Uninsured cost us all

Moderated by Tom Sabulis

By Ricardo Azziz

What would you guess are the biggest threats to the health and longevity of Americans? Cancer? Infectious diseases? Heart disease?As top causes of death in the United States, these are certainly strong contenders.

What about lack of health insurance? It’s one of the biggest threats to our health as individuals, and to the health of our nation’s economy.

Some 48.6 million Americans lack health insurance, and millions more are under-insured, according to the U.S. Census Bureau. More than 19 percent of Georgians are uninsured, far exceeding the national average and placing us among the top-10 states for uninsured residents.

Georgia is among the top five states with the highest number of premature deaths due to lack of insurance.

But before you say, “It’s not my problem,” let’s take a closer look. Uninsured citizens depress our collective ability to grow the state’s economy – driving up the cost of health care, reducing the number of healthy workers, limiting tax revenues and diluting the competitiveness of businesses and health care providers.

No one is insulated from the cost of the uninsured. In 2010, Georgia hospitals employed 157,000 people, contributing $38 billion to the economy. Any person in genuine need, regardless of insurance status, will receive care at our community’s hospitals – for legal, but most important, for moral and ethical issues. This commitment to care comes with a high cost. In 2010, Georgia hospitals provided over $1.5 billion in uncompensated costs to the uninsured. Georgia’s only public academic health center, Georgia Health Sciences Medical Center, provided $37 million of that cost, more than $100,000 every day in unreimbursed care.

You may be surprised to learn that a large proportion of the state’s uninsured are active participants in Georgia’s workforce. Why would people with jobs be uninsured? For starters, 98 percent of Georgia firms employ fewer than 500 people, and less than half offer health insurance. Even when insurance is offered, it is often cost-prohibitive; 38 percent of eligible workers in the smallest businesses fail to enroll or opt out of employer-sponsored health insurance.

Meanwhile, health care costs continue to rise due to factors including an aging population, the profusion of technology and a system that emphasizes treatment rather than prevention, particularly for the uninsured.

An estimated 26,000 to 45,000 citizens die prematurely each year due to lack of insurance, able to access care only when their problems become extreme. And catastrophic care costs a lot more money than preventive care.

The high rate of uninsured and the low rate of employer-sponsored health insurance in Georgia is unlikely to improve in the short term without active intervention, such as an accessible and transparent small/individual insurance marketplace, better education of employer and employees, and economic incentives and disincentives for small businesses or ultra-small businesses offering insurance.

It is time to decisively face the problem of the uninsured in Georgia – because it is everyone’s problem.

Dr. Ricardo Azziz is CEO of Georgia Health Sciences System and president of Georgia Health Sciences University.

8 comments Add your comment

Retired Vet

January 19th, 2013
12:45 pm

I look at what could have been my situation and I shudder. I am a retired military person who retired before the Tri-Care plan was established, and I am able to take davantage of the VA Healthcare program or an employer provided health insurance. I have looked at applications for health insurance for individuals, and some of the questions that require a “no” answer would render me uninsurable. That’s a frightening thing to consider.

Roy from Troy

January 19th, 2013
10:01 am

What’s all the fuss. The solution is simple. Replace all current health & prescription insurance plans with a federally mandated individual insurance plan like Medicare. The government describes plans of coverage that may be offered and insurance companies develop the premiums based on experience and costs – separately for adults and children (as defined by our government). There is no “group” or family category. Only individuals will be covered. Families could buy adult and children’s coverage as needed. Because there is no group involved, coverage would be portable and independent of employer and other groups. The systems are already in place – what’s not to like.
What about the uninsured? That’s easy. If you don’t buy this insurance you will be required to apply for coverage paid for by the government – and you will have to prove need for government support. If you don’t have a private or government insurance card and get medical care – get out your credit card or pay with cash.


January 19th, 2013
7:23 am

The problem with letting the “free market” determine what the outcomes will be with health insurance is that insurers only want to cover healthy, young people. Older people with issues–Parkinson’s, Altzheimers, cancer, kidney disease, bone disease– have been in a bind. In my family’s case, I have a good insurance plan, though it is high deductible so that I can afford it. My husband has Parkinson’s, and, until he and I are eligible for Medicare, I cannot stop working. Not only would insurance be unaffordable, but we wouldn’t be able to get it for my husband. No insurer would underwrite a policy. This was why I was hoping to get a single payer health plan like France has. But our nut jobs in this country refuse to not let the “free market” dictate policy. In other words, the health care insurers have poured billions into the pockets of our elected officials to keep our dysfunctional system the way it is. To wit, Medicare Part D, wherein Dubya the Dumb passed the most expensive health care entitlement program that primarily benefited the pharmaceutical industry because it does not allow negotiated prices. Follow the money.

David Hoffman

January 19th, 2013
4:08 am

All other long existing industrialized representative democracies have much lower rates of uninsured than the USA. Those other nations have systems that cover 90% to 99% of their population. We refuse to learn from other nations health care financing systems, because they do not adhere to a rigid mythological free market ideal. We pay more per person for a lower percentage of population coverage than those nations.

David Hoffman

January 19th, 2013
3:58 am

SAWB, the problem with a potential en mass move to Health Savings Accounts(HSAs) is the void in funding the healthcare system during the transition. The funds that pay for care would be diverted to build up the HSAs, leaving no funds, for a period of time, available to pay for the present day health care of those insured or uninsured who have really large medical costs. We are talking about maybe 12 months of diverted insurance premiums funds to build up all the HSA accounts needed for the entire USA population. How do the medical bills get paid in the interim? It is about a 1 Trillion dollar issue. Where do we get the transition funding?


January 19th, 2013
1:37 am

The problem is that we have developed this idea that someone else should pay for our healthcare. This is fine if you have a job that covers these expenses, but becomes a problem when you do not. We would be much better off if everyone was once again responsible for their own healthcare through the use of Health Savings Accounts. That way a job loss would not automatically result in the loss of healthcare. While employers or the Government could contribute to these accounts ultimately each individual would be responsible and free to make their own decisions.

middle of the road

January 18th, 2013
6:49 pm

“Sure, the occasional person would be financially ruined by catastrophe,”
It is not just “ruined by catastrophe”. Since most people would not be able to afford a million-dollar cancer treatment, hospitals would not be able to afford giving them out for free, so they just would
just not offer them. So the patients would just die – like they used to before insurance.


January 18th, 2013
4:15 pm

Part of me wishes there was no such thing as insurance. There wouldn’t be the financial inventive to charge more and do more to get higher reimbursements. Sure, the occasional person would be financially ruined by catastrophe, but since insurance if offered at affordable rates, that never happens. So we’re better of now.
Wait …