The scene in emergency-room waiting rooms these days is nothing like what you see on "ER." On a recent Thursday in the emergency department of an Olympia hospital, I sat for seven hours beside a relative lacking health insurance who needed a doctor’s attention. His feet were so swollen and painful he could barely walk from the car to the hospital door.
Around us, an evolving crowd of about 40 adults and children waited hours for a health care professional to see them. Five of them were a uniformed American serviceman with his wife, their little boy, and infant twins.
Not one patient was bleeding, fainting, or moaning. The emergency in the lives of all these people was that they had noplace to get primary care except the ER.
Uncompensated care given by hospitals and health care providers around the state now totals almost $1 billion a year, reported insurance commissioner Mike Kreidler last week. The amount of charity care provided has surged by more than one-third, or 36 percent, between 2008 and 2010. Patients with health insurance end up paying much of that cost.
And that cost will continue to rise. About a million Washington residents, or 14.5 percent of the state’s population, now have no health insurance at all. “This is a grim milestone for the state, and we believe the situation will remain bleak for two more years,” Kreidler said in a press release.
His report includes analyses of how the lack of coverage is affecting counties throughout the state. In 31 of Washington’s 39 counties the percentage of residents without health insurance increased, to the point where 1 in 5 residents in some counties lack coverage. The highest percentage of uninsured residents live in Adams, Grant, Okanogan, Franklin, and Yakima counties, but percentages also rose in King, Pierce, Snohomish, and Spokane counties.
Still, Kreidler said, “There is hope on the horizon.” The most significant reforms in the Affordable Care Act — the new federal health care program — are scheduled to begin taking effect in 2014. More than 800,000 Washington residents will be eligible for expanded Medicaid, or for low- and middle-income subsidies to help pay for health insurance. As a result, the uninsured rate is projected to decline from more than 14 percent to 5 percent.
“For many families struggling to get or keep health coverage, 2014 can’t come soon enough,” said Kreidler in the press release. Right now “we have hundreds of thousands of people living one bad diagnosis away from bankruptcy.” For anyone skeptical about the need for health care reform, he added, ”there are a million people out there that they should talk to.”
Skeptics might also count the crowd in their nearest ER waiting room.