Imagine a recurring national catastrophe that leaves 18,000 dead every week.
Such is the scale of the healthcare crisis facing the country today, policy experts say. The Institute of Medicine attributes 18,000 deaths a year to lack of health insurance.
"If you take those numbers seriously, a jumbo jet load of uninsured is dying per week," said Christopher Conover, director of Duke's Jim Bernstein Health Policy Scholars Program. "Eighteen-thousand uninsured die each year because of lack of coverage, but they don't have 'uninsured' stamped on their death certificates."
Existing problems with the healthcare system exacerbated by the slumping economy have made for a perfect storm in the realm of health policy.
Democratic Sen. Barack Obama and Republican Sen. John McCain have dedicated considerable space in their platforms to address health care reform. Yet despite the severity of health care deficiencies in the country, the issue has taken a backseat in the minds of many voters.
"The economy has overwhelmed everything else-it's the pressing matter on people's minds," said Elizabeth Vigdor, a research scholar at the Center for Health Policy.
She cited the estimated 45.6 million Americans who are uninsured as the biggest problem with the current system.
Dr. Victor Dzau, chancellor for health affairs and president and chief executive officer of the Duke University Health System, recently signed the "Open Letter on Health Reform in the 2008 Presidential Election" in support of Obama, along with more than 9,000 physicians and medical students. Dzau has applauded both candidates, nonetheless, for their careful consideration of the issue.
"Both candidates have fundamentally the right idea," he said. "They have different means and different ways to approach the issue but it is certainly my hope, we will have a better situation for health care in this country."
Those in the waiting room of Lincoln Community Health Center in Durham said Monday they hoped healthcare reform would be a priority for the next president.
The community clinic offers primary health care to all patients regardless of insurance or legal status. It charges on a sliding fee scale that takes into account income level. Seventy-eight percent of Lincoln Community Health Center's patients were uninsured in 2006, according to the 2007 Durham County Community Health Assessment. Eighty-two percent lived below the federal poverty level.
Patients Luette Owens and Wanda Justice agreed that healthcare will be a salient issue in the upcoming election.
"It used to be cheaper, even here," said Justice, who is currently unemployed, noting still that the clinic has been helpful to her in obtaining affordable health care. "Things are getting tougher now."
When asked who their pick for president was, many patients named Obama.
"Older people, we need health care," said 63-year-old Molly Brown. "To me, Obama is for people who can't afford to have insurance and don't know where they're going to get the money to just pay the bills."
Health policy experts said there are benefits and drawbacks to both proposals. Obama's plan maximizes the number of people who can obtain coverage, but it is more costly. McCain's plan provides a more efficient system to disperse healthcare, but in a way that covers fewer Americans.
But the Durham community is not holding its breath for government solutions, health experts said.
The lack of federal programs to ensure quality, affordable care has caused a search for community solutions, said Dr. Evelyn Schmidt, director of Lincoln Community Health Center.
The Duke University Medical Center has partnered with Durham Regional Hospital, Lincoln Community Health Center and Durham County Emergency Medical Services in Project Access-a program involving Duke physicians to provide uninsured Durham residents with specialized care.
Vigdor suggested that Americans may prefer community-based health care solutions to government interventions.
"Americans have a deep distrust of the government," Vigdor said. "They have a much more collective anxiety about that. We're very fearful of government."
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