Tuesday, May 05, 2009

Lies, Damned Lies, and 46 Million Uninsured

From economist Keith Hennessey comes a really interesting breakdown of how many uninsured people there are in the United States, and how many of those people actually need/want insurance. Since the 46 million number appears prominently in the national health care debate, this information is very valuable.

First, nearly a quarter of the 46 million are already covered by Medicaid or SCHIP, and therefore should not be included. Another 20% are not citizens of the US, while a third are either significantly over the poverty level or are young, single, and childless. If you were to take out these groups from the number of uninsured, the new number becomes 10.6 million, or 2% of the population.

2% just doesn't generate much passion though.

16 comments:

Jason The said...

Well, screw 'em then!

Cameron, this is quite possibly the worst argument I have ever heard in defense of the status quo of our current health care system.

It neglects several things. What we are all paying for insurance. Policy conditions and arbitrary coverage decisions by insurers. Children who do not qualify for SCHIP, but remain uninsured (millions), the self employed, the single college student, the horrendously inefficiencies of the employer based insurance system... I could go on and on.

I know it's nice to be able to boil things down into vast oversimplifications to make a convenient argument and support a predisposed perspective, but health care, and the well being of human beings (US citizens or not) is not the time to do so.

It's a New Testament thing. You should read it.

Cameron said...

Spare me the histrionics. I've lived the poor college student, the self employed, the young children at home scenarios. I don't need your blog mother "read the New Testament" cluck clucking. But if you'd like a real conversation, be my guest.

The stat you and yours use to justify government paid and/or run health care is a fabrication.

Once we accept that the vast majority of people do have insurance, we can move on to the cost of insurance.

Jamie said...

*Grabs the popcorn*

Democracy Lover said...

It's great that the people who really don't give a damn about others have experts like Hennessey to manipulate statistics to make them feel better about themselves. His entire premise is bogus of course.

Health insurance is not the issue, it is the problem. Americans don't need health insurance they need health care. Health care that is there when the need it, that allows them to choose their own physician and insure continuity of care, and emphasizes preventive care. Americans need to know that they will never have to choose between getting their prescriptions filled and feeding their children; never have to risk bankruptcy or foreclosure as a result of major illness; and never have to worry about whether their insurer will choose to pay their claim or find some lame reason to deny it.

It amazes me that people that see themselves as religious and moral just don't give a damn whether their neighbor gets proper care or loses their home because of cancer treatments. The key issue is apparently some misguided ideology about keeping the people's government from actually benefiting the people.

Cameron said...

Jaime, I wouldn't pop too many. Jason's mo is to spout off and then never come back.

DL, you're simply playing the same dishonest game Jason is. Instead of refuting the facts presented, you resort to petty name calling.

The fact is that the 46 million number is used constantly to decry our health care system and, perhaps more importantly, push for ever more government involvement.

The other fact is that the 46 million number is false, fiction, dishonest, bunk.

And none of you have refuted that fact.

Democracy Lover said...

I don't really care why people don't have access to quality health care or who they are. That's not the issue, they are my neighbor and their health can easily affect mine and that of my family. Finding convenient excuses why people don't "deserve" help is simply not a moral approach to the problem.

I don't know anyone who deserves to lose their life savings and their home because they get cancer. I don't know anyone who deserves to choose between food and prescription drugs. I don't know anyone who should be allowed to profit from denying other people access to care their doctor says they need.

The 46M number is accurate. Hennessey is just find excuses to leave his fellow men bleeding by the side of the road because they don't "deserve" his help.

Cameron said...

I realize you don't care how the 46 million number was computed because it fits your preconceived notions about health care. But I think it's always instructive to take a second look at the stats being bandied about - whether they agree with you or not.

The 46 million cannot be accurate because it includes people who already have health care. 25% of that number is completely false right out of the gate.

The rest of the number is no sure thing either, but reasonable people can disagree about what should be included. Had you read the link to Hennessey's website you would know this.

Many people don't think non citizens should be eligible for state paid health care. President Obama is one of those evil, uncaring people. There goes another 20% of your number.

