The unaffordable care act

“The actual number of Americans who were involuntarily uninsured was, at worst, somewhere around 13 million [not 47 million as claimed] And it is a myth that these people were ever denied care. This is why HHS isn’t keeping up with the number of uninsured who are signing up through the exchanges. The plight of the uninsured was a phony issue. A genuine issue, on the other hand, was increasing insurance premiums. And, perversely, the authors of Obamacare never addressed the underlying causes of this problem. In fact, the ironically named Affordable Care Act actually exacerbated the cost problem.”

Obamacare is unaffordable

Who are the Ohio uninsured?

Today I saw a statistic at a progressive site that reported 1.3 million adults and children in Ohio don't have health insurance. Notice--that's people, not citizens. And if Ohio does have about 11.5 million people that's about 10%. A very small number for which to upend what we have by ramming health care bills down our throats which our Congress and Senate seem unable to read or explain. Just this morning I was listening to a report about a committee where it was just roughed in--no details, no CBO report, but would be added to the mix. So I looked a few minutes and found this report from Buckeye Institute written in mid-2007 which begins with the media depiction of poor people without insurance. The writer doesn't even address the illegals we have in Ohio. It's a bit wordy, but addresses the key points: 1) within the uninsured stats, are those uninsured for only a few months; 2) some who have incomes that could afford it chose not to carry insurance; 3) young adults, the healthiest segment, have high uninsured rates (and in my opinion are naive, but that's another blog); many poor are eligible for gov't programs, but don't sign up.

“While there are certainly a good number of poor people among the uninsured, what is left largely unexplored is the fact that a large portion of the uninsured choose to go without insurance. And, in fact, it is likely that a majority of the uninsured are only uninsured for a few months. The people who choose to go without insurance or who are between insurance plans do not fit the media stereotype, but they fill the ranks of the uninsured in far greater numbers than do the families living in poverty who want insurance but cannot afford it.

Who would choose to go without insurance? The simple answer is that those who do not see a value in health insurance choose to forgo purchasing a policy. People who are in good health and do not see any reason to pay a monthly premium for a policy they are unlikely to use may make a choice to use their money elsewhere. Young adults in Ohio, the healthiest segment of the population, are uninsured at rates over twice as high as other segments of the population.

People with money also choose to forgo insurance. Almost one-third of Ohioans who are uninsured make incomes at twice the federal poverty level. Sixteen percent of the uninsured have incomes at three hundred percent of the federal poverty level. It is likely that the vast majority of these people, if they really wanted insurance, could afford it.

Surprisingly, the poor also choose to go without insurance. In Ohio, the state offers Medicaid to any child living in a family below 200% of the federal poverty level. Many families choose not to sign up for this program, however. According to the Kaiser Family Foundation, roughly 71% of Ohio's uninsured children are eligible for Medicaid but are not signed up for the program. The Governor is using the large number of uninsured children in the state to push for an expansion of Medicaid. As these numbers clearly show, though, most of the children are already eligible for Medicaid, they are just not using it.

The problem of current plan (Obamacare) is addressed at this article on the folly of expansion.

What does Health Care Obamanation mean to you?

We've seen the ads. Is there anything in them that actually tell us what the state of health in the U.S. is? What do we really know about the uninsured, and if we knew, would it make any difference to the politicians or to the voters?

The percent of uninsured rose a bit in the U.S. during the Clinton years, dipped slightly in early 2000s (probably from SCHIP, a new program of the late 90s) and now rests at about 14-16% of the population (virtually unchanged in 20 years), depending on which source you use, the U.S. Census CPS and SIPP reports being the most accurate with the longest record. The actual numbers are up because the population has increased, so that's what will be cited in political ads and speeches. No politician will stand at a podium and say, "Despite all our promises and all the taxes you've paid, we're no further along on this than we were 30 years ago because we're inefficient, pork-fed pols who need poor people in order to get elected." However, only about half of that small group are uninsured for a whole year, and the Congressional Budget Office estimates about 16% of the uninsured go for 24 months without insurance. If it’s your family and you’re paying out $1000 a month to COBRA to your new plan, even one month is too long. It’s a bit like rejoicing that military deaths are far lower today than 20 years ago when there was no war. If it’s your son or daughter who died in Iraq, that’s not much comfort.

Who is uninsured? Actually, it’s the youngest (19-24, who also tend to be the people with “it will never happen to me” attitude), better educated, married, and higher income people who are more likely to go without insurance. Some people who claim to be uninsured on surveys actually have it through a government program (Medicaid or SCHIP), and some people who are eligible, don’t apply, and some who could have it through their employment, don’t choose it because they don’t want the co-payment.

Also, being uninsured does NOT mean a person gets no health care. If you've ever been to the ER, you know that. We all wait together. The uninsured may not seek care as early as they should, however, and that might cause problems down the road. Most of the political ads I’ve seen about health care actually involved people who had insurance (like Obama’s mother, or Hillary’s examples), but they were brought up as examples of the need for it to be “universal,” lessening what you and I have, and increasing what others have.

Still, with a new hurricane approaching New Orleans and all the reminders of stranded people, drowning buses, a racist mayor wanting a chocolate town, and a woman governor who didn’t know when to say “help,” I really can’t imagine that we want to FEMA-tize our health care.