David Cottle, a professional musician, is one of more than 300,000 Utahns who do not have health insurance coverage — and it's a growing medical problem that can't be solved by taking a pill.
Cottle represented the plight of the uninsured this past week in a discussion at the University of Utah that included a panel of medical and insurance experts. He describes himself as a healthy male, in his mid-40s, who visits a doctor maybe twice a year.
For six of the past 10 years Cottle has gone without insurance and estimates he's saved about $20,000 during that time. Insurance is a luxury he can afford — barely — but it's one he goes without more by choice.
"It's because I feel like I'm getting gouged," he said. As a freelance musician, Cottle has worked part-time jobs to help pay everyday bills and typically those employers are unable to provide insurance coverage. He's searched for "catastrophic care" coverage with a high deductible and low monthly payments for use only in emergencies, but even that costs too much, he said. "I'm convinced the insurance companies are the ones who are making a lot of money here."
His solutions are either that the state require everyone to carry health insurance, much like the state requires auto insurance, thus lowering the costs across the board, or something even more drastic, like cutting all employee heath insurance programs and forcing people to pay on their own.
"People wouldn't pay that much," he said, and again, in theory, the costs would go down.
But it's the people who simply can't afford even the most reasonably priced coverage or don't know how to access the health-care system that have some professionals scratching their heads for solutions.
Sen. Peter Knudson, R-Brigham City, an orthodontist, helped pass a bill last session that allows for the formation of a legislative task force to look at those issues. His solution is to figure out a way to get costly drugs that are beneficial as preventative medicine into the hands of the uninsured before their illness requires even more costly emergency care. "In the long run, you and I pay for it," he said in an interview.
Another answer could be to mandate that businesses provide insurance for employees, he said, but that could be "the pea that pushes the small employer over the hill and out of business." Some recommend tax credits or another mechanism that lowers the costs to employers who offer insurance benefits to lower-income workers.
Some said, though, the only real solution may be an uprising.
"How terrible do we have to treat people until the middle class rises up and demands what they've paid for?" asked Dr. Joseph Jarvis, a Salt Lake City physician and health-care consultant. He says he can no longer "ethically" practice clinical medicine because of the current climate of health insurance in this country. "I spent half my time fighting insurance companies and the other half caring for patients. That is not the way to care for sick patients." And the issue is not just cost of or access to health care.
Americans pay twice as much as the $2,000 per-year per-person average in other countries, Jarvis said. Yet in some of those countries, adequate and affordable health care is available to everyone.
Jarvis' solution — get rid of the administrative overhead and the focus on profits that comes with insurance and managed care companies and pool it all in a non-profit agency. "This is a revenue-neutral proposition," he said.
Not quite what some insurance carriers would have in mind.
"I believe we have a number of mechanisms to provide coverage to people who are working," said Annette Herman, CEO for UnitedHealthcare of Utah, insurance carrier for 250,000 people.
"We need to research and figure out how to get all the people enrolled into the programs that are available," said Herman. As for the fighting between doctors and insurance companies mentioned by Jarvis — "We do not do 'Mother, may I?' medicine," Herman replied. "UnitedHealthcare is unique in this initiative."
Low-income clinics
The following are clinics for the low-income uninsured:
IHC Neighborhood Clinic, 977-0502; Lincoln Elementary School Family Clinic, 578-8376 and Community Health Centers main office, 412-6920.
Each agency works on a sliding-fee scale or provides some form of charity care.
E-mail: sspeckman@desnews.com