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Health Care in McCain's Small Universe

By Hanh Kim Quach
Health Care Policy Coordinator
Health Access California

Kudos to Prof. Tony Sheppard at CSUS, whose careful reading of the newspaper leads us to this story about McCain's recent doctor's visit and cancer screening.

The offending comment:

"Like most Americans, I go see my doctor fairly frequently."

Of course, he can. As a member of Congress, he has access to fancy health coverage through the federal government, which pools together millions of federal workers and provides a really impressive array of options.

For health advocates, though, this off-the-cuff comment belies a deeper concern: Sen. McCain's lack of empathy and understanding for what Americans face is startlingly scary. Because he believes that most have "fairly frequent'' access to the doctor, he sees nothing wrong with his health proposal, a scheme that would cause more people to have worse coverage and bear increasing costs to stay healthy and productive.

For 47 million Americans who lack health insurance and countless others who have inadequate coverage through high-deductible health plans or other products of that ilk, seeing a doctor "fairly frequently'' is a fiction. And given that approximately 2 million more Americans became uninsured annually every year since 2000, we can only expect that number to grow.

If you're uninsured, or have inadequate health coverage, and you're forced to foot 100 percent of the bill to see a doctor - you're not going to go. "I'm healthy; I don't need a mammogram; I don't need a colonoscopy?'' many rationalize. The evidence is there: uninsured patients spend less than *half* the amount that insured people do on health care, according to the Institute on Medicine. Specifically with regard to doctors - 71% of Americans with insurance see a doctor annual, versus 41% of those with no insurance.

Not getting medical care isn't just a problem of the uninsured. Patients who have inadequate coverage are twice as likely to either delay or avoid getting health care because of cost, and far less likely to follow treatments for chronic conditions such as arthritis, high cholesterol or hypertension, according to the 2007 EBRI/Commonwealth Fund survey. Again, specifically with regard to doctor visits -- those with inadequate insurance are nearly twice as likely to avoid seeing a doctor or specialist because of the cost.

This is what we'll be treated to under a McCain health care plan, where employers will be encouraged to dump their workers into a less regulated and less efficient, more expensive individual market to fend for themselves, and where consumers are encouraged to buy high-deductible health plans. Sen. McCain's remark may have been flippant, but shouldn't be ignored.

Hanh Kim Quach is the Health Care Policy Coordinator for Health Access California. Before joining the organization, she worked as a journalist for nearly 9 years covering issues in California. Health Access California is a statewide health care consumer advocacy coalition of over 200 groups. This article has also been published on the Health Access Weblog.

Posted on March 25, 2008

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