Plan in works to cover uninsured

By Jill Coley, The Post and Courier

Published January 18, 2008

Diane West’s uninsured brother, William West, was hospitalized a week ago, suffering complications from a life-threatening inflammation of the pancreas. The 50-year-old, who also had hepatitis C and diabetes, died early Thursday.

Now, Diane West and her sisters are gathering in Cross to mourn. When it comes time to pay his medical expenses, they will throw up their hands, she said.

“I guess they’re billing, but I don’t know,” said West, a resident of Moncks Corner.

Tri-county area hospitals provided more than $68 million in services that patients couldn’t pay for during 2006, the South Carolina Hospital Association estimated. Statewide, the amount topped $660 million.

More than half of that cost was shifted to insured residents and employers who provide insurance. In 2005, the average American family paid $922 more per year in premiums to help cover the care provided to the uninsured, the hospital association said.

In a matter of weeks, the Covering Carolina Collaborative is expected to unveil its plan to cover the uninsured. The collaborative — comprising the state hospital association, S.C. Medical Association, S.C. Chamber of Commerce and S.C. Managed Care Alliance, an insurer’s group — has met since early 2007.

The plan will address affordable health care coverage by using different approaches depending on the population, said hospital association spokeswoman Patti Smoake.

“For people at a certain level, market options do not help,” Smoake said. “Some can’t afford any premiums.” Solutions expected to be mentioned in the plan include expanding Medicaid and tax credits.

Carolyn Thiedke represents South Carolinians for Universal Health Care, a group that favors a single-payer system, similar to those in Canada and France.

“One of the reasons our health care system is so expensive is this really complex insurance system,” Thiedke said. “Any proposal that tries to work within that system will ultimately fail.” Plans that call for vouchers and tax credits continue to work within the private insurance system, she said.

South Carolinians for Universal Health Care, which is seeking nonprofit status, is creating a plan to present to the Legislature in the next year and a half, Thiedke said.

“Right now in South Carolina, your health is your individual responsibility,” said Lynn Bailey, a Columbia-based health care economist affiliated with the universal health care group. “You’ve got to figure out how to take care of and how to pay for it.”

More than 115,000 of those without health coverage in the state are children, records show. The third edition of the Uninsured Children in the South, a report released this month from University of South Carolina’s Southern Institute on Children and Families, found that 46 percent of the nation’s uninsured children reside in the South.

Institute President Nicole Ravenell said she would welcome an expansion of coverage. The Legislature voted last year to increase the eligibility level for the State Children’s Health Insurance Program from 150 percent to 200 percent of the federal poverty level. But the expansion has yet to be enacted.

Still, a lot can be done under current rules, she said. Reducing barriers to applying for assistance and educating people about what’s available can help. “In South Carolina, there’s very little outreach of enrolling in programs. Our goal is to make eligible people get enrolled.”

West said her brother didn’t have the best work history and struggled with alcoholism, but, she asked, is that a reason he should go without a safety net?

Before his death, the family worried how they would pay for the $400-a-month medicine to keep him alive. “Everyone should have access to health care. I truly believe that, especially in this country,” she said. “I thought we heard all this before. I thought we figured this out.”

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