"Not just the health care you can afford

The pharaohs in ancient Egypt had their pyramids. King Louis, the Sun King, had Versailles. Now Hoosiers living in towns like Geist, Carmel and Zionsville have Community Hospital North. Maybe you saw the coverage of Community North’s grand opening on TV, or read about it in The Star, where the headline read, “BIGGER, BETTER.”

The pictures were fantastic, making Community North look more like a five-star hotel than a place where people wearing masks and rubber gloves open you up and feel around for what’s inside. With an atrium of steel and glass, free in-room movies, made-to-order meals, a health boutique, gift shop and café, not to mention the inevitable Starbucks, Community North looks like a great place for a weekend getaway.

I’d go there if I could. And so would you.

But if Community Hospital North is anything, it’s a monument to America’s wildly out-of-whack health care industry. The Star article described Community North as “competing” for patients from the northern suburbs. It’s not the patients the hospital wants, though, so much as access to their health insurance policies. How else will those 282 private guest suites and that “concierge service” be paid for?

If you got it, as they used to say, flaunt it.

The trouble is, fewer of us got it than at any time since the Roaring Twenties. New tax data, reported in March, shows that the top 1 percent of Americans — those making above $348,000 a year — are receiving their largest share of national income since 1928. Meanwhile, the rest of us — those in the so-called bottom 90 percent — have actually seen our average incomes dip.

One of the most obvious ways in which this income inequality shows itself is in the continuing train wreck we call our health care system, especially as it relates to insurance coverage. Now, we’ve all been told about the 44-47 million Americans that are uninsured. Politicians are forever citing these disgraceful numbers. What’s talked about a lot less are the ever-growing numbers of under-insured Americans.

The under-insured make too much money to qualify for health services available to the destitute, but their health coverage is paper thin. A major sickness or accident hammers them financially. Indeed, roughly half of all bankruptcies in this country happen because people are unable to pay their medical bills.

According to a Reader’s Digest report, between 2000 and 2003, seven in 10 adults who were driven into debt by medical expenses had insurance. In 2001, 42.5 million people in insured households paid 10 percent or more of the family’s net income in medical expenses. Premiums for family coverage in employer-sponsored health insurance plans have increased 73 percent since 2000; they’re rising three times faster than the average paycheck and more than twice the rate of inflation.

The Reader’s Digest poll found that two-thirds of adults 21 and over said they “can’t afford to be sick.” About half of the respondents — people, by the way, who identified themselves as middle class — said they put off or refused medical treatment for a serious condition or delayed taking or renewing prescription drugs. Nearly a quarter reported having overdue medical bills, close to half use credit cards to meet their health costs and almost the same number have had to draw down their savings to settle accounts.

This is no way to live. What’s more, it doesn’t have to be this way. A sliver of good news is that more and more Americans, including business leaders who are sick of seeing their profits flushed away so that insurance companies can build new office towers and, yes, so that hospitals can introduce concierge service, are finally calling for universal health coverage.

John Edwards deserves praise for being the first presidential candidate to offer a plan that, experts agree, could actually work. Edwards would roll back tax cuts for households earning more than $200,000 a year, collect capital gains taxes and create a federal health insurance agency that would negotiate rates on behalf of the public with insurance companies. Whatever Edwards’ chances of being nominated are, he has set a standard on this issue by which all other candidates should be measured.

Locally, Dr. Chris Stack is among a growing number of activists who are calling for what amounts to Medicare for everybody. Stack points out that administrative costs associated with private health insurance account for a third of our health care spending. We can grin and bear this industry-driven bureaucracy or we can cut it out.

That may be a kind of surgery they’re unfamiliar with at Community Hospital North. But it would give the rest of us a new lease on life.

Note: There will be a rally for universal health care at the Anthem Insurance headquarters on Monument Circle Wednesday, May 16 at 10 a.m.