June 20, 2002

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HEALTH CARE/Why are so many uninsured? It’s not for lack of money.

No good reason for health inequities

BY TRINH TRAN

Ethical failure was blamed for the nation’s uninsured at a conference titled “Toward Health Equity.”

Sponsored by the Leonard Davis Institute of Health Economics, the May 10 forum gathered Penn health experts as well as political leaders.

Health care expert Mark Pauly said money, or the lack thereof, was not the real problem because the actual cost of covering the uninsured is “peanuts.”

“The real problem is political will, not economics,” said Pauly, Bendheim Professor at the Wharton School and chair of Health Care Systems.

Bioethicist Arthur Caplan said statistics citing the number of uninsured have not motivated action.

“We’ve depended upon numbers to motivate a solution to the problem,” said Caplan, director of the Center for Bioethics. “Numbers do not compel any moral action. They’re just numbers.”

Caplan expressed exasperation regarding the struggle to cover America’s children.

“Why anybody would worry about 12-year-olds abusing and overusing the health care system, I don’t know. Most of them are not spending their weekends trying to figure out how to see their doctors,” he said.

Loretta Sweet-Jemmott, associate professor in the School of Nursing and director of the Center for Urban Health Research, said she was concerned about the quality of health care for adolescents who engage in risky sexual behavior. She said health care could be improved through outreach programs that are culturally sensitive.

But Pennsylvania State Senator Connie Williams said even when programs are in place many children still go without care. “We cannot get families to admit that they don’t have insurance for children,” she said.

Caplan said such programs, which entail screenings and sign-ups, are not obstacle-free.

Universal coverage could be achieved with enough public backing, said Williams. She pointed to an example where firefighters, America’s newly celebrated heroes, were able to get coverage for hepatitis under workers’ compensation. “So much of what happens is public pressure and grassroots support,” she said.