Oct. 6 Daily News editorial

The Senate Finance Committee is struggling to finalize a health-care bill this week — a bill would extend insurance coverage to tens of millions of uninsured Americans without breaking the Treasury. It’s a tall order, but reducing the ranks of the uninsured is absolutely essential to fixing what ails the country’s health-care system.

The economic stakes in this effort — for both families and the national economy — are high. Cheryll A. Borgaard’s report Monday on local families facing big medical bills without health insurance or the means to pay puts a human face on this issue. The steadily rising number of such families affects everyone’s pocketbook and seriously strains hospital budgets.

St. John Medical Center wrote off nearly $30 million in charity care over the past 12 months, according to Borgaard. That total write-off includes the hospital’s “bridge assistance” program and uncollectable accounts. This charity care is up 36.6 percent from the same time period a year ago. Officials at St. John told Borgaard that they look for the upward trend in charity care to continue as this area continues to suffer high jobless rates.

The hospital — and by extension, all of those patients who have private health insurance — must shoulder the rising cost of providing this care to the uninsured. Insured or not, people fall ill or suffer traumatic injuries. State law requires hospitals to provide care for those who cannot pay. Budget realities require hospitals to pass on some of this cost to patients with health insurance.

We are reminded of a comment by the director of a Citizen’s Health Care Working Group, formed by Congress in 2004 to learn what kind of health care system Americans wanted. The group found that Americans wanted a system that guarantees basic health care for everyone. When questioned about the cost of a system providing universal care, George Grob answered that we were already providing universal care — at the highest possible cost.

Grob’s point was indisputable. Americans without insurance or the means to pay for regular visits to a doctor’s office have just one option when they are injured or fall ill — a visit to a hospital emergency room, which can cost upwards of several hundred dollars. Some will wait until they fall very ill, requiring a stay in the hospital.

Absent fundamental change reducing the number of uninsured citizens, the cost of this form of universal care will continue to grow. There is something of a vicious cycle at work here. As more care for the uninsured is billed to patients’ private insurance, premiums rise, making health insurance less affordable, which increases the number of uninsured. If there is a political consensus on health-care reform, it is that, somehow, this cycle must be broken.