Last week the U.S. Census Bureau released the latest statistics on health coverage in our country, and the numbers are troubling.

In 2006 there were 47 million uninsured Americans, up from 44.8 million in 2005. The percentage of the U.S. population without health Insurance reached 15.8 percent, the highest rate since 1998. It's clear we've got a health care crisis in our country, and as the census data shows it's only getting worse.

A major reason for the increase in the ranks of the uninsured is the continuing breakdown of the employer-based insurance system:

Job-based health insurance, which is the way most people get their coverage, began falling in 2001. The percentage covered by job-based insurance fell to 59.7%, from 60.2% in 2005.

Many jobs, particularly low-wage ones, don't come with insurance. An additional 1.3 million full- or part-time workers were uninsured last year compared with 2005, the Census found.

Reasons for the decline in coverage among workers include fewer employers offering coverage and fewer workers enrolling, even if their employers do provide insurance. Premiums rose 7.7% last year, hitting $11,480 for a typical family plan offered by employers, according to a survey by the Kaiser Family Foundation.

Out of control health care costs have made it prohibitively expensive for many employers to offer health coverage to their workers, and those that do offer coverage charge extremely high rates. As Douglas Besharov of the American Enterprise Institute said,

"Employers are really feeling a bite here, and so as much as possible, they're trying to limit these increases and push them onto the employees. That means a lot of people drop their coverage."

Another troubling trend from the census statistics is the rising number of uninsured children. In 2006, 8.7 million had no health coverage, compared to 8 million in 2005 - a nine percent increase in just one year. That makes it even more urgent for President Bush to sign the State Children's Health Insurance Program reauthorization bill passed by Congress. SCHIP has covered 5 million children since 2000, so without it the ranks of uninsured children would be even bigger.

Karen Davis of The Commonwealth Fund summed up the implications of the latest data on health coverage:

"Today's news is very disturbing. It means more Americans are going without needed care or facing crushing financial bills. Lack of insurance undermines the quality of care, as the uninsured fail to receive preventive care and cannot afford to take the medications that would keep their chronic conditions under control. And it undermines the health and productivity of our workforce and the strength of our economy."

– 09/05/07

Embarq Corporation, a major provider of local telecommunications services, recently informed some 14,500 retirees that their medical coverage, life insurance, and matching gifts programs are being "significantly changed."

These significant changes mean that workers, some of whom started working for Embarq in the 1950s, will have an average yearly cost of $2,000 which could escalate for older retirees suffering from increasing health issues.

Sandra Muntis, a former Embarq employee and a CWA member from Elida, Ohio, doesn't know what she's going to do.

Her husband has multiple sclerosis, and she suffers from diabetes. She wrote to her local that without supplemental health care from Embarq, her family "could not afford procedures requested by physicians to keep [them] in good health."

Another retiree struggling to deal with this new plan is Bessie Reveal, 74, of Greenville, NC. She started working for Embarq in 1955 and retired after 31 years of service.

"We made this company what it is today," she said. "We worked hard for it. We didn't run things like they run it now. ... They're taking everything that we worked for away. We don't have nothing. You're trying to survive. Unless you saved some money when you were working, you're up the creek. And it don't take long to spend what you save."

The plan is estimated to save Embarq $300 million over the next ten years. But according to The Daily Reflector,

That's of little consolation to retirees, King said, when they see executives bank multimillion-dollar bonuses and severance packages. When Len Lauer's employment as chief operating officer with Sprint was terminated last August, he received a package that could be worth $13 million, plus pension benefits. Michael Fuller, who had been with Sprint and Embarq for 32 years, exited with a $24 million package when Embarq eliminated the position of chief operating officer.

This cost-cutting tactic doesn't quite add up for Embarq's retirees, some of whom have devoted decades of service to Embarq.

"We're not going to roll over and play dead for them," said Reveal. "I gave the biggest part of my life to the company, and this is what thanks you get for it."

The photos accompanying this blog post show CWA members protesting Embarq's benefits cuts. You can voice your own protest by becoming an activist for CWA's Health Care Voices campaign. Click here to tell Embarq CEO Daniel Hesse not to sacrifice retirees' health for the company's bottom line.

