As the wealthiest nation on Earth with the most advanced medical technology, the United States ought to serve as a global model for health care delivery. But this is not the case, as an estimated 46 million Americans live in fear of serious illness because they don't have health insurance that would help pay their medical bills. Experts say something needs to be done to rescue a growing number of Americans from the perils of uninsured health care.
Ethel Shaw may soon join the ranks of America's uninsured. Shaw works for contractors that provide custodial services at two U.S. government agencies.
At 61, Shaw says she is tired and wants to retire, but her medical problems, including diabetes, high blood pressure and glaucoma, won't permit it.
She has health insurance through her one job that helps pay some major medical bills, but the plan is very limited.
For example, Shaw says it does not cover routine necessities, such as diabetes supplies like a glucometer to measure her blood sugar level.
"I've been trying to hold on to that one because I can't afford to get no more because it's too high. That stuff is high, you know, and we're not making all that kind of money," she said.
America's health care system is unique among industrialized democracies in that there is no universal, government-sponsored health care plan for all citizens.
American employers historically have offered health insurance as a job benefit to cover doctors' office visits and medication for their employees.
But Jonathan Parker, of the Service Employees International Union, says more and more employers are opting out of health insurance benefits for their employees.
His union represents 1.8 million workers in the health care, government and service industries.
"Now, when you go to the bargaining table, it's not wages, it's health care that is the number one item on the list in terms of bargaining and having to make sure is still part of the contract," explained Parker.
Health insurance has become very expensive, and that is the reason many employers are backing out of it.
Karen Davenport, executive director of health care policy for the Center for American Progress, says the amount of money an employer pays each month to insure a worker, called a health care premium, has increased five times faster than wages over the past several years.
Davenport says there are several reasons for the sharp rise in premiums, including the large number of people who cannot get insurance through their jobs.
"The ones that are probably of greatest concern would be the people who are uninsured who delay care and who end up using not just emergency room services, but more complex, more complicated, more intensive services when they do get care," she said.
Children's National Medical Center in Washington provides specialty and emergency care to children.
Kathleen Chavanu, the hospital's executive director of Quality Improvement and Clinical Support Services, says some people are unable to pay for the care they receive there.
"I think that we provide a high amount of uncompensated care here at Children's National Medical Center, anywhere from $28 and $30 million a year that we report that is provided as uncompensated care," noted Chavanu. "And that's really approximately eight to ten percent of our population."
According to the American Hospital Association, hospitals doled out $27 billion in uncompensated care in 2004.
As a charitable organization, Chavanu says Children's makes up the shortfall through fundraising campaigns.
But privately run hospitals pass along the cost of uncompensated care to insured patients in the form of higher hospital bills. The health plans in turn raise premiums to cover the more expensive costs.
Those who want to reform the system disagree over the best solution to U.S. health care crisis.
The Bush Administration advocates private health savings accounts that give Americans tax credits for money they set aside to pay their medical bills. Critics say such plans favor large insurance companies over low wage earners.
That's why many people support universal health care plans similar to those in other countries. Again, Karen Davenport, of the Center for American Progress.
"It's about building large pools of people who have health insurance and about being able to spread risk and share costs across large groups," she added.
In virtually every major poll of Americans, the looming health care crisis is near the top of the list of concerns, next to the war in Iraq.
Health care reform may be on the way sooner rather than later.
But the safety is not there yet to help people like Ethel Shaw.
"I'm worried about my health… I don't know how I'm going to make it if I give up the job. But if I stay on the job, I don't know how I'm going to make it because I'm half sick," said Shaw.