Utah has some 250,000 people who are not covered by any kind of medical or health insurance. This is part of a larger national problem in which an estimated 37 million Americans are uninsured. Finding a way out of this situation - with its often tragic human face - is one of the most vexing challenges facing state and national government.
Soaring medical expenses in the past 15 years, and the accompanying rise in insurance costs, have priced many people right out of health coverage. Many work for small companies that have no insurance plan, some are self-employed, many are out of work, work only part-time or earn only minimum wages. The homeless, immigrants, college students, and women who are single parents also are often uninsured.But the source of the problem - lack of money - also is a major obstacle to finding answers. Every approach to helping the uninsured involves significant expense, with the bill to be laid at the door of the taxpayer.
For example, proposals are being discussed in Congress for some form of national health insurance, an enormously expensive undertaking that would require significant tax increases. But even at the state level, answers are complex and expensive.
The Coalition for Utah's Future - an independent group of leading citizens studying local issues - is suggesting expanding Medicaid to all Utahns whose income is less than the federal poverty level. This would require an additional $6.3 million in state Medicaid in fiscal 1992, reaching as much as $27 million by 1995.
One advantage to using Medicaid is that the program would provide an additional $3 in federal funds for every $1 in state money. But, given the federal deficit, the financial pipeline from Washington is not exactly a desirable or dependable source, either.
In addition, the existing Medicaid program already is growing faster than Utah can keep up. The program costs Utah $234 million a year and is facing an $11 million deficit this year. Congress continues to add new categories of clients.
Under the circumstances, the idea of expanding Medicaid even more is bound to face tough opposition. And even if Medicaid were expanded, it would not solve the problem of all 250,000 Utahns who are uninsured. At least half that number would still be without insurance.
But the situation cannot simply be ignored in the hope that it will somehow go away. It's creating serious health problems among the uninsured and is costing all Utahns in the form of even more inflated hospital and doctor bills.
Two measures, SB143 and HB132, have been introduced in the Legislature calling for establishment of task forces to study and recommend a health care policy for Utah and ways to finance health care for persons who are uninsured.
There may be no single answer to the problem and Utahns may not like the tax bill that invariably must come with any findings. But a study to get dependable facts and figures and look at possible alternatives is never a bad step.
Both measures ought to be adopted and studies begun. The problem is only going to get bigger and tougher and must be addressed one way or another as soon as possible.