A healthy advantage Featured

8:00pm EDT September 25, 2009

They’re called “invincibles” — the millions of uninsured young adults who decide against enrolling in their employer’s health insurance. Even though many can afford the premiums and out-of-pocket expenses, they deny coverage, believing their age offers protection from injury and illness or that the cost is beyond their reach. Adding to this dilemma is lack of information on the importance of health insurance and a mistaken belief they are still covered by their parents or school.

Unfortunately no one is ever invincible when it comes to his or her health.

Smart Business learned more from Barry Arbuckle, Ph.D., president and CEO of MemorialCare Medical Centers and immediate past chair of California Hospital Association.

How serious is the issue?

Upward of 13 million uninsured are young people — the largest age group without health coverage. While health benefits remain a financial burden for employers and their work force, about 25 percent of employees who can afford coverage opt out of the company’s offerings. The results are numbing. Young adults without health insurance are less likely to have a family physician or visit a clinic, sometimes turning instead to a hospital’s costly emergency care for medical needs. Delaying or postponing care, screenings and comprehensive physicals places individuals and families at risk for potential health problems, while increasing insurance costs. What they may not realize is that health coverage is one of the best ways to protect against large financial outlays, especially during economic downturns.

Where do the problems start?

Challenges often begin when children become adolescents and teenagers and outgrow their pediatricians and may wait years before selecting an adult physician. Vaccinations and quick sports physicals are not enough. A teen’s lack of exercise, unhealthy eating and risky behavior typically continue into adulthood, posing potential lifelong damage. More than half of adult deaths are tied to health-related behaviors that began as teenagers, with an estimated eight Californians dying each day because they are uninsured and received care too late.

Can hospitals and doctors help?

Hospitals and physicians can partner with schools, parent-teacher associations, school nurses and public health departments. Working together, we can better transition students to a primary care physician, institute education and counseling programs on prevention and the difference between healthy and risky behaviors, emphasize the importance of lifelong health coverage and encourage age-appropriate screenings. A study at University of California, San Francisco recommends these preventive measures be directly addressed with young people: dental care, healthy eating, regular exercise, wearing a seatbelt and bicycle helmet, and exposure to secondhand smoke.

Miller Children’s Hospital — the state’s largest children’s hospital and a leader in preventive care — links with Long Beach Memorial Medical Center, its sister hospital on the same campus, Saddleback Memorial Medical Centers in Laguna Hills and San Clemente as well as the Orange Coast Memorial Medical Center in Fountain Valley to ensure the health care of children transitions seamlessly into adulthood.

What is the role of employers?

A healthy work force is critical to productivity and success. Advocate for insurance for all Americans. Encourage legislation that allows parents to claim young adults as dependents to maintain insurance coverage until age 30. Convince employees of the importance of accepting medical coverage. Show how a health plan provides access to preventive care and that just one night as an inpatient could equal a year or more worth of out-of-pocket expenses. Make it clear that visiting a physician at the onset of an illness can result in fewer days absent from work. For employees with both spouses at jobs offering health coverage, demonstrate how to compare which coverage best meets their needs and how staying in the physician and hospital network further reduces expenses. And remind workers to keep medical and health-related receipts for a possible tax deduction should they exceed their deductibles.

What else can be done?

A study by United Healthcare shows that lack of information can keep young adults from accessing health insurance. While they realize the importance of health coverage, many enter the work force not knowing what to look for in a health plan, how to select coverage that best meets their needs, the availability of short-term insurance to fill the gap between parental or school coverage and their new job, and that joining a health plan saves money and keeps them healthy in the long run. All of us — hospitals, doctors, schools, health plans, employers and the government — must ensure this message is clearly understood and continue to be advocates for quality, accessible health care for everyone.

BARRY ARBUCKLE, Ph.D., is president and CEO of MemorialCare Medical Centers (www.memorialcare.org) and past chair of the California Hospital Association. Reach him at arbuckle@memorialcare.org or (562) 933-9708. MemorialCare Medical Centers include Saddleback Memorial Medical Center in Laguna Hills, Orange Coast Medical Center in Fountain Valley, Long Beach Memorial Medical Center, Miller Children’s Hospital in Long Beach and Saddleback Memorial Medical Center in San Clemente.