Cost of caring for Missourians without health insurance impacts everyone in the state

Wednesday, September 3, 2008
FRED LYNCH ~ Dr. Jason Fish and dental assistant Shalen Clark worked on a tooth filling for Medicaid patient Annie Bell at Cross Trails Medical Center in Cape Girardeau.

The cost of health care and insurance, debated and discussed although not resolved at the state and federal levels, is more than just a grumbling point among Missouri consumers.

A study done by the Cover Missouri Project in conjunction with the Missouri Foundation for Health concludes that the cost of caring for uninsured Missourians impacts everyone in the state.

Being uninsured carries life or death consequences, the study found. Nearly 10 working-age uninsured adults in Missouri died each week in 2006, and approximately 2,800 adults in Missouri died between 2000 and 2006 due to a lack of health coverage, according to Cover Missouri.

The cost of caring for the uninsured is borne by insured Missourians and continues to rise along with the number of uninsured Missouri residents.

Julie Metzger, director of social services at Southeast Missouri Hospital, was among the local health care professionals who attended a meeting where a Cover Missouri team discussed the situation. Children and the elderly have protection, Metzger noted, but the people in the middle are the ones at biggest risk, especially those who don't have employer-provided insurance and can't afford to carry their own.

Medicare covers people 65 and over, and for people with limited income, there's Medicaid, but for those in between, not having coverage can mean a difference between life or death.

"If you get cancer or are disabled and you're 40, you have to be disabled for two years before you can get Medicare," Metzger said. "The bills are going to be mounting. If you need expensive cancer treatment and are unable to work, the insurance is not there anymore."

The costs of health care for the uninsured go beyond the obvious. According to information from the Missouri Foundation for Health, treatment for the uninsured costs more because they frequently wait to seek treatment until they are seriously ill; they can't afford early screening and preventive care.

"When they do seek treatment," Metzger said, "their condition is in a much more advanced stage and much more costly. If they had had the ability to seek treatment in the beginning, it might have been something that might have been treated easily."

Frequently people seek treatment in emergency rooms because they know they won't be turned away because of a lack of ability to pay. The MFH notes that that reduces the "quality and availability of personal health services," even though, as Metzger says, when they do present at the emergency room they really are sick.

Economic consequences of poor health care leads to lower productivity on the job, time lost from work and lower earnings, the MFH reports. In addition, according to the MFH, workers in poor health earned about 11 percent less per year than those in good health.

"It's very eye opening when you think about the transitioning and changes," Metzger said. "None of us expect to get sick while we're still working. When we do we could have big problems."

Social workers like Metzger try to help patients as best they can, she said, by seeking out other options, helping them get on Medicaid, finding help with medication from pharmaceutical companies, health education and referring to low-cost clinics.

Cover Missouri is seeking ways to make health care accessible at a reasonable cost for everyone, but it will take legislative action. According to Ryan Barker, health policy analyst with the MFH, "Unless policymakers choose to act to address this problem the number of uninsured will continue to grow and the significance of the problem will have an increasingly negative impact on the entire health care system."

TBY (The Best Years) is a publication of the Southeast Missourian that serves the older adult audience. Paper copies are available at the Southeast Missourian offices and on racks around Cape Girardeau.

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