This article first appeared in the St. Louis Beacon: September 24, 2008 - Give leaders in the public health field any reason to gather and you’re bound to hear chatter about disparities in funding and shortages of nurses. Put them on a panel in front of a large crowd at a television studio six weeks before a presidential election and prepare to hear a full-blown discussion about what’s ailing the country’s health care system.
Five health experts from the St. Louis area took part in such a panel discussion Tuesday night at KETC Channel 9 . The event, co-hosted by the television station and the nonprofit Missouri Foundation for Health, previewed the airing of “Critical Condition,” a two-hour documentary that profiles four families dealing with a lack of insurance and access to health care.
Filmmakers spent two years following 15 people who, through a variety of circumstances, became uninsured. Four stories made the final cut, which debuts Sept. 30 on PBS stations (9 p.m. on KETC Channel 9).
“We’re all one step away from not having health insurance,” said Jilann Spitzmiller, the film’s co-producer and co-director. “If you have a job you might get sick and lose your benefits. The thing about the film is we bring a human face to the statistics.”
Those statistics show that roughly 46 million Americans are without health insurance. In Missouri, nearly 730,000 people (or roughly 13 percent of all residents) are uninsured, including 150,000 children (10 percent of that total population) and 8,000 people (1 percent) over the age of 65, according to the U.S. Census Bureau’s Current Population Survey. The overall rate of the state’s uninsured dropped slightly in the last year, but numbers increased for children and the elderly.
For Illinois, the total not covered is 1.7 million; with 210,000 people under 18; and 22,000 people over 65.
Dolores Gunn, director of the St. Louis County Health Department , said more than 60 percent of the 86,000 patients her agency sees annually have no health insurance. Ninety-five percent of them are working at least part time.
Sidney Watson , a professor of law at Saint Louis University who specializes in health care access for the poor, said that in about 64 percent of the more than 1,000 bankruptcy filings she recently surveyed in Missouri either sickness or the cost of medical care led to the financial downfall.
“What we see over and over is the downward spiral – people get sick, can’t work and lose their job,” Watson said. “They lose their health insurance and become sicker and can’t enter the workforce.”
Though panelists bemoaned Missouri’s past cuts to Medicare and called for increased state support for programs that help the uninsured, most of the conversation was focused on the national picture.
Several panelists complained that the Wall Street financial crisis has derailed the conversation about health care, which they said has been in a crisis for years.
“My question is: ‘Where are the priorities?’” Gunn said. “If we can bail out Wall Street overnight for $700 billion, can’t we step up to fix health care? We have more than enough money to provide basic health care services to everyone in the country. To say it’s cost prohibitive isn’t true.”
Added James Kimmey, president and chief executive of the Missouri Foundation for Health , an organization that funds community health activities: “We know how to do this stuff better, but we ain’t doin’ it.” (He added that institutions that profit from the current system don’t have the incentives to change it.)
Several panelists called for a greater focus on preventative care. Gunn said the cost of seeing a patient who comes in for a health maintenance visit is exponentially less than the cost of treating a patient who has already been diagnosed with a health condition like diabetes.
Nonprofit organizations have largely taken the lead in providing services for area residents without insurance. (Gunn pointed to the work of the St. Louis Regional Health Commission, a group of safety net providers working to address the health care needs of the uninsured.)
Judy Bentley, founder and president of Community Health-in-Partnership Services (CHIPS), a nonprofit organization that provides health care and social services for the uninsured and underserved, said her group tries to find people who might not have access to health care by staking out grocery shops and beauty salons in St. Louis.
“We try to make relationships with people where they are,” she said. “It’s these people who we want to keep productive at work.”
Most of the people served by CHIPS are employed but work for a company that doesn’t provide health insurance, Bentley said.
She and other panelists agreed that Missouri residents and people across the country face tough questions about health-care funding.
“Are we committed to expanding health insurance and figuring out how to pay for it or are we going to run away because we don’t know how much it will cost?” Watson asked.
Elia Powers is a freelance journalist.