No tears for those who choose not to buy health insurance

LETTER — Posted Oct. 9, 2006

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Regarding "Uninsured climb to 46.6 million" (Article, Sept. 18): I read, with growing alarm, the stats you presented regarding the plight of the uninsured, and with even more trepidation, realized that you weren't touching upon the underinsured with those figures.

Media outlets are claiming that a "crisis is looming." Not looming, kids -- been here a while. Now so monstrous that no matter how many residents we throw at it, how many Medicaid expansions we legislate, how many charitable souls we con into helping with it, we can't sweep it under the rug and forget it anymore. Boomers are starting to figure out what Medicare/Medicaid really is and the guy next door doesn't answer his phone because he can't pay his ER/hospital/radiology/doctor's office bill. Something has to give.

I think one of the first things that comes to mind when I read your stats that is startling to me, but not mentioned, really, is how many people make a choice to be uninsured. When we saw this with automobiles, we solved this by legislating the necessity for insurance for the privilege of driving on our roads. We should legislate health insurance in the same way.

Don't mistake me. I do not say this cavalierly. I have had to choose between niceties and insurance in my life, too.

I chose to pay for insurance and forgo cable TV, a nice car and fast food until I could better afford it. I also paid out of pocket for both of my children's care, so I know how expensive it is. But I never thought I shouldn't pay for my own or my children's health care. I never thought it should be someone else's problem. I also don't think this situation applies to everyone that is uninsured. However, looking at your article, I am surprised at the number of people it does apply to.

Our government is finally beginning to tell people in this country how to get off their lazy cans and lose weight. It don't come easy, folks, no magic fix, gotta do it yourself. Why can't we send the same message about all our health care?

Taking good care of yourself and preventing disease is your responsibility, too, and may also prevent your financial ruin. Choosing to forgo insurance coverage offered you at work for an extra couple of trips for you and the family to Chili's each month is not sound reasoning. People need to hear this.

If you describe yourself as working poor and can't afford to match funds for group coverage at work, or can't afford to carry at least a cheaper catastrophic policy of some sort, look around.

I'm not going to weep for you if you carry a cell phone, have cable/dish TV, watch DVDs on a regular basis, drive a car to work less than 5 miles (everyone in this town does that) a day and I see you every other day down at the Sonic Drive In, or the nail and tan salon. That's a choice you are making, not a hardship forced upon you.

I do, however, weep for the poor people who die waiting for care while the nonemergent, illegal and just plain impatient crowd our ERs and run them out of business. I weep for a future that seems to have people looking to government to help them out of this crisis.

When we look to government to help us with our health care woes, we also should look for news stories about Medicare payments being held to physicians in order that government may cook its books, and letters that went out to seniors demanding back overpayments accidentally sent them, for examples of how efficiently and expertly the system might be managed. Sadly, we may get what we asked for.

I don't claim to have the answer, but I am willing to pitch in, and I think more of us need to have a change of attitude about this crisis we find ourselves in the middle of.

Rikki J Scoggin, MD, Holdenville, Okla.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/10/09/edlt1009.htm.

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