Thursday, May 28, 2009

What Is The Deal With 44 Million Uninsured Americans Anyway?

You know, it never ceases to amaze me that in politics and government, if you say something often enough and long enough, it becomes an integral part of the public debate.

Whether it is true or not.

It is truly amazing when you think about it that in a country as rich and as generous in spirit as America, there could even be one person who goes without having any health care insurance coverage in any given year. But our existing medical industrial complex structure coupled with various patchwork 'reforms" over the years have skewed the private health care insurance system to where it is barely recognizable anymore.

Here's the honest truth: There are probably, on average, 44 million Americans right now, this second, who are without health insurance coverage.

And tomorrow, there will be approximately 44 million people without health insurance. Except that it won't be exactly the same people.

The reason is that people go in and out of health care insurance coverage all the time. Students graduate from college and look for a job but might be without health care insurance coverage during the job search.

Many younger people think they are 'invincible' (who didn't at age 22?) and consequently, many of them opt out of health insurance coverage at work even if they have access to it to save a few hundred dollars per month in premiums.

Older people transition from job to job and, as this nasty recession has shown, sometimes their health insurance coverage expires before they find a new job.

The key question that we need to be asking as a nation is this: 'How many people lack health insurance and for how long?'

If we have 44 million of the same poor souls walking the streets every night without health insurance, that is one thing. But is that true and are the politicians in Washington telling you the whole truth and nothing but the truth, so help them God?

Nope, surprisingly enough, they are not. Once again.

The real figure we need to focus on is around 24 million. There are, on average, about 24 million people who go longer than a year without any sort of health insurance coverage whatsoever.

Is that good? No, it is not great. But it is close to being 50% less than the problem we have been led to believe is out there. Politicians use skewed numbers and little white lies and statistics mainly as a subterfuge to scare the public to "do something and do something about it fast...like this summer!"

44 Million Americans is 14% of the population. 24 million Americans is 7.7% of the population. 7.7% is a more manageable number to 'fix' than 14%, isn't it?

Ok, so if there are on average 24 million, not 44 million, poor souls wandering around this nation without health insurance for longer than a year, what are the other 20 million people doing? There is an excellent CBO study from May, 2003 by researcher Lyle Nelson called, oddly enough, "How Many People Lack Health Insurance and For How Long?" that you can reach by clicking on this link: CBO Health Insurance Study. It will take you right there so you can read it for yourself.

Roughly half of the non-elderly people who lose health insurance coverage find it again within 4 months. That is 10 million people right there.

Another 26% or 5.2 million people found health insurance coverage between 5-12 months. Close to 400,000 people who are making 4 times the level of poverty or over $87,000/year for a family of four opt not to have health insurance for some unknown reason. Senior citizens are all covered by Medicare so they are not included.

There is really no precise way to find out just how many people are not covered by health insurance at any particular point in time. For example, there is no website where people can go every day to log in their health coverage status so we can know exactly how many are uninsured.

These statistics are all based on self-reported surveys which in and of themselves raise the specter of accurate reporting or not. [1] These figures are all statistical analyses of data offered to the Census on a voluntary basis.

There is some question about whether or not to count Medicaid-eligible lower-income people as "covered" or not if they have not enrolled yet in a Medicaid program.

The point of this is not to debate the fact whether or not 44 million is the 'right' number or 24 million is more correct. Any time you or anyone loses their job or business and can't afford health care coverage is scary and we should do all we can to help those in transition.

It is also not to debate the point that we desperately need health care reform in America, for many of the reasons we have already pointed out in other postings.

The point of this article is to urge you to be diligent and skeptical anytime you hear Washington politicians throw around facts like this one without citing any sources or explanation of what it really means. We are now being asked to consider re-arranging the component parts of close to 16% of the national GDP this summer, mostly under the guise of "covering these 44 million people who do not have any access to any health care services".

People have access to health care through community health centers and local hospital emergency rooms, much of which goes unreimbursed each year to the hospitals. I have yet to find a physician who flat-out denies giving someone health care if their lives are in jeopardy. These Good Samaritans routinely do the work out of their own pockets and don't get enough credit for doing so many times.

We can fix the health care system in America in a way that will allow coverage of these short and long-term uninsured people each and every year by addressing some of the inherent conflicts and contradictions in the existing system. We don't need to give up and throw many more billions of your taxpayer dollars, and borrowed money from your children, again, at a broken and distorted system and hope it will all correct itself somehow.

Health care in America is too important not to do the right things to fix it. Stay tuned for more.

[1] Have any one of you ever been asked by the Census Bureau to fill out one of their routine annual health care-related forms, the Survey of Income and Program Participation (SIPP), the Medical Expenditure Panel Survey (MEPS), and the National Health Interview Survey (NHIS)?Just curious to see how far the reach of these surveys have been over the years. The SIPP and MEPS surveys appear to be more scientific and specific in nature.

1 comment:

  1. I have heard that a good percentage of the 44 milion uninsured are illegal aliens.

    ReplyDelete