Ohio at Fever Pitch Over Health Insurance Coverage, Sick Days Initiative

Blade Series on Health Insurance Problems Should Sound a Warning Bell, As Democrats Start National Convention OhioNewsBureau 

By John Michael Spinelli

COLUMBUS, OHIO: With no universal health coverage in Ohio and affordable health insurance being offered primarily through employers, it was only a matter of time until the massive loss of jobs and the subsequent loss of health insurance to working Ohioans and their families through those jobs would come home to roost, exacerbated all the more by the formidable opposition mounted by elected leaders and business groups to defeat a November ballot initiative that if passed would mandate employees receive seven paid sick days. The Blade's series, and the sick feeling business is having over sick days for Ohio workers comes as Democrats start their national convention in Denver, where they will make health coverage, and the ability of Americans to afford it, a top priority.

In the painful and unwanted throes of rising unemployment, which in Ohio has hit a 16-year high (7.2%), the results of a health insurance poll performed by the Health Foundation of Greater Cincinnati showing that about 19 percent of Ohioans ages 18-64 lack health insurance should cause some considerable disquiet among state and business leaders, who are addressing the issue by coalescing to defeat a November ballot initiative pushed by the Health Families Coalition to give average workers what state legislators and state employees have, a modicum of respect and a handful of paid sick days they can use when they need to attend to their own health or that of a child, spouse or family member. 

Yet as Ohio grows fatter – its now ranked as the 17th most obese state in the nation, which only further compounds health issues today and into the future, The (Toledo) Blade’s new series called “Not What Your Doctor Ordered” should come as a eye opener to all Ohioans. The subtitle of the series, “How health insurance plans shape patient treatment,” brings into focus the all-to-real fear that private insurers, who appear to be in the driver’s seat of American health care whether Republican Sen. John McCain or Democratic Sen. Barack Obama are elected the nation’s next president, will maintain their Wizard of Oz power to dictate medical treatment decisions. 

From the Blade:

“Increasing health-care costs and an influx of expensive drugs and tests, combined with an aging population, set off a health-care crisis in the United States. Contending with soaring costs, insurers changed the business of health care by requiring preauthorizations, mandating cheaper drugs, and tightening controls on treatment decisions.” 

Doctors argue that their decision-making is being challenged, while health insurance companies respond that they are just striving to “efficiently manage the costs of covering health care for millions of people.” Insurers say they must “balance the needs of patients with the budgetary constraints of businesses that pay for the coverage.” 

Returning recently from a weekend sojourn to Canada, I had a chance to speak with a Canadian born nurse practitioner, who worked for years in Canada’s health care system and also worked for years for a hospital in nearby Buffalo. The matron of the bed and breakfast I stayed at responded to my questioning of her over breakfast about why Americans should demand a single-payer universal health care system like Canada has or every other industrialized nation has. 

Pausing to think of how to respond to me, she told me that the first big reason everyone should be covered is because it removes the stress that builds up over a lifetime of how sickness, to an individual or to loved ones, will be paid for without catapulting oneself or family into bankruptcy, as so often occurs in the great nation of America. Her next comment was that Americans have been indoctrinated over the decades to believe (wrongly) that choice of doctors or hospitals is not part of “socialized” medicine, when in fact it is. 

US expatriots we met in France a few months ago chimed in with the notion that the French believe in socialized medicine because, as it was related to me, the law of averages catches up with everyone eventually, so we ought to be paying into such a system because one day we’ll need help from it. And instead of living in fear about the costs that can destitute any one person or family to address a serious illness or injury, paying forward – a notion that seems popular among sports figures in particular in the USA – will pay off for you in your hour of need. And the more need you have – terminal cancer or stroke, for example – the more a system of universal coverage that takes a little from everyone and excludes no one will come to your aid when your future hangs in the balance. 

But since we’ve handed over our health insurance system to private, profit-making companies who can deny coverage to anyone who might deplete their coffers without any penalties for doing so, it’s no wonder that shareholder profits are valued far higher than the health of any one individual. And when doctors are caught between a rock and a hard place when it comes to what treatments or medicine they can prescribe, it’s little wonder that we have rising numbers of people who have no or little health care coverage or whose health care insurance is far more feeble than they think it is when they need it most. 

The Blade's online survey of members of the Ohio State Medical Association and the American Medical Association showed that 99 percent of the 920 respondents reported interference by insurers in their treatment of patients. 

Survey results from the Blade: 

Ninety-five percent of respondents said insurers interfered with decisions about prescriptions, 91 percent with testing, 74 percent with referrals, and 69 percent with hospitalization decisions.

Eighty-six percent said interference compromised patient care, 76 percent said it adversely affected their patients, and 65 percent said they were unable to successfully protest denials.

Seventy percent noted they experience interference at least once a week, with 92 percent answering that interference increased during the past five years.

Fourteen percent believed interference from an insurer had contributed to the death or serious injury of a patient. 

The National Federation of Independent Businesses (NFIB), one business group among others that have been doing what they do best when any accountability is proposed for their members, namely saying it will result in job losses and turn Ohio into a business unfriendly state, dropped its self-produced report that said 75,000 will be lost if Ohioans approve an initiative that may be on the November ballot that would mandate that businesses with 25 or more employees give seven paid sick days to their employees. 

With Ohio already gasping for breath due to the hundreds of thousands of jobs, many of which were in manufacturing, lost over the Bush White House years, the specter of loosing even more jobs in an effort to treat workers with a little dignity and respect seems to have spooked Gov. Ted Strickland and other lawmakers who these days seen to be hyper skittish about crossing representatives of the NFIB, who see workers as so much chattel rather than human resource assets. 

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