There were forty-six million uninsured Americans in 2004.21 Forty-six million Americans like Dr. Richter’s patients, the uninsured siblings with juvenile diabetes who were unable to afford proper medication and treatment for a treatable condition. “I took care of them for years. When George was twenty-one years- old, he essentially died from complications of diabetes. At the same time his sister, Tina, was five months pregnant and had a premature baby that didn’t survive, mainly because the mother was a poor candidate for pregnancy after years of untreated diabetes. Then a year later, at twenty-five years old, Tina had a heart attack, ended up needing bypass surgery and died on the table. And this was just one family, but it became routine. These were people who didn’t need to live this way.”
Forty-six million Americans are like another of Dr. Richter’s patients, a woman in her late fifties with post-menopausal bleeding. “She came to me because her family was begging her to see a doctor. She had obvious signs of cancer and I said, ‘Look, here are the things we need to do.’ And she said, ‘I just can’t afford it right now.’ And she kept waiting. Then she had a pulmonary embolism and died, which is a sign of cancer. She just kept delaying and ignoring signs for at least a year and a half. She didn’t do anything because she was afraid of the costs, but then she died.” This woman paid the ultimate price with her life. People without insurance are right to fear high medical costs, but they shouldn’t have to pay with their lives.
Ironically medical procedures and treatments often cost more for people who are uninsured, than for people who are insured. A study prepared by the Hospital Accountability Project of the Service Employees International Union investigated this issue and found: “While insurance companies and other third-party payers have aggressively negotiated discounts for their health plan participants, the uninsured have been left behind. Without any bargaining power of their own, uninsured ‘self-pay’ hospital patients are expected to pay non-discount ‘gross charges.’ ” The study further found, “. . . patients who pay full gross charges—typically the working poor who earn too much to qualify for Medicaid or charity care but are not covered by insurance—generally pay twice as much as the payment received for insured inpatients.”22 People without insurance, and those with inadequate private insurance, are on the front lines of our medical crisis.