Too many uninsured --
'Inexcusable'
-- AAFP President Lanny Copeland, M.D.
South Georgians have a name for the very ill: the "low sick."
As more Americans go without health insurance, they become the low sick, said AAFP President Lanny Copeland, M.D., of Albany, Ga.
"Family physicians are the catch-net. We're often the first to see the uninsured," said Copeland. "They have illnesses that they've just not attended to. They're much sicker than they should be. And they require more of our time."
An estimated 16.1 percent of Americans are uninsured -- about 43.4 million people, the highest number since 1992. More people are employed, don't qualify for Medicaid and have no health benefits through their work.
"It's not just the small companies that don't provide health insurance," said Copeland. "My nephew worked for a huge airline. It played the game quite nicely, keeping him under 30-35 hours of work each week so it didn't have to pay his health benefits."
At the AAFP Annual Assembly last fall, Copeland called on the Academy to champion universal coverage again, as it did in 1989-1994.
"In the past, many physicians donated their time to care for the indigent, but with market-driven changes, less time is available to serve this population," said Copeland. "Politicians do not want to take a stand as to how to fund universal coverage. This is an ethical dilemma, one that must be solved."
The AAFP is recommitting itself to universal coverage. Here's how:
- The new Task Force on Universal Coverage, chaired by Copeland, will examine AAFP's current policy on how to secure health insurance for all Americans. The task force will consult with experts and make recommendations to the AAFP Congress of Delegates this fall.
- The AAFP, AMA, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American College of Physicians/American Society of Internal Medicine and American College of Surgeons are studying ways to work together for universal coverage.
"It's inexcusable that we allow so many people in our country to be uninsured," said Copeland. "Too often, the ones that can't pay or aren't insured get weaned away or turned away from our health care system."
During the past two years, Copeland visited Canada and New Zealand and found that even though they insure their entire populations, the countries are urging people to buy supplemental insurance. Copeland suggested the United States might move toward universal coverage with a somewhat privatized system, allowing physician input through an oversight commission.
"In the future, there may be a blend between what we now have and what other countries have, and health systems in various countries may look much the same," said Copeland.
He added, "We've got to come to grips with one thing: We have infinite needs and finite resources."
FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.
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