Think again

The week of the living uninsured


This is “Cover the Uninsured Week” – the fourth such week in four years. They haven’t been good weeks or good years.

Year after year, the sponsors of “Cover the Uninsured Week” report higher numbers of Americans without health insurance. Four years ago, 40.9 million Americans were uninsured. Now it’s 45.8 million and climbing.

This is like watching a horror movie. Call it “The Week of the Living Uninsured.” In every one of these weeks since 2003, we’ve watched lab-coated health professionals and business-suited executives gather at our health clinics to talk about this problem with earnest concern. And still the uninsured emerge in larger numbers every year.

Maybe I’m being too harsh. “Cover the Uninsured Week” has at least called attention to a major failing of our health care system. You can go to its Web site at www.CoverThe and discover new information about the epidemic of the uninsured in America. Examples: More than half of Americans without health insurance don’t get health care when they need it, and 80 percent of the uninsured are in families headed by working adults.

But the producers of “Cover the Uninsured Week” continue to focus more on the consequences of this epidemic and less on its causes. And they have little to say about its cures.

Go to the Kaiser Family Foundation Web site at, and you’ll find a more blunt assessment of why more and more Americans are joining the ranks of the uninsured: “The number of uninsured age 65 and under increased by nearly six million between 2000 and 2004, primarily due to a decline in employer-sponsored insurance.”

The foundation notes that, during that four-year period, the proportion of Americans under 65 who get health insurance through employment declined by five percent. That’s a huge change, which computes to another six million Americans who no longer bring home their health care with their paychecks.

At some point, this debate about consequences has to recognize causes and get real about cures. And this is where the sponsors and partners behind “Cover the Uninsured Week,” who range from the U.S. Chamber of Commerce, health insurers and drug companies to consumer groups, foundations and the AFL-CIO, are hopelessly deadlocked.

You can’t find a straightforward admission that employers are abandoning health care for their workers on the “Cover the Uninsured Week” Web site. And if you click on “What you can do,” you’re asked to sign an e-mail letter to your congressperson to “urge you to make health coverage for Americans your top priority.” Any member of Congress on the receiving end of that message can easily click the reply button to say that he or she agrees with you and is working on common-sense solutions that will be fair to employers, workers and consumers alike. This exchange will be another triumph of form letters over substance.

A problem this large doesn’t remain unsolved for so long because there aren’t solutions. It remains unsolved because vested interests with political clout can block solutions that will cost them money.

That’s the real horror of our feckless search for health care reform. We are blocked at every turn as we search for ways to solve the problems of shrinking coverage and rising costs. Measures to force employers to pay their fair share for their workers’ health insurance are nixed by the business community. Expansions of Medicare to cover children are blocked by the government-haters who would rather privatize Medicare than expand it. Purchasing pools for prescription drugs are vetoed by the pharmaceutical lobby.

Meanwhile, as we become more desperate for solutions, we stumble onto paths of least resistance which offer some hope of universal health care that business groups, anti-government ideologues and drug company lobbyists won’t oppose.

Massachusetts just went down one of those benighted paths. Here’s where it leads: Don’t count on your employer to provide health insurance, buy your own.

Meanwhile, if we have to keep reliving this week, we should demand a different script. Maybe we should call it “Desperate Working Families Week.” But, whatever the title, we need to demand more reality in this production and a plot line that leads to action.

The realities are compelling enough to hold most viewers’ attention. Employers are abandoning health insurance for their workers, not only because they can, but because they gain economic advantage over their competitors by doing so. And we as taxpayers will never be able to make up for the human and economic costs of this abandonment by expanding government health care to working families — because the number of working people without health care is multiplying beyond our capacity to cover them with our tax dollars.

Let’s ask America’s working families to defend the principle that we should be able to earn our health care from our jobs. That doesn’t mean that employers have to sponsor separate health insurance plans, but it does mean that they should contribute to a system that keeps health insurance affordable for all working families.

Otherwise, if we let employers abandon health care for their workers, we’ll be left with two very scary choices: Buy your own health insurance or join the ranks of the uninsure.

Tim Nesbitt is former president of the Oregon AFL-CIO. For more information, check out the Oregon AFL-CIO online at