Perspective: The Real Crisis in Health Care, Something Has Got to Give

President Bush's proposals to expand Health Savings Accounts and health insurance tax breaks may help a little. However, the help appears mostly targeted to the healthy and wealthy and does little to curb health care costs. It may even raise the cost of employer-based coverage on which sicker workers will still have to rely. Even if Bush's ideas were helpful, they are small-scale, nibbling at the edges of the country's health care crisis.

by John Bouman

Forty-six million Americans have no health insurance. About 1.8 million of them are here in Illinois. The facts are painful. The uninsured are sicker and die sooner. They have trouble on the job because they are frequently “sick at work” or preoccupied with family health issues. They have crushing medical debt, which is the second leading cause of family bankruptcy and a leading cause of family stress and breakdown. And the cost of their emergency care is built into hospital rates charged to insured patients, whose insurance is therefore $1,000 more each year in Illinois. In addition to this human and social cost, the financial cost of the uninsured is now a major part of the cost of doing business in America. Something has got to give.

The public sector in Illinoishas stepped up admirably. Through Medicaid, KidCare, FamilyCare, and the new All Kids program, Illinois offers publicly supported health coverage to about two million Illinoisans who are elderly, have disabilities, or are in working families with children. Even with this strong performance, Illinois’s uninsured population grows every year due to losses in the private sector, mostly in small businesses. Middle-class families and people without children (mostly younger and lower paid) are now the bulk of the uninsured.

Illinois Sen. Debbie Halvorson and Rep. Mary Flowers have a promising idea that would go to the heart of this issue. It is the Healthy Illinois Program, now pending in the General Assembly. It would decrease the cost of private-sector insurance for small employers and their employees and provide public subsidies to ensure affordability for lower-paid workers not eligible for any current public health coverage program. Healthy Illinois asks every sector to agree to changes—hospitals, insurance companies, doctors, and consumers. Healthy Illinois is one idea that offers relief for the health coverage crisis on a scale that would have a significant impact.

President Bush’s proposals to expand Health Saving Accounts and health insurance tax breaks may help a little. However, the help appears mostly targeted to the healthy and wealthy and does little to curb health care costs. It may even raise the cost of employer-based coverage on which sicker workers will still have to rely. Even if Bush’s ideas were helpful, they are small-scale, nibbling at the edges of the country’s health care crisis. The public is desperate for strong action, and the political potency of the health coverage issue is perhaps unsurpassed. The true crisis lies not in the rising cost of health care but in the impending social and human costs of neglecting real solutions. Something has got to give.