{healtcare}Churning Isn’t Just for Butter Anymore

http://www.commondreams.org/view/2013/02/10-2



It isn’t often anymore that I learn a new word in the health care system discussion, but this week I did. Churning. I was at a meeting here in Colorado where I have taken on a new role in advocating and administering for a publicly financed, universal, single-payer system with Health Care for All Colorado. And the definition of churning I learned is a sad commentary on a system that still allows access to care based on inequality of coverage that leaves so
many people suffering and tens of thousands dying in America every year.

Churning is the policy wonk term for those who qualify and are covered by a public program like Medicaid and who then have access to a private insurance plan through a new job that offers it or through a family member’s coverage but who then lose that coverage and end up back on the public insurance for which they qualify. They churn. And they suffer.

Churning doesn’t happen in an orderly or smooth way. There is a person with health care needs churning. There may be weeks or even months during which that person has no coverage and therefore only the access that money can buy them, and we all know how far that will go. Sometimes there are children involved who churn with their parents. Kids with illness for which they need care can suffer during delays of approvals for both public and private plans. How do we explain churning to a child up in the middle of night with asthma symptoms or other problems? “Sorry, sweetheart, mommy is churning this week, and we do not have the money to buy that inhaler. Maybe the insurance will come through next week.”

Those who have tried to transition from one private plan to another due to a loss or change of jobs will understand. It is stressful to make these changes even under the best of circumstances. Imagine that policy wonks discuss ways to reduce churning from public to private and back to public plans again when there is a clear and equitable way to end it for good. Adopting a sensible, equitable, universal, publicly financed, single-payer – Medicare for all for life – system would end all of this awful churning and the need for policy wonks to study and find ways to reduce it.