Tuesday, July 07, 2009

The Health of America, Part 12

Some Americans lack health insurance. The Census Bureau counts 45.7 million in 2007, down from 47 million in '06--though I've previously suggested that such data are exaggerated both by counting some actually covered by Medicare and/or Medicaid and because such a "snapshot" includes many in brief periods between coverage.

Still, the President and Congressional Democrats are mooting "mandating" we all buy health insurance. Which makes Richard Martin's article in the July 4th St. Petersburg Times required reading:
Many people assume that the 47 million Americans who don't have health insurance [actually 45.7 million] simply can't afford it.

But the fact is, some don't want it.

Among the 47 million are 9.1 million who earn $75,000 or more a year and 11 million who declined coverage from their employers, according to estimates from the U.S. Census Bureau and the Employment Policies Institute. That also includes many who are young, single and healthy, plus a growing number who rely on alternative and faith-based therapies usually not covered by traditional insurance plans.

These are the voluntarily uninsured, people who may not welcome Washington's efforts to make sure that all Americans have some kind of coverage.

Talk of mandatory health insurance coverage is getting louder. On Thursday, Senate leaders announced that their legislation would require people to carry health insurance or face fines of more than $1,000.
Using the latest (August 2008) Census report, the uninsured include:
  • 17.6 million in households earning $50,000 or more annually

  • 9.1 million in households earning $75,000 or more per year

  • 21.0 million with full-time jobs; and

  • 18.3 million between the age of 18 and 34
Obviously, as I've observed some Americans deliberately forgo health insurance--including declining employer coverage--which may be an economically sensible choice. True, many states require drivers to have automobile insurance, but driving creates economic externalities because uninsured motorists could hit other cars or pedestrians. Health insurance is different, with far fewer externalities not already covered by existing government programs.

Don Surber asks, "Why should they be required to purchase health insurance just to subsidize the health insurance of everyone else?" The obvious answer: in the current Administration, that's a feature, not a bug.

1 comment:

OBloodyHell said...

> both by counting some actually covered by Medicare and/or Medicaid and because such a "snapshot" includes many in brief periods between coverage

More critically, I'd argue, it includes a large number of people who can afford insurance but choose to "bet the other way". And I have long been one of those individuals. I have great general health, and don't need insurance for the most part.

One obvious option would be to provide some measure of minimal subsidized independent coverage (i.e., a "voucher system" for health care), but to limit the availability of said coverage to those distinctly below the poverty line, or some equally low number based on a dividing line for those who reasonably can't afford it and those who can but choose not to. And it should be set as low as possible -- if you can afford even basic-cable TV and a cell phone, you can afford health insurance instead. You can pick which one you want, but don't whine how you can't afford the latter.

The advantage of such is that one can readily estimate how many it might apply to and thus clearly budget for and estimate the expense of it.

That it would be performed by private insurers would keep prices under control -- esp. if the voucher limits were based on the bottom 15% of insurers, or some similar metric.

...And of course, it doesn't add still more control to the power of the Federal government, which is why it'd never pass.