The sixth leading cause of death in the United States is the lack of health insurance, according to Critical Condition, a new documentary on the perils of being uninsured in the U.S. Being uninsured beats diabetes and HIV/AIDS on the Top Ten List of causes of death in America, according ot the Institute of Medicine.

The PBS series POV features the chilling documentary, Critical Condition, on Tuesday, 30th September 2008. You can check your local listings here for broadcast times on your local PBS station.
Critical Condition highlights the stories of four uninsured Americans with advanced stages of diabetes, cancer, liver disease, and a deteriorating back condition.

The bottom line is spoken by Dr. Patrick Dowling, the Chief of the Department of Family Medicine at UCLA, who toward the end of the film asserts: “We ration care in this country by ability to pay.”

The four profiles, by sharing their very personal and challenging stories, illustrate the key statistics on uninsured Americans:

  • Insured Americans’ premiums pay $992 to cover the costs of the uninsured
  • Eight in ten uninsured Americans come from working families
  • 80% of the uninsured are adults
  • The majority of uninsured adults (75%) have gone without coverage for a period of at least one year
  • The large majority of the uninsured (78%) are American citizens
  • 70% of uninsured employees work for firms that do not offer health benefits or they are not eligible for their employer’s plan
  • Three-quarters of the uninsured are not eligible for public coverage
  • The uninsured are more likely to postpone and forgo care, with serious consequences that increase their chances of preventable health problems, disability, and premature death (which is the case for all four of the Americans profiled in the film)
  • About a quarter (23%) of uninsured adults report needing care in the previous year but not getting it due to cost, compared to just two percent of those with private coverage or Medicaid/SCHIP
  • The uninsured are more likely than the insured to develop a disability over time, and even after accounting for health differences, they are more likely to die early
  • Hospitals typically charge uninsured patients 2.5 times what they charge privately insured patients
  • Over half a million Americans are currently battling cancer without insurance (which is the case of one of the four Americans profiled in the film).

You can see an interview with Critical Condition‘s documentary filmmaker, Roger Weisberg, here.

The film was funded by the Annie E. Casey Foundation, the Charles A. Frueauff Foundation, the Josiah Macy, Jr. Foundation, the Kaiser Foundation Health Plan, Nathan Cummings Foundation, the New York Community Trust, the Park Foundation, the Public Welfare Foundation, Public Broadcasting Service, the Silverweed Foundation, Spunk Fund, and the Trull Foundation.

Health Populi’s Hot Points: In addition to these four Americans and their families, another hero featured in the film is Dr. Dowling. In addition to his duties on the UCLA medical campus, Dr. Dowling participates in community health fairs which is where he randomly met Carlos, the fellow with the deforming spondylosis. Dr. Dowling negotiated on Carlos’s behalf with UCLA to get him the very risky spine surgery he needed…at no cost to Carlos.

I won’t spoil the endings — or new beginnings — of any of the four stories told in grueling, frustrating, and often gut-wrenching details.

The best summary is given by Dr. Dowling, who said that he was, “very pleased that we could help this one individual out,” but, “we can’t do endless surgery on uninsured patients; it begs a national solution.”

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