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More Are Losing the Health Care Lottery
More Are Losing the Health Care Lottery
July 30, 2009 - 7:13 am
'The Lottery,' a short story found in many high school literature anthologies, depicts a society that is blind to its own brutishness. Each year to guarantee a good harvest, the citizens of a fictional Bennington, Vt., author Shirley Jackson's hometown, randomly choose one resident to sacrifice by public stoning.
The American health care system is nearly such a lottery. Citizens smart enough, lucky enough, or willing to make sacrifices that can include working in a job they don't want, get reasonably good health insurance. That insurance includes a modicum of preventive care and efforts to diagnose disease in its early, more treatable stages.
Citizens who can't find the shrinking number of jobs that come with coverage - or those who lose such jobs - are in the lottery. Their numbers are growing. According to the Kaiser Family Foundation, only 60 percent of American employers still offer their employees health insurance. Two-thirds of the uninsured are employed.
Four years ago, the New Hampshire Legislature created a plan to save lives and money by providing the uninsured with free cancer screenings when appropriate and help quitting smoking. The screenings were never funded, and this year, to help balance the budget, lawmakers killed the modest $1 million to $2 million in spending they had originally approved.
On Sunday, Monitor reporter Dan Barrick described Rochester resident Amanda Gonzales and her family's plight. They are among the millions of Americans who work but are uninsured.
Cancer runs in Gonzales's family, and she has a worrisome lump in one breast. Most breast lumps are not malignant, but knowing that does not provide peace of mind. Gonzales had a mammogram four years ago and another one could tell her whether she has anything to worry about. If the lump is a malignant tumor, it could also give her a much better chance of beating the disease. But the cost of a mammogram, she said, is roughly equal to a month's grocery budget for the family of five.
"If the results come back fine, that's great, but I'll feel I wasted my family's money," Gonzales told Barrick. She and her family lost the health insurance lottery. Now she'll have to wait to see if she loses the lottery of life.
Had the screening program been funded, Gonzales, 31, might have been helped and the cost of more expensive treatment later may be avoided. That cost, if its incurred, will be borne by taxpayers if Gonzales becomes indigent, or by employers and the insured who will pay through higher premiums.
Much has been made of Massachusetts's bold, and increasingly more expensive experiment in providing near universal health insurance to its residents. But what New Hampshire has done, under Republican and Democratic administrations alike, is the more typical state response and the reason why health care reform must occur at the national, not the state level.
New Hampshire, one of the richest in the nation, takes in $230 million from the cigarette tax and its share of the settlement money paid by tobacco companies to help mitigate the damage caused by their product. It spends not one penny to combat tobacco use and has, according to the American Cancer Society, the worst tobacco cessation and prevention record of any state.
The state fails at meeting the screening needs of its low-income residents, fails to adequately care for those with a mental illness, and fails those who've lost the health and health insurance lotteries - all in the name a harvest large enough to prevent the need to modernize its tax system. But then, who are we to cast stones?
posted on July 30, 2009 12:09 PM ()
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