Rising Number Of Uninsured Is Everyones Problem


    GRAND RAPIDS — Despite an unprecedented economic boom, more people in Michigan were without health insurance in 1999 than in 1990.

    The cost to hospitals across the state: $823 million in unpaid medical bills in 2000, most of which were generated by people without health insurance. That’s about $150 million more than what went unpaid in 1999.

    Citing those trends, a coalition of health care providers, insurers and business advocates are offering ideas to bring basic coverage to the more than 1 million state residents who are without health insurance. Seventy percent of the uninsured in Michigan are people who are employed in low-wage jobs and go without insurance because they or their employer can’t afford it, according to the Access to Health Care Coalition. The same people typically don’t qualify for federal Medicare or Medicaid coverage.

    “The growing number of uninsured residents challenges every community’s health care resources,” said Spencer Johnson, president of the Michigan Health and Hospital Association that represents 156 non-profit hospitals in Michigan. “These are people in the workplace, receiving wages and also paying taxes for government health programs like Medicare and Medicaid, yet they themselves are ineligible for health care coverage.”

    The association is among a dozen organizations and businesses that comprise the Access to Health Care Coalition, which formed two years ago to explore ways to improve access to the health care system for people without insurance.

    In a report issued last week, the coalition called for stepped-up efforts to extend existing programs that offer health coverage for those who are unable to afford it, make employers and their workers more aware of such, and expand health care centers in schools.

    In two specific instances, the coalition wants to see changes in rules that would allow people enrolled in the state’s insurance program for low-income children, MIChild, to use that monthly fee to pay for health insurance offered through their employer that can cover the whole family.

    The coalition also endorsed expanding a program now used in three counties, including Muskegon County, that uses existing Medicaid funds, employer and employee premiums, and public and private donations to fund a low-cost bare-bones health plan for small businesses. Efforts to form a similar program in Kent County, where an estimated 50,000 people are without health insurance, are ongoing.

    Michigan’s uninsured rate went from 10 percent in 1990 to 11.2 percent in 1999, according to a Blue Cross Blue Shield of Michigan analysis. Quite often those people hesitate to go to a doctor when they become ill, or they visit a hospital emergency room for care.

    When a person without insurance is unable to pay the ER bill, the hospital ends up either eating it or shifting that cost to other areas in order to recoup the loss, resulting in higher health care costs for everybody.

    “The high cost of the uninsured is also a high cost for the insured. This is a problem for everybody,” said Lody Zwarensteyn, president of the Alliance for Health, a Grand Rapids health care planning agency.

    Many of the people who go without health insurance work for small businesses, which make up a sector of the economy that has generated most of the nation’s job growth during the past decade, yet are the least able to afford health coverage for their employees. The situation has worsened in the last three years as health insurers, citing escalating costs, passed on double-digit increases in premiums, forcing many small businesses to drop their insurance plans or raise employee contributions.

    “It really does come down to money for the uninsured,” said Marianne Udow, a senior vice president at Blue Cross Blue Shield of Michigan.

    With its report issued, the coalition plans to continue to press political and business leaders across the state to take up the cause and weigh its ideas. The coalition wants to work with other organizations to increase awareness of the issue and implement its recommendations.

    “We don’t want this to be a book on a shelf that doesn’t go anywhere. We want to focus on what’s doable and what’s practical,” Udow said.

    While the coalition’s report does not offer the “ultimate answer” to affordable health care for all, it does set the foundation to begin addressing the problem, members say.

    “It’s important not to let ‘perfect’ get in the way of ‘good,’” said Dr. Gregory Forzley, medical director for Advantage Health, a physicians’ group in Grand Rapids owned by Saint Mary’s Mercy Medical Center.

    “It’s not the total answer, but it’s a great start.”

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