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Q. When is 45 million not 45 million?

A. When we're talking about Americans without health insurance.

You've all heard the statistic: "45 million Americans with no health insurance." I just saw it in this article: "According to the U.S. Census Bureau, almost 45 million Americans have no health insurance." It's been a major topic for Democratic presidential candidates:


  • John Edwards: "You tell me what it means when you ignore 45 million Americans today, who have no health care coverage."

  • Hillary Clinton: "The money we save from the waste we eliminate and the way we change how we care for people should be used to help finance coverage for the 45 million Americans who have no insurance,"

  • Barack Obama: "If you are one of the 45 million Americans who don't have health insurance, after this plan becomes law, you will have health insurance available to you,"

But if you look more closely, the numbers fall apart.

Oops, they counted non-citizens. So, what do I mean about 45 million not being 45 million? Well, the number originally came from the Census Bureau's 2005 Current Population Survey (CPS) Annual Social and Economic Supplement (ASEC), which was corrected last year to 44.8 million people without health insurance. If you read the report, however, you'll find that 9.2 million of the uninsured are not citizens of the United States.

That means that there are 35.6 million Americans who don't have health insurance. That's 12.3% of the population, rather than the quoted 15.3%. Does "36 million" sound as impressive as "45 million?" I don't think so.

Let's pause here for a moment and consider what the Democrats are proposing. What they are saying is that they want to radically change the way health insurance is handled in this country because 1 person in 8 is without insurance. That is, they want to force 7 out of 8 people to change their health care system to accommodate that one person.

A tyranny of the minority.

Uninsured for how long? Now let's look at those 35.6 million people a little more closely. When we say that somebody is "uninsured," most of us imagine some poor betrodden worker laboring for years without medical attention because he can't get insurance. I call this "chronically uninsured" - somebody who can't afford to get into the insurance system, and so goes without insurance for long periods of time.

The Census Bureau report (cited above) notes that the number of uninsured people that they quote are not "chronically uninsured." In fact many of them have had insurance during the preceding year, but were "between insurances" at the time of the survey. They suggest looking at a Congressional Budget Office Report, "How Many People Lack Health Insurance and For How Long?," to understand this effect.

The Census Bureau says that its data best corresponds to a "point in time" survey, i.e., the answer you would get if you asked people: "Are you insured right now?" The CBO report tells us the relationship between "point in time" data and "uninsured all year" data:

The most direct comparison of the two measures comes from a study of SIPP data that found that 14.8 percent of Americans (including the elderly) were uninsured at a point in time in 1992, while 7.6 percent were uninsured all year.(13) That nearly two-to-one ratio is echoed in the 1998 figures from SIPP,16.6 percent versus 9.1 percent.

So of the 35.6 million uninsured from the Census Bureau survey, we can estimate that about half didn't have insurance for an entire year. Those 18 million people are the "chronically uninsured," and are the people that policy changes should address. Or, I should say more accurately, they are the only group of people whose plight warrants major legislative intervention.

Conclusion. As you can see from the pie charts below, the problem is much smaller than health care reformers would have you believe. In the chart on the left, we see the story as they're presenting it, with those 45 million Americans languishing under our cruel and insensitive health care system. On the right, you can see the story as it actually is - the people who actually need help, the "chronically uninsured" are in the thin purple wedge at the right of the chart.

immigration%20demographics.png

The 18 million citizens who are chronically uninsured represent only 6% of the population. Turning the health care industry upside down for 1 out of 15 people seems a bit much, and running a presidential campaign on the basis of the welfare of 1 out of 15 people seems like a distortion of priorities.

But "45 million" repeated again and again will probably carry the day for health care reformers.

UPDATE by See-Dubya: Welcome, Digg people. Have a look around; you'll find plenty to STOKE YOUR RIGHTEOUS OUTRAGE AT HOW ANYONE COULD BE SO (sob) AWFUL. Also, do take note that this post was written by my very able guest blogger, Geoff of Uncommon Misconceptions. Do click through and share some of your thoughts with him.

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Posted by Geoff on July 10, 2007 6:51 AM
Trackbacks: View (8)Ping
Comments

Sadly, insured patients have become the guinea pig to foot the bill for millions of uninsureds sucking the system dry and they are just about getting doctored 2 death in the process.

TheAngryPatient.com is a web diary about one patients nightmare incarceration in a hospital.

