The uninsured: Got a solution?

The uninsured have got it doubly tough.

Not only must many wait to see doctors until their medical problems get really serious, but when they finally end up in the emergency room, the hospital charges them more than insured patients.

In one hospital system in San Diego, that meant up to 400 percent more.

It seems unconscionable, but according to a current class action lawsuit, this hospital system (which has five hospitals in the area) has been overcharging the uninsured since at least 2002. The system has now agreed to a $73 million settlement with as many as 60,000 patients. In reality, however, “only a fraction of that amount would go into patients' pockets as refunds because most of them have paid little or nothing on their outstanding bills,” according to the story in the San Diego Union Tribune.

Sixty thousand people is a lot of uninsured, but those are only the ones who came to area emergency rooms. There are many more without insurance – 47 million nationally – and the number keeps growing as people lose their jobs, change jobs, retire, have babies or work for employers who have discontinued offering coverage.

Health care insurance – and the millions who don’t have it – is a huge issue in this year’s presidential election. I’m glad I don’t have to come up with a solution for such a complicated problem, but it seems that everyone ought to have some basic coverage the minute they come into the world. This universal health coverage wouldn’t pay for things like heart transplants or experimental surgeries, but there would be an unequivocal list of benefits like the hierarchy of covered treatments that citizens of Oregon developed a few years ago.

Our current non-system provokes so many questions:

Why should so much of our insurance premium dollar go to the insurance company?

Why should insurance company CEOs be making millions while their companies continually cut back benefits, raise deductibles and refuse to cover those with pre-existing conditions?

Why should insurance employees be rewarded for dropping coverage on customers who have made claims? (Congress is working to make this illegal.)

Many nurses are in the thick of the fray; they see the uninsured every day and the consequences of our non-system. If you could have a presidential candidate’s ear for 10 minutes, what would you tell him/her?