Paul Ginsberg, president of the Center for Studying Health Systems Change (HSC), says there are at least 7.4 million working-age Americans with chronic illnesses who lack any health insurance coverage. Five million of them suffer a “triple whammy”: low incomes, ongoing health problems and no health insurance. “Yet,” Ginsberg says, “the major [Congressional] proposals to expand coverage of the uninsured generally fail to consider the very important needs of this group of Americans.”

Ginsberg said that about 1 million uninsured working-age people suffer with diabetes, a disease that, in most cases, can be controlled so that the patient can have a relatively normal life.

Millions of other low-income people lacking health insurance include one million who suffer from arthritis, 1.5 million who suffer depression, 900,000 with asthma and 1.6 million with high blood pressure. Many others suffer from HIV/AIDS and various forms of cancer.

Policy alternatives now being considered by Congress would be laughable, if the situation wasn’t so serious. Two Republican recommendations – both of which enjoy some support from the other side of the aisle – call for tax credits and subsidies for employers. Both come from the right wing notion that the privately-run health care “system” just needs a little “tweaking” to make the necessary corrections.

It is recognized by policymakers that two-thirds of uninsured adults with chronic illnesses who do not have health insurance could be reached by simply eliminating all Medicaid eligibility requirements. Why won’t this recommendation be taken seriously? “Too costly,” we are told, and told again.

There is little or no regard to the “cost” to patients as they are forced to pay out of their own pockets to get care even if this can destroy a family financially. And the fact that the chronically ill often postpone treatment and care until the situation deteriorates, only adds to the eventual cost of that care.

There is little question that the cost of not providing for these chronically ill people is far higher than the cost of making government responsible and paying the bills before the illnesses become too costly. But prevention is not the cure most often prescribed for enhancing the bottom line of the corporate interests who control the nations health care system, such as it is.

Democrats, independent and left candidates in the upcoming Congressional elections would do well to adopt these issues and advance solutions to them. If they do, successful races are surely in the offing. The road to a universal national health program is paved with these kinds of reforms.