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News from the University of Arkansas for Medical Sciences
Students
Hear Lack of Health Insurance Is
"Domestic Security Issue"
MARCH
11, 2003 | Medical, nursing, and public
health students at the University of
Arkansas for Medical Sciences (UAMS) heard
today that they must help solve the
problem of health insurance access for the
working poor.
Joseph Thompson, M.D., M.P.H., an
assistant professor in the Department of
Pediatrics of the UAMS College of Medicine
and associate director of the Arkansas
Center for Health Improvement,
released a new analysis of the impact of
the uninsured on Arkansas hospitals,
showing that admissions of patients
without insurance increased by 30 percent
between 2000 and 2001 while the average
charges for those admissions increased
from $8,185 to $9,268 (See box below.) The center is a
joint health policy research program of
UAMS, the Arkansas Department of Health,
which collects data from all Arkansas
hospitals, and BlueCross BlueShield of
Arkansas.
Dr. Thompson spoke during a panel
discussion at UAMS that was part of the
week-long nationwide observance, Cover the
Uninsured Week, a project of the Robert
Wood Johnson Foundation and a broad
coalition of advocacy organizations.
Panelists spoke to a packed auditorium of
students and staff.
Chancellor I. Dodd Wilson, M.D., commented
that the number of Americans who cannot
get health insurance is 16 times the
population of Arkansas. Unreimbursed care
at UAMS and its network of regional Area
Health Education Centers (AHECs)
approaches $100 million per year, he said.
"It’s a big problem for
institutions" like UAMS.
Dean James M. Raczynski, Ph.D., of the
UAMS College of Public Health commented
that health insurance access is a
fundamental public health problem "of
the 21st century." The
increase from 1999 to 2001 in unreimbursed
hospital charges for patients without
insurance is "staggering" and
probably due to patients arriving at
hospitals in later stages of disease, he
said.
Dr. Thompson called the rising proportion
of working Arkansans who cannot obtain
health insurance "a domestic security
issue." Most citizens without health
insurance are full-time workers whose
employers cannot afford to provide
coverage. "They are the people
walking next to you on the way to the
parking lot this afternoon," he said.
"Hold on to your idealism," Dr.
Thompson told the students in the
audience. "We do have a challenge and
the challenge is hard. With your help, we’ll
be able to solve this."
Dean E. Albert Reece, M.D., Ph.D., M.B.A.,
of the College of Medicine called the
situation a paradox: the U.S. can provide
the "best medical care in the world,
but we have a troubled system." He
explained that uncovered hospital charges
cut into revenue that supports medical
education, pointing out that government
subsidies to medical schools have dropped
dramatically since the 1950s, so that
patients’ fees have become a critical
source of revenue.
The health
insurance gap is "not a crack in our
system; it’s a deep wide chasm,"
family medicine practitioner Larry Braden,
M.D., of Camden, Ark., said. Dr. Braden
describes patients in his community who
have died of colon cancer and cervical
cancer because they could not afford to
pay for regular medical check-ups, and one
patient who is on dialysis with advanced
renal failure because he couldn’t afford
to see a doctor.
"Their deaths and advanced illness
occurred on my watch," he told the
students. Physicians must struggle with
how much free care they can give to
patients who lack insurance, he said.
"You have to get in and work through
your entire careers" to help reform
the health care system so everyone can get
the care they need, he told them.
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Joseph Thompson, M.D., told
students that the national health insurance gap is "a
domestic security issue." (Kevin Christensen) Click on
photo for larger view.
Left to right: Dean E. Albert Reece, Dean James M. Raczynski,
Paul Cunningham of the Arkansas Hospital Association, Larry
Braden, M.D., of Camden, and medical student Kate McCarthy
(Kevin Christensen) Click on photo for larger view.
Students, staff, and faculty were clearly moved by dramatic
stories of working families without health insurance. (Kevin
Christensen) Click on photo for larger view.
Chancellor I. Dodd Wilson, M.D., presided over the panel
discussion, part of the nationwide Cover the Uninsured Week
observance. (Kevin Christensen) Click on photo for larger view.
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First-year
medical student Kate McCarthy told the
panelists, including UAMS Chancellor I.
Dodd Wilson, M.D.; Dean Reece of the
College of Medicine; and Dean Raczynski of
the College of Public Health, that the
economics of health insurance are
affecting students’ "capacity to
care." As the working poor delay
preventive and primary health care,
waiting until they are in medical crises
to come to hospital emergency rooms,
medical students have fewer chances to
observe "the natural progression of
illnesses," she said. The high costs
of providing unreimbursed care also affect
where medical school graduates choose to
practice and the specialties they select,
she said.
"The goal is to find insurance for
these people," she said to applause.
Paul Cunningham of the Arkansas Hospital
Association warned that as the problem of
unreimbursed costs becomes more severe,
community hospitals may have to close. No
hospitals have closed in Arkansas since
1994, he said. Hospital administrators
worry more about the rising proportion of
in-patient admissions with no health
insurance than they do about Medicaid
reimbursement, workforce needs, and
disaster preparedness, he said.
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1999 |
2000 |
2001 |
Number of
Patients
Admitted without Insurance |
17,815 |
20,545 |
26,843 |
Percentage
Increase in
Admissions without Insurance |
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15 |
30 |
| Percentage
of All Admissions |
4.9 |
5.5 |
6.8 |
| Hospital
Charges, in millions |
$151 |
$168 |
$248 |
Percentage
Increase
In Uncovered Charges |
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11 |
48 |
Average
Charge, by Admission
Of Uninsured Patient |
$8,484 |
$8,185 |
$9,268 |
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Links on This Page
Arkansas Center for Health Improvement: http://www.achi.net/
Cover the Uninsured Week: http://covertheuninsuredweek.org/
UAMS Doubles Efforts: http://www.uams.edu/today/2003/022703/RecruitPhysiciansinDelta.htm
Robert Wood Johnson: http://www.uams.edu/today/2002/091902/schroeder.htm
Health Care Access in the Rural South: http://www.uams.edu/today/2002/041802/htyh.htm
Grant Helps: http://www.uams.edu/today/080201/rural.htm
© 2003 University of Arkansas
for Medical Sciences (UAMS). A single copy of these materials
may be reprinted for noncommercial personal use only. "UAMS,"
"UAMS Online," "UAMS Today," "UAMS
Update," "uams.edu," and "Here’s to Your
Health" are marks of UAMS.
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06/23/03 |
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