Health-Care Crisis?

BostonBarrister · February 5, 2008, 2:00am

How many Americans are really uninsured?

The Democrats keep citing a number of 47 million. And in one way that’s probably correct: There are around 47 million people within the borders of the U.S. who are uninsured.

However, that number breaks down a lot differently than one might think.

According to Harvard economics professor Greg Mankiw:

[i]This number from the Census Bureau is often cited as evidence that the health system is failing for many American families. Yet by masking tremendous heterogeneity in personal circumstances, the figure exaggerates the magnitude of the problem.

To start with, the 47 million includes about 10 million residents who are not American citizens. Many are illegal immigrants. Even if we had national health insurance, they would probably not be covered.

The number also fails to take full account of Medicaid, the governmentï¿½??s health program for the poor. For instance, it counts millions of the poor who are eligible for Medicaid but have not yet applied. These individuals, who are healthier, on average, than those who are enrolled, could always apply if they ever needed significant medical care. They are uninsured in name only.

The 47 million also includes many who could buy insurance but haven’t. The Census Bureau reports that 18 million of the uninsured have annual household income of more than $50,000, which puts them in the top half of the income distribution. About a quarter of the uninsured have been offered employer-provided insurance but declined coverage.

Of course, millions of Americans have trouble getting health insurance. But they number far less than 47 million, and they make up only a few percent of the population of 300 million.

Any reform should carefully focus on this group to avoid disrupting the vast majority for whom the system is working. We do not nationalize an industry simply because a small percentage of the work force is unemployed. Similarly, we should be wary of sweeping reforms of our health system if they are motivated by the fact that a small percentage of the population is uninsured.[/i]

So, using an old and thus conservative estimate of just the number of children eligible for medicare who don’t enroll ( http://gateway.nlm.nih.gov/MeetingAbstracts/102233882.html ), making the conservative assumption that the category “incomes of more than $50K” completely overlaps and subsumes the category “a quarter of the uninsured have been offered employer-provided health insurance but declined”, we can adjust the number thusly:

47million - 10million illegal immigrants = 37million.

37million - 18million = 19million

19million - 3.4million = 15.6million

We are left with a very conservative (as in higher than is likely the case) estimate of 15.6 million uninsured Americans who are unable to get insurance. That’s out of a population of approximately 303.1 million ( http://www.census.gov/Press-Release/www/releases/archives/population/011108.html ), which gives us a problem uninsured percentage of 15.6/303.1 = 5%.

Now, no doubt we could make improvements on health insurance. I rather like the idea of getting rid of state-law restrictions or at least letting someone buy a policy from any state, as well as giving individuals the same tax deduction as employers and decoupling health insurance from employment. But this is hardly a national crisis screaming for government takeover of health care.

pat · February 4, 2008, 11:13pm

These numbers may or may not be skewed but if the cost was somewhere in the neighborhood of sane, it wouldn’t matter as much having insurance. Insurance is only part of the problem. The problems are a spiral, each piece leads to another which in turn furthers the problem.

We can’t address one piece and leave the rest. It will just create a log jam somewhere else. It just moves a problem, it doesn’t solve the problem. All aspects have to be fixed at the same time and collectively real it in.
While the problem is contagious, I don’t think the solution would be.

The_Mage · February 5, 2008, 6:10am

And how many are young healthy people who choose not to even have heath insurance? I run into these people all the time. (And keep annoying the teenager who has the $500 a month car payment.)

One problem is how people look at health insurance. It is supposed to be a financial product. Something to use to reduce the chances of you loosing everything.

But many try to look at it like its health care. Something that takes care of you.

Recently it came to light how many really do not understand the concepts and math involved.

This year we were given the ability to customize our insurance (through my wife’s work) with more flexibility then ever before. I would have chosen the HSA account, but because of my wife’s medical problems, it didn’t make as much financial sense.

We chose a high deductible of $2,000, and the same for maximum out of pocket because my wife actually would pay over $3,000 just for a years worth of medicine, and it all applies to that deductible.

Then I saw our payment. ~$12 every 2 weeks. I had to run the numbers again because I couldn’t believe we were going to pay less then $25 a month for health insurance.

And yet my wife keeps hearing other people complaining about their insurance going up.

I realized that everyone was just trying to get everything covered, and are not doing the math. I looked closely, and found things covered by the insurance that actually cost more then what was covered, or break even on something that may or may not need to be covered.

Unfortunately some people simply can’t do math. Which is why so many people want universal health care. They can’t do the math and see how bad of an idea it would be.

DrSkeptix · February 5, 2008, 6:22am

[quote]The Mage wrote:
And how many are young healthy people who choose not to even have heath insurance? I run into these people all the time. (And keep annoying the teenager who has the $500 a month car payment.)