Then visit eq65 to stay up to date on the latest developments in Embarq's attempt to cut retirees' health benefits.

– 09/04/07

We've already touched on some state initiatives to bring health coverage to all residents. Here are a couple more efforts that have been under debate.

California is currently in the middle of a serious debate on how to reform its health care system. A recent poll showed that 69 percent of California voters are dissatisfied with the state's current system, compared to just 28 percent who are satisfied. That's a considerable reversal from a poll in December, which showed 51 percent were satisfied with the health care system and just 44 percent were dissatisfied.

"If anything, the poll says the Legislature should think broadly about health care reform, and the cynicism will only increase if nothing gets done," said Anthony Wright, executive director of Health Access California, a group advocating expanding health care through both government and employer programs.

"Clearly, voters are in the mood for broad change."

In an attempt to bring that change, Governor Arnold Schwarzenegger is touting a public-private hybrid plan that would cover 6.5 million uninsured Californians by expanding state government programs and requiring employers who don’t provide coverage to pay 4 percent of their payroll to subsidize coverage for the poor.

Members of the state Legislature have proposed alternative plans, including one that is similar to Schwarzenegger's but that calls for employers to pay a higher percentage of payroll for employees' health coverage. Another proposal in the Legislature would create a single-payer health care system, but Schwarzenegger has rejected this outright.

Californians, however, have not. The new poll shows that 36 percent of California voters support the single-payer plan, up from 24 percent last December. That's three percentage points more than the support for the governor's plan.

The Schwarzenegger plan is similar to one enacted last year in Massachusetts, which requires that all residents buy insurance, pays for the program through assessments on employers, hospitals, and providers, and subsidizes insurance for the poor.

But now that it's been implemented, some say the Massachusetts plan has had some unintended, negative consequences for the poorest residents:

The rules, which are scheduled to take effect Oct. 1, are part of the state's effort to push nearly everyone in Massachusetts to get health insurance. To fund subsidized coverage for low-income people, the state is drawing on money previously used to pay for free care at hospitals and health centers, so the state needs to reduce payments for free care in the long run.

…

Proposed deductibles and copayments are likely to scare some needy patients away, they said, while proposed limits on eligibility could financially hurt hospitals and community health centers that serve uninsured patients who can't afford to pay.

These are the exact types of issues that need to be worked out as we move forward with national reform to achieve universal health care, and that's what makes these state efforts so important.

– 08/29/07

While the national debate on health care reform heats up in anticipation of the 2008 election, individual states have been working on their own solutions to the health care crisis.

In Colorado, where 17 percent of residents lack health insurance, the state legislature created the 208 Commission last year to develop ideas on how to best reform the state's health care system. The group is now examining a comprehensive analysis created by an independent consulting firm that lays out four potential plans for reform.

The four options include proposals to expand current government programs, require employers to provide coverage or pay a certain amount per employee to a group plan, mandate that all Coloradans buy insurance and subsidize those who cannot afford it, and create a single-payer system to cover all residents.

Pay attention to the progress of Colorado's 208 Commission, because

"The states are the laboratories right now," said Alwyn Cassil, public affairs director for the Center for Studying Health System Change in Washington, D.C.

"There's motivation at the state level, because states are living with this every day," she said.

The motivation in Missouri, for example, just got even clearer. A study found that both employers and individuals in the state have seen their health care costs rise rapidly in the past few years:

The study by Compdata Surveys, a national compensation survey and consulting firm, said 72.3 percent of Missouri employers paid more than $450 a month per family for health plan premiums as of March 1, 2007, compared with 45.3 percent in 2003.

At the same time, 52.9 percent of employees paid more than $250 in monthly premiums for family coverage this year, up from 30.1 percent in 2003.

…

“Individuals often believe they are carrying the majority of health-care cost increases on their own,” Amy Kaminski, Compdata’s manager of marketing programs, said in a statement. “However, in actuality, both parties are sharing the burden of increasing costs at various degrees.”

The double edge of the health care crisis in crucial, because it means that momentum for reform is likely to increase on both sides. It's going to take a strong, widespread coalition to achieve the necessary reforms to guarantee coverage for all.

– 08/27/07