Health care reform, or the more spin-worthy, health insurance reform, is being discussed in the halls of congress, on cable news programs and around the kitchen tables of many Americans. However, one of the fundamental premises of the argument may be wrong.
The oft quoted figure of 46 million uninsured people in the United States comes from a survey of 50,000 households by the Bureau of Labor Statistics and the Census Bureau. The Current Population Survey then uses statistical techniques to give a figure representative of the entire U.S. population.
Supporters of President Obama and the Democratically lead congress's health care plan repeat this 46 million number on a regular basis without truly explaining where it comes from. A careful look inside the numbers of this survey among others paints a very different picture of health insurance in America.
A Look Inside the 46 Million Uninsured Figure
First, 6.4 million out of that 46 figure are Medicaid undercounts. These are people who are on one of two government health insurance programs, Medicaid or S-CHIP, but are incorrectly recorded by the census bureau as uninsured. While there is some disagreement as to the actual total of Medicaid undercounts this figure represents a low side estimate.
An additional 4.3 million are eligible for a free or subsidized government health insurance program, but have declined or are not yet enrolled. If any of these people go to an emergency room they are automatically enrolled in a program so they are not truly uninsured.
Another 10.1 million of the 46 million “uninsured” have incomes of more than more than 3X the poverty level. For a family of four, if the household income was more than 3X the poverty level in 2007, they had $62,000 of income or more, and well were above the national median. An additional 9.3 million are non-citizens.
Of the remaining 15.6 million uninsured, 5 million are between ages 18 and 34 and without kids. This leaves 10.6 million people in the United States who have no health insurance and do not fit in any of the above categories.
Not a Question of a Lack of Health Insurance
At this point the discussion becomes not just about who is uninsured, but who needs, or deserves, taxpayer funded assistance. It would seem redundant to include those who are already enrolled in government programs or are eligible, and simply subtracting this number brings the total uninsured down to 35 million.
Next come some hard to answer questions. Should non citizens get a taxpayer funded health insurance program? What about healthy young adults who opt not to purchase insurance of their own? And do people with incomes near or above the national median need a government program? None of these questions have ready answers, but they help to steer the debate in the right direction.
Sources :
http://www.census.gov/cps
Readers who enjoyed this article may be interested in Health Care Reform at the Local Level and Government Run Health Care for Native Americans.
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