The hospitals must therefore find the shortfall somewhere to make up the deficit. What this usually means is that services are cut and quality of care reduced. With limited resources cash-strapped and overwhelmed hospitals like Kings County Hospital in Brooklyn that saw more than 60,000 walk-ins in 2008, cannot employ or attract the best and brightest in the medical professions because they cannot afford to pay them. This also contributes to a lowering of the quality of care.
There is a cost to the care; it's not free. Further compounding the situation, private company insurers have proven inefficient and ineffective in controlling costs and, as a result, actively work to exclude healthcare coverage whenever possible. The end result is that all healthcare coverage, except for some low-income children and those covered by Medicare, is now provided only by insurance companies and other private-sector corporations.
This healthcare monopoly has further corrupted the system with insurers cherry picking the best people to insure, and rejecting those with pre-existing conditions. Ezra Klein writing in the Washington Post recently put it this way: "The private insurance market is a mess. It's supposed to cover the sick and instead competes to insure the well. It employs platoons of adjusters whose sole job is to get out of paying for needed health care services that members thought were covered."
Below are the consequences of this systemic abuse.
· Over a third of families living below the poverty line are uninsured. Hispanic Americans are more than twice as likely to be uninsured as white Americans while 21% of Black Americans have no health insurance.
· More than 9 million children lack health insurance in America.
· 18,000 people die each year because they are uninsured.
The conclusion is that the current system is increasingly inaccessible to many poor and lower-middle-class people. Those lucky enough to have coverage are paying steadily more and/or are receiving steadily fewer benefits. President Obama has voiced support for universal healthcare coverage for all Americans which would be provided by selecting among various coverage options, including an option for government-funded healthcare (aka a public plan option or public option).