HEALTH CARE/Joan Retsinas

Uninsured Still Missing from the Table

The holiday table beckons, with the American family, a la Norman Rockwell, gathered around. At the Republican candidates’ table, the uninsured are missing. Nobody invited them. Maybe the candidates hoped, much as many families hope every season, that nobody would miss those sad-sack relatives. Consider the candidates.

Herman Cain, the dynamo behind Godfather Pizza, touts his entrepreneurial genius, without apologizing that the bulk of his workforce – all those 20-hour-a-week employees scattering pepperoni over zillions of pies – got no insurance from their employer. Texas Gov. Rick Perry presides over a state that boasts not just a high rate of job-creation, but the highest rate of uninsured children in the nation: 20.5%. That statistic has vanished in the euphoria over the low-wage economic miracle that is Texas. Congressman Ron Paul (R-Texas) knows that some people lack health insurance. As a physician, he cared for some of them, pro bono. He even rejected Medicare and Medicaid; if patients couldn’t pay, he treated them anyway. He expects other providers to do the same, in a conservative Valhalla.

Former Sen. Rick Santorum (R-Pa.) loves family – not just his own, but all families. He wants family-friendly policies, but also wants to push government out of families’ lives, letting families buy their own health insurance, from their own (even if meager) funds.

Congresswoman Michelle Bachman (R-Minn.) decries the high costs of governmental efforts to cover the uninsured. Many of her taxpaying fans are insured by Medicare, but they don’t know that Uncle Sam picks up most of that tab. Neither does she. Former Utah Gov. Jon Huntsman wants to let states craft their own solutions to the health care mess, not Uncle Sam.

As for former Gov. Mitt Romney, he did craft a solution in Massachusetts. That plan, relying on mandates and subsidies, has extended health insurance to almost all Massachusetts residents. Yet instead of taking credit for it, he has proudly promised never to do anything like that to the nation if we elect him. All these presidential wannabes vow to repeal Obamacare, regardless of the impact on the uninsured. The uninsured should wait for prosperity, should stop complaining, should just disappear from the political landscape, as they’ve disappeared from candidates’ electioneering blather.

And the electorate is probing candidates’ backgrounds (who did or didn’t hire an illegal immigrant to mow the lawn?), parsing their records, making them unroll exhaustive “plans” for curing our economic ills, but isn’t discussing the uninsured. Poof! The uninsured have disappeared from the conversation.

Since the uninsured were one spur to national health reform, it is time for a reminder. The uninsured still exist: 52 million strong.

“Uninsured” often translates into “sick” because we’ve shrunk the safety net public clinics and hospitals. The uninsured can go to emergency rooms (and receive dunning letters until the end of time), but they can’t go there for routine treatment of diabetes, heart disease, arthritis, asthma – the chronic illnesses that ail so many of us. They can’t go there for routine vaccines. They can’t get medicines there.

Try budgeting $1000 a month into a monthly income of $3000. Try finding a policy if a family member has an illness. And premiums don’t count the co-pays, deductibles and non-covered expenses. The Commonwealth Fund estimates that 72 million Americans have “medical debt.” A study of bankruptcies traces almost half to medical debt. Occasionally, the election-conversations will touch upon the uninsured. Candidates dredge up some long-mentioned “solutions” to lower costs: tort reform, alliances, and bare bones policies. They don’t lower costs enough.

As for jobs, they are not the solution. In boom cycles we’ve had high numbers of people without insurance. Companies don’t have to give employees insurance: it is a benefit, not a right.

These candidates’ holiday tables are crowded. Lobbyists, the Fortune 500 CEOs, hedge fund dynamos, right-wing ideologues – all take their place. It’s time for the candidates to invite the uninsured.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, December 1, 2011