News Release
Why Americans are Uninsured
2/8/08 - Much of the political push for mandatory universal coverage is based on the much quoted raw data that 46 million Americans do not have health insurance.
Much less attention is focused on the underlying component numbers of this total that are much more revealing:
The majority of uninsured people remain without coverage for only a matter of months. They are typically between jobs, recently graduated, starting a business or moving to a new location. More than three out of four uninsured people are employed in a full time capacity and more than half of the uninsured have a household income above the national median. The majority of those without insurance are able to solve their insurance problem without additional government mandates without trouble. One practical implication of this is that the pool of uninsured people is constantly changing. Any government mandate designed to address the uninsured would have to identify, reach, process the coverage of most of these people within a matter of months only to have the benefit would expire only a few months later. It seems impractical from this perspective.
Relatively few people in are country are "chronically uninsured". Since those who have spent down assets for health care costs are provided free care under our various state Medicaid plans, the people left struggling are the middle income people trying to maintain a standard of lifestyle while paying for health care are the same time.
There are more low cost, supplemental, and short term medical insurance options available now than at any point is our recent history. An easing of state laws now makes much more choices available to most health insurance consumers. The issue of "eligibility for coverage" has been largely addressed by HIPAA law that ensure coverage to everyone (at a higher cost) and the expansion of guaranteed issue limited benefit insurance plans in the commercial markets through services like MedSave.com.
A recent Kaiser Foundation study citing 2007 U.S. census date shows that a surprising majority of uninsured people are in relatively affluent households. The uninsured represent surprisingly "normal" cross-section of society, proportionally represented at all age groups, evenly split between both sexes, racially and geographically proportional. We estimate that 80-85% of uninsured Americans could afford enroll in available health insurance plans if they chose to do so as a personal and financial priority.
Mandatory universal coverage would still leave 5 million to 15 million without coverage, depending on whose estimates we believe, because this is the maximum expected efficiency of any government mandated system. More than this number of people, for example, currently drive without auto insurance even though is mandatory in all states. Other countries estimate 5%+ of uninsured even if the policy is 100% universal coverage.100% efficiency is not possible under any system.
If we filter out those who are uninsured for only a short period of time, those who could be insured but choose to ignore coverage, and those who are eligible for state-assisted health plans but are not enrolled (for whatever reason), then the number of uninsured Americans is strikingly smaller. No one knows for sure how many of us really need legislative help to get insurance, but we believe the number is close to 5 million or about 2 percent of the U.S. population. While this is still a serious problem, it is nowhere near the "crisis" level that some political figures pretend.
In summary, we believe that that an argument for universal coverage based on the raw statistic that cites the number of uninsured Americans is weak and without real understanding of the nature of the issue. For now, our best approach is better consumer education on the costs and benefits of available health insurance options. We believe that if more people know how easy and inexpensive it is to enroll in high quality insurance, then much if this problem would resolve on its own.