Monday, November 17, 2003

Meanwhile, back in the burbs, the hollowing out of the middle class continues:

... 43 million people in the United States ... lack health insurance, and their numbers are rapidly increasing because of ever soaring cost and job losses. Many states, including Texas, are also cutting back on subsidies for health care, further increasing the number of people with no coverage.

The majority of the uninsured are neither poor by official standards nor unemployed. They are accountants like Mr. Thornton, employees of small businesses, civil servants, single working mothers and those working part time or on contract.

"Now it's hitting people who look like you and me, dress like you and me, drive nice cars and live in nice houses but can't afford $1,000 a month for health insurance for their families," said R. King Hillier, director of legislative relations for Harris County, which includes Houston.

Which is absolutely fine for people -- until they start having trouble swallowing, or get a strange rash or a few odd aches, at which point they more or less have to let it slide until it becomes an emergency -- and a far more expensive thing to treat than it would have been earlier.

There are a bunch of aggravating factors here -- aside from the soaring cost of insurance, per se -- which this particular article doesn't discuss. For instance, uninsured patients can wind up getting caught in the crossfire between hospitals and insurance companies. It's now standard practice for hospitals to set outrageously high "base rates" for treatment, so they can negotiate deep "discounts" with insurers and still make a profit. But the uninsured don't have anyone to negotiate "discounts" on their behalf, so they wind up getting billed the outrageous "full rate", in extreme cases, more than eight times as much as an insurance company.

The upshot to all of this is personal bankruptcy... oh, what was that about bankruptcy reform?

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