Monday, April 23, 2012

Who Are The Uninsured?

There was an enlightening article in the Los Angeles Times over the weekend. It discussed the plight of visual effects artists in Hollywood, the guys and gals who make the computer generated graphics you see in movies like "Titanic 3D" and just about every modern movie you can think of. Apparently there is a lot of job dissatisfaction in the field. They are unhappy with their long working hours and lack of company subsidized health care insurance. Now they are attempting to unionize their work force.

The workers, oops I mean artists, are frequently forced to work on very tight schedules. Their gigs may last weeks at a time while working fifteen hour days to make sure a movie is finished in time for its release. The jobs may be exhausting, but they are paid $1,000 per day. The newspaper discussed one artist, who didn't want his name released because of fear of reprisals. He is a forty year old guy who had been working seventeen hours a day for 75 days straight on the movie "National Treasure: Book of Secrets." He was so exhausted from his work that he crashed his car while going home from a particularly long day. Shortly after the job, he developed chest pains and went to the emergency room where he was eventually diagnosed with having a heart attack. He didn't have any health insurance so now he is stuck with a $100,000 medical bill.

Hmm. First of all, I'm not even going to mention the whining these artists are doing about their work hours. Fifteen hour days for weeks at a time but getting paid $1,000 a day? Most medical residents would kill for that kind of compensation considering their working conditions are similar but they don't make nearly $1,000 a day. More like $800 a week. Heck, most doctors don't make $1,000 a day. So right away I lost pretty much all sympathy for these people.

Then to read that this one guy made $75,000 in two and a half months but still didn't have any health insurance had me bringing out my tiny violin to play him my saddest song. Seriously? He is easily pulling in over $100,000 a year but still didn't buy health insurance? He wants to unionize because he wants somebody else to pay for his insurance because he is still cheap to buy it himself? Since I am classified as a private contractor by the government, I've had to buy my own health insurance ever since I finished residency. I've never complained about it because that is the price of doing business. I've never once thought that somebody should be responsible for my own well being.

This brings up the question of how many people in the United States don't have health insurance. I've read numbers as high as fifty million people have no coverage. But who are these people who don't have insurance? Are they all some poor destitute or even middle class families with children who can't afford it? Let's break down those numbers. The Census Bureau has noted that nearly ten million of those people are probably illegal immigrants. A study by Blue Cross/Blue Shield showed that about fourteen million people are eligible for some sort of government help like Medicaid or SCHIP if they are ever sick and find themselves in the emergency room. They just haven't bothered to sign up for these government insurance programs yet. Millions more people are uninsured but only for a few months of the year as they may be between jobs. Then there are the millions of people like the sad sack in the newspaper who make plenty of money to buy their own health coverage but choose not to because they think they are young and invincible. Overall, Blue Cross/Blue Shield calculated that only about eight million people in the U.S. are actually long term uninsured but want insurance. Also remember that lack of health insurance doesn't mean lack of health care in this country. Thanks to EMTALA, anybody can walk into the emergency room and get health care, whether they can pay for it or not.

So it's obvious that many people are uninsured not because they can't afford it. They would just prefer that other people pay for it. Everybody wants a company to pay for their health insurance because according to tax laws it is classified as tax free income. Who wouldn't want tax free income? Ultimately I think the only legitimate way to get everybody insured in this country will be to have a single payer system where everybody pays a TAX to have the government insure them. Just call it a tax and get it over with. Stop playing games with "mandates" and "obligations". Start talking about TAXES to get everybody used to the term and discuss the benefits of insuring everybody in the richest country in the world. The people will understand. Until then there will always be haves and have nots in health insurance.

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