The 46 million stat is used as a club to show how uncaring and un-Christian government health care opponents are - just as you and Jason have done here. The problem is that over 10 million of that group aren't poor. They are over 300% above the poverty line, which translates to about $60,000 for a family of 4. If your idea is to help the poor, then you'd have to exclude these folks too.

Another 5 million are childless adults between the ages of 18 and 34. There are a number of reasons why someone might fit in this category and be uninsured, one of which is that they don't want to be.

If you want a truthful stat that you can use the same way you use the 46 million, then in order to not be dishonest you'd have to use 10.6 million. I realize it just doesn't have the same scary effect that the other stat does, but at least it's truthful. I'm pretty sure the New Testament has something about honesty in there somewhere.

Democracy Lover said...

You don't have to be poor to be without adequate health insurance in this country. In fact, it's quite possible to have a middle class income and still not be able to afford a policy that will pay for your family's health care needs. Why should that be the case? Why should people, even with health insurance, face bankruptcy or foreclosure because of medical bills?

It's not as though the money was needed elsewhere - most of the money spent by the government is wasted on no-bid contracts and an oversized military.

Jamie said...
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Cameron said...

Even if you include that group, the number sits at around 20 million, or about 6% of the population. Which is a far cry from 46 million and 16% that is constantly reported.

The problem here is that government health care advocates use the scary 46 million number to jump right into the conclusion that government has to take over. Only government can provide for these "needy" people.

If you actually look at the numbers and describe them accurately, most people in this country would not agree that taxpayers need to subsidize health care.

Cameron said...

Jaime,

I agree that premiums are too high. So let's look at that problem. The Jason/DL's of the world spend all their time brow beating people with "46 million people are without health care" so that we'll jump to the conclusion that government has to step in and use taxpayer money to insure them.

As I've shown here, if you are upfront with people and show them what the numbers really are, people will take a more measured approach to the situation. But measured is not the approach we're wanted to take. The response this little 2 paragraph post got, and the way that the commenters came in with guns blazing, is a prime example of that.

Jamie said...
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Jamie said...

DL, I am curious, do you really think the government will pay for those with high risk health problems if government takes over the health care, or would that be a waste of money?

Democracy Lover said...

Jamie, excellent question.

There are certainly situations in which it is unclear whether an expensive and high-risk procedure is warranted in a particular case. Currently most insurers will simply deny the procedure at least initially and that is not always the right answer. I would expect a fair and well-run government health care system to setup clear and easily understandable guidelines for physicians and patients in these situations. In addition, I would expect an appeal process so that a physician could make an exception for a patient when warranted.

There's a lot we don't know about how the mechanics of a public system would work. What we do know is that we can control those mechanics through the democratic process and insure that providers and patients are treated fairly and equitably. That's something we cannot do at present.

Jamie said...

Thanks, that is one of my concerns. I guess I am scared of someone telling me that I am too high risk or the things I need done aren't really necessary.

Cameron said...

"I would expect a fair and well-run government health care system to setup clear and easily understandable guidelines for physicians and patients in these situations. In addition, I would expect an appeal process so that a physician could make an exception for a patient when warranted."This is what currently exists. I have worked as a patient financial advocate in a cancer center, and have some experience working with insurance companies.

Once a type of cancer is diagnosed, the treatment plan is pretty much set by the guidelines previously agreed upon. If that treatment doesn't work, and the doctor wants to use something else outside of those guidelines, there is an appeal process available with the insurance company. We gather all relevant data and set up a meeting with the insurance company doctors and the patient's doctor to discuss the desired treatment. Many alternative treatments were paid for through this process.

So your vision for how a gov't run health system would work is pretty much how it's working now.

In reality, a gov't system would work much like Medicare works. For our patients with Medicare, there was no appeal process. There was no phone number to call where you could talk to a person. We were given a list of approved treatments for each diagnosis and that was it. Anything deviating from that list would not be covered, period.

So count me very skeptical of a government system being better, more efficient, or more patient friendly than what we have now.