Posted by angry patient on July 10, 2007 5:30 PM

Compare THAT to 100% coverage given to citizens in other leading nations

Posted by Anonymous on July 11, 2007 2:38 PM

I feel socialized healthcare would work in the US. We have enough money to fight a war on oil, and if we cut that spending by 10% millions of americans will receive healthcare. Dont even get me started on the FDA and prescription drugs.

“We have enough money to fight a war on oil”

No we don’t.

Take a look at our national debt. FYI, we have no money. We have borrowed time.

Posted by Karroog on July 11, 2007 5:25 PM

Socialized health-care has serious flaws also.

The fact remains: NO MATTER WHAT THEY DO, THEY CANNOT CLOSE THE GAP RELATING LONGEVITY TO INCOME! Even in countries with fully socialized health care, the disparity between income and longevity exists.

I like the fact, that I’m a more educated individual, that I have better health care than someone working in a blue collar job. It gives me more insentive to pursue my education, and it gives other people that insentive too.

Why do all liberals wish they lived in Europe? Why don’t they just move there?

Posted by Jai on July 11, 2007 5:27 PM

Let’s pause here for a moment and consider what the Northerners are proposing. What they are saying is that they want to radically change the way labour is handled in this country because 1 person in 8 is black. That is, they want to force 7 out of 8 people to change their plantations to accommodate that one slave. A tyranny of the minority.

Posted by Marcaias on July 11, 2007 5:29 PM

Ugh, if you want to prove your case don’t use ugly 3D pie charts. first of all, volumes are harder to compare than lines, and the way you rotated the axes is very deceptive as well. as an ‘analyst’ you should understand you yourself are lying with data.

Posted by Omar on July 11, 2007 5:29 PM

So if there are far fewer people who are uninsured, then reforming the system should be much EASIER than what they are proposing, and that is an encouraging development for all those who want to reform the system.

36 million is more than the population of Canada and many other countries, though. Not chump change.

Posted by uniteddeathtechnolog on July 11, 2007 5:32 PM

Well Jai, let’s hope your “insentive” to educate yourself is great enough that you’d learn to spell at a junior high level

Posted by CJ on July 11, 2007 5:33 PM

to jai: i like how you say you are “more educated” while spelling incentive twice with an s. good stuff.

Posted by me! on July 11, 2007 5:33 PM

Thank you for that insight Karroog.

It’s true folks, the economics of our current system can only work for so long before they snowball out of control. People who don’t understand economics are always the ones who think there is a free lunch to be had if we don’t spend so much in another area or if we reform policy in some way.

There is no free lunch people, everything has a cost associated with it . . . even if that cost is obscured or delayed.

Posted by Kniteman77 on July 11, 2007 5:35 PM

hahahaahhaha

“im going to fight numbers with estimations and nonsense”

good try

Posted by Lono on July 11, 2007 5:38 PM

“turning the health care industry upside down for 1 out of 15 people seems a bit much”

So you’re saying let’s not reform health care because it’s a nuisance? a pain-in-th-a$$? Numbers aside, that’s not really a compelling argument.

Posted by Yugo on July 11, 2007 5:38 PM

“That means that there are 35.6 million Americans who don’t have health insurance. That’s 12.3% of the population, rather than the quoted 15.3%. Does “36 million” sound as impressive as “45 million?” I don’t think so.”

—-

Bzzzz… wrong answer. 35 million Americans without insuarnce is AWFUL.

But worst, you miss the point entirely: even the vast majority of Americans WITH insurance are hosed. I work for a fortune 500 company, and my insurance only covers 80% of the bill. God forbid I get in a terrible accident and need $500k in treatment - I’d be hosed with a $100k bill.

Posted by jeff on July 11, 2007 5:38 PM

“Does “36 million” sound as impressive as “45 million?” I don’t think so.”

No, it really does still sound impressive, especially when it’s about something like this…

Moronic article. Non-citizens are people, and the healthcare system cannot turn them away (and by cannot, it is illegal to do so) and so they still count. “Between insurance” is not actually a category that means anything, you either have insurance or you don’t, and insurance companies don’t cover you for healthcare needs that occur before or after your coverage begins. The economic and healthcare system impact of both groups still exists, whether you want to call them “uninsured” or something else. 44.8 million uninsured is exactly that.

