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Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on March 20, 2009, 09:00:47 PM
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The Myth of the 46 Million
By Philip Klein on 3.20.09 @ 6:10AM
"Even for folks who are weathering this economic storm, and have health care right now," President Obama said at this month's White House health care summit, "all it takes is one stroke of bad luck -- an accident or an illness, a divorce, a lost job -- to become one of the nearly 46 million uninsured…"
Whether it's in political speeches, commentary, newspaper features, or hard news stories, the statistic of 46 million uninsured is one of the most-widely cited numbers in the health care debate. It promotes the idea that nearly one out of every six Americans does not have access to health care and it plays into the arguments of those calling for massive expansion of government to fix the problem. Yet the ubiquitous figure is highly misleading.
To be clear, the statistic is not pulled out of thin air. It comes from an annual report by the Census Bureau, which most recently pegged the number of uninsured at 45.7 million for 2007. But the problem lies in the way the statistic is commonly cited and understood.
For starters, the statistic does not mean that there are "46 million uninsured Americans," as the New York Times reported in a recent story on health care, and as is echoed throughout the media. Just a quick look inside the Census Bureau data shows that 9.7 million of the uninsured are not citizens of the United States. Liberals can argue that we still have a moral duty to cover non-citizens, but this doesn't change the fact that as a matter of accuracy, the Census data only tells us that 36 million Americans are uninsured.
But this doesn't fully convey the problematic nature of the 46-million statistic. As even the authors of the Census Bureau report themselves acknowledge, "health insurance coverage is likely to be underreported" in the Current Population Survey from which the health insurance data is derived. The reason is that respondents are asked in February through April about their health coverage status in the previous calendar year. Some may answer the question as intended, but others may cite their current insurance status, and others may say they were without insurance even if they only spent a portion of the year without coverage.
"[T]he estimate of the number of people without health insurance," according to the report, "more closely approximates the number of people who are uninsured at a specific point in time during the year than the number of people uninsured for the entire year."
In reality, a person who goes without coverage for a few months while between jobs is in a completely different boat from somebody who is permanently without insurance. But the broad citation of the headline figure would have you believe that there are literally 46 million people who never, ever, have coverage.
How many people actually spend the whole year without health insurance? It's difficult to say, and recent data is hard to come by. But in 2003, the Congressional Budget Office took a stab at answering the question, and looked at two studies from 1998 that conducted interviews multiple times over the course of the survey period. One study pegged the number of people who were uninsured for the entire year at 31 million, while another put it even lower, at 21 million. In either case, the number was significantly lower than it was in 1998's Current Population Survey, which found 43.9 million uninsured.
Another problem with citing the 46-million figure is that many of those who are identified as uninsured are actually eligible for existing government programs but simply never bothered to enroll. In 2003, a BlueCross BlueShield Association study estimated that about 14 million of the uninsured were eligible for Medicaid and SCHIP. These people would be signed up for government insurance if they ever made it to the emergency room.
In addition, some of the 46 million could theoretically afford health coverage, but chose not to purchase any. In 2007, 17.6 million of the uninsured had annual incomes of more than $50,000 and 9.1 million earned more than $75,000. In fact, as Sally Pipes notes in the Top Ten Myths of American Health Care: A Citizen's Guide, those making more than $75,000 per year are part of the fastest growing segment of the uninsured population.
The Census figures also show that 18.3 million of the uninsured were under 34. Some in this age group may have simply determined that they are young and healthy and thus can do without coverage.
When all of these factors are put together, the 2003 BlueCross BlueShield study determined that 8.2 million Americans are actually without coverage for the long haul, because they are too poor to purchase health care but earn too much to qualify for government assistance. Even being without insurance still doesn't mean they won't have access to care, because federal law forbids hospitals from denying treatment to patients who show up at the emergency rooms.
This exercise isn't about downplaying the problems facing the American health care system, but a necessary part of devising the proper remedies. Under current state laws, mandates force insurers to provide certain benefits, meaning that young and healthy Americans must choose between paying exorbitant premiums to cover treatments that they don't need or going without health insurance. Many of these so-called "young invincibles" who are included in the ranks of the uninsured could be wooed into the market were they allowed to purchase catastrophic insurance with lower monthly premiums.
Right now, the tax code exempts people from paying taxes on health care benefits purchased through their employer, while denying the same tax advantages to individuals. Ending this discrimination would make health care more affordable to those who are self-employed or not covered through their workplace. In addition, this would allow Americans to have health care policies that are portable, so it would reduce the gaps in coverage people can face when they quit or lose a job.
Those pushing for a major government intervention in health care are distorting the 46-million statistic to boost their cause, and by disseminating it so widely without further elaboration, the media is rigging the game in their favor.
http://spectator.org/archives/2009/03/20/the-myth-of-the-46-million
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Regarding being uninsured for "only" part of the year. That can be a damning thing should something happen to you in that period of time. I know of a man whose job was changing insurance policies, and on the day or 2 that they were without, he had a heart attack. He ended up having to "sell" his home to his daughter so it would be in her name so that it couldn't be taken away from him to help pay the hospital bills.
Also, what about the people who come down with cancer or some other horrible disease while they're uninsured? Or pregnant? Then, once they or their spouse does get another job, they will be discriminated against because they had the "gall" to have a pre-existing condition, and will either not have that covered, or have to go through a waiting period. Something needs to be done so that those who need medical attention aren't treated like second-class citizens when it comes to getting insurance coverage. While I don't agree with those who make enough money yet choose not to carry coverage, something needs to be done so that even those who are unemployed or under-employed can have and keep a policy.
I was without insurance for a good part of 2007, due to being fired in late January, and insurance for my current job didn't start until December. Call me crazy, but if I was asked if I had insurance for that calendar year, I'd have to say "no", since that was true for the majority. I could not afford to pay for Cobra and keep a roof over my head. I am very thankful for having the job I have today that gives me incredible benefits, at least for now. Who knows what the future may bring? I understand that I am one of the lucky ones. I don't know what I would do if I had to go through what a lot of our fellow Americans are going through. No one asks to be sick!
KarenInWA
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I don't think Klien makes his case that the uninsured are a myth. He'd need to investigate examples that are counter to his point. For instance how many people are paying insurance premiums, but if they actually do need medical care it turns out their insurance is worthless? http://www.time.com/time/nation/article/0,8599,1883149-1,00.html (http://www.time.com/time/nation/article/0,8599,1883149-1,00.html) These people think they're insured but as it turns out they were just paying into a scam.
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What else would you expect from The American Spectator?
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