The Change Agent

Volume 18: Voting in the 2004 Elections

America's Health Care Crisis

by Steve Bender

In the coming months, as the presidential election heats up, you will be hearing the candidates talk a lot about health care. Many people feel that there is a health care crisis in the United States. Though the United States' economy is the biggest in the world, and in many ways we are the richest country in the world, 43.6 million Americans have no health insurance. That is about 15% of those who live here. This number has increased since 2002, when the Census Bureau reported that about 41 million people in the United States were uninsured. Yet, many more people go without insurance during some part of the year. According to a study by Families USA, about 74.7 million people under age 65 (almost one-third of Americans) were without health insurance for all or part of 2001 and 2002.

Every other industrialized country in the world has some form of health insurance for all their citizens, but not the United States. As the years go by, the situation is getting worse, not better. Though there are certain things that state governments can do to help with this situation, for the most part, this is a national problem that the federal government needs to help solve. Hearing the politicians talk about this issue can be very confusing, and it's hard to know who to believe. This article will give you:

a) some pre-reading reflection questions,
b) some facts and figures about the health care crisis in the United States, and
c) some ideas for activities in the classroom.

Pre-reading Questions

  • Who do you know who is working at a job that doesn't provide health insurance? What do they do when someone in their family is sick or needs to see a doctor?
  • Who do you know whose job offers health insurance, but the premiums are so high that they can't afford to pay?
  • Who do you know who lost a job, and therefore lost their insurance?
  • Do you know a senior citizen who can't afford all of their prescription drugs? What do they do when they can't afford all of their prescriptions? How does this affect their health?

Health Care Facts

  • Approximately 43.6 million Americans had no health insurance in 2002 and the numbers keep growing. About ¼ of these (over 10 million) are children.
  • In 2001 there were 41.2 million uninsured Americans; in 2000 there were 39.8 million.
  • 8 out of 10 uninsured Americans are in working families with modest incomes. Either their jobs don't provide health benefits or they can't afford the premiums.
  • More than 7 out of 10 people without insurance have at least one full-time worker in the family. This means that over 30 million people have a full-time worker in their family but have no insurance.
  • Workers' health insurance premiums increased an average of 12.7% from 2001 to 2002. This was the largest increase since 1990 and the sixth year in a row of premium increases.
  • Job loss is the primary reason why adults become uninsured at some point during the year. Though laid off workers are eligible to keep their insurance by using the COBRA program, only 20-25% of unemployed workers eligible for COBRA coverage can afford to purchase this coverage.
  • 35% of laid-off workers are ineligible for COBRA because they work for a small firm, or were uninsured before they got laid off.
  • Up to 1.6 million people-including about half a million children-have lost health insurance in the last two years due to cuts in Medicaid and the State Children's Health Insurance Programs (SCHIP). The biggest reasons for these cuts are drops in state tax revenues and deep state budget deficits.\
  • These cuts would have been much worse, but the federal government gave $10 billion in temporary relief to state governments by increasing federal Medicaid rates. However this rate increase expires on July 1, 2004 which could force states to make even deeper cuts.
  • Each one percent increase in unemployment increases the number of Americans who lack health insurance by about 1.2 million.
  • Because of extremely low eligibility levels, more than four out of five low-income, uninsured adults are ineligible for Medicaid or other public health coverage in their state.

Activities

  • With all the numbers provided in the Health Care Facts column, there are lots of possible math problems to give your students using fractions, percents, etc.
  • Using these charts and graphs, you could create lessons on how to read them, and/or have students create their own charts and graphs on this or other issues.
  • After discussing the questions, students could write about their own experiences or interview someone they know (a classmate, a family member, a neighbor, or a co-worker) about their experiences.

Discussion Questions
1. Why do you think so many people don't have health insurance?
2. What kinds of people are affected by this problem?
3. Who do you think might be responsible?
4. Who should solve the problem?
5. What do you think should be done?


Steve Bender is the executive director of the 1199 Training & Upgrading Fund in Connecticut. He administers adult education programs for the 1199 members throughout the state.

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