Today the New York Times published a story on the mental and physical health of New Orleans evacuees. According to the story:
The study, conducted by the Mailman School of Public Health at
Columbia University and the Children's Health Fund, is the first to
examine the health issues of those living in housing provided by the Federal
Emergency Management Agency. Based on face-to-face interviews with more than 650 families living in trailers or hotels, it provides a grim portrait of the
hurricane's effects on some of the poorest victims, showing gaps in the tattered
safety net pieced together from government and private efforts.
I haven't been able to find the source on line, so I can't comment on the specifics. However, the overall picture is not surprising. One observation they made caught my eye:
Forty-four percent (of adult evacuees) said they had no health insurance, many because they lost their jobs after the storm, and nearly half were managing at least one chronic condition like diabetes, high blood pressure or cancer.
Our reliance on employer-based insurance coverage continues to fail all of us, but especially the poor. It is infuriating to me that we continue to insist this is the only way, while Western Europe, Australia, and Japan have been able to provide universal coverage to their citizens. The only reason we can't is that we cater to large insurance corporations who like the current system. Remember how they reacted when Clinton proposed changing it?
The current system is completely anticompetitive. Employers negotiate with a few insurers, who are only interested if the employees are a good risk. The employers are interested in insurance that is the least expensive for them. The employees themselves, who will actually use the services are not consulted on what they want.
Once the insurance goes into effect, the only competition that goes on occurs between the provider offices and the insurance company. Basically, the system is this: the physician office employs at least one person to make sure all claims are paid. The insurance company employs people whose job it is to assure that as few claims as possible are paid. They fight it out with each other, raising costs, and slowing down service delivery. It's no wonder we have an incredibly expensive system that nobody likes.
I'm glad that Massachusetts is trying to provide insurance to all, but I'm pessimistic about the plan. State governments don't have the resources to manage a plan like this. Ultimately, as New Orleans is showing us, the solution has to be with the Federal Government.