting off necessary care due to cost concerns. Families without insurance who wait to seek preventive care are often forced to seek costly emergency room care when they get seriously ill.

"People are coming in here sicker than in years past, and you have to think why that is," Robert Pachner, medical director of Columbia-St. Mary's Urgent Care unit, told the Sentinel. "Given the economy, you can connect the dots."

In addition to being more dangerous to the families and children who are uninsured, this practice also places a burden on hospitals and results in a hidden tax of higher premiums for those who do have insurance. One example of the strain on hospital budgets is visible in Minnesota. Many large public hospitals in the state are looking to cut vital services, such as drug rehabilitation programs or burn units, to compensate for funding lost treating the uninsured, reports the Minneapolis Star Tribune. 

Len Nichols, director of the  Health Policy Program here at the New America Foundation, estimates that the number of Americans without insurance has probably risen significantly since the official numbers were last available, from 45.7 million to 50 million or more. That's 50 million reasons to fix health care now.