And even if I believed your numbers and your conclusion, 1 in 15 people, if it makes our healthcare system as bad and inexpensive as it is, is enough reason to upend it. Just goes to show blogs and pie charts don’t mean you have something worth saying…

Posted by Dr Mike on July 11, 2007 5:39 PM

Seems like you have a real bias here (judging by your web site), so I don’t know why I bother to point this out but…

It’s a bit disingenuous to write an article about fudged figures and then fudge them yourself. You make assumptions about people being “between insurances” or not being fundamentally uninsured, but you don’t know one way or the other what the actual figures are. You are just as bad as the people you are trying to criticise.

Your only valid argument here (and I am not sure I even believe you based on how you spin this story), is the first “cut” where you remove the non-citizens from the equation. The rest is pure BS and speculation.

Why wouldn’t people lie the other way about having insurance anyway? Most uninsured people would be poor right? And admitting to not having insurance is pretty much as bad as saying “I’m a poor white-trash trailer-park dude.” Seems to me that people would be more likely to lie and say they have insurance when they don’t.

Finally, you leave out the important fact that even if you have insurance, a lot of the time it’s crap insurance. That’s not related to your blog here about the 45 million number, but it’s relevant to the whole situation Americans find themselves in today with Health Care. The system most definitely needs a radical change, whether you can see it or not.

Posted by Jeremy on July 11, 2007 5:39 PM

Go to the CIA’s fact sheet website to notice how the USA’s infant mortality rate is much higher than Cuba’s.

Then keep telling yourself that 100% free market economics in health care works…

Posted by Jay on July 11, 2007 5:41 PM

The tyranny of the minority? What ever happened to the rights of the minority? Your argument is based solely on what you believe to be the belief system of the majority. Just because the majority has health care doesn’t mean it isn’t a broken system, and that yes, maybe those 7 out of 8 should help the 1. (A principle this nation was founded on.) And I would even propose that most of that 7 of 8 would be willing to consider helping the one out. The irrefutable line is that our health care system is based on profit and not the desire to provide for the nation’s citizens in their time of need despite their income or their effort. Your freedom of speech is unquestionably protected even if you should write the most hateful and even conspiratory material. Should free speech only be given to those who deserve it? The care of our citizen’s health should be treated the same… as an inalienable right for all of humanity.

Posted by Jay on July 11, 2007 5:43 PM

Hahahaha

Torn apart on your own comments page. Nice.

Posted by Gabe on July 11, 2007 5:47 PM

The “Minority” of 36 MILLION PEOPLE (Just let that number sink in for a moment)is not the only reason cited for Health-Care Reform. Even Shills such as Dr Sanjay Gupta admits the system is broken.

The US Healthcare system is ranked at #37 by WHO ahead of Slovenia and Cuba (Whoo-hoo! We’re number 37!). while our life expectancy is lower than Cuba, and child mortality rate is higher we are spending $6000-$7000 per capita on health care compared to $250 in Cuba.

Why? Because insurance agencies seek higher profits each year based on our health care. The uninsured is a relatively small item in the whole picture. Our system is becoming more expensive every day, so coverage will decrease to maintain profits.

Broken.

Posted by CA on July 11, 2007 5:50 PM

“When we say that somebody is “uninsured,” most of us imagine some poor betrodden worker laboring for years without medical attention because he can’t get insurance. I call this “chronically uninsured” - somebody who can’t afford to get into the insurance system, and so goes without insurance for long periods of time.”

Think again. Being a contract worker myself, I see many, MANY people who are exactly like the first description you give. And by calling us “chronically uninsured” you are just trying to make it sound like it’s our fault.

Personally, in the last 10 years I have had insurance for 2 months. It is not because I can’t afford it, because I can, and would GLADLY pay for it if I could. It is because by being a contract worker, I do not get insurance benefits through my place of business. And I cannot buy my own insurance because no insurance company will take me, PERIOD, due to preexisting medical conditions. This isn’t a “boo-hoo poor me sob story,” merely an example. There are many other people like me.

Why is it that the only people who can get insurance anymore are the people who don’t need it as much? How is this right?

Posted by Chronically Uninsured #1 on July 11, 2007 5:52 PM

I have health insurance, and I still want reform. Insurance companies try to find every way possible to reject claims. I and the company I work for pay them way more money each year than I get back in coverage.

Posted by Jer on July 11, 2007 5:54 PM

Why would you not want non-citizens to be covered by your health system? I don’t know about you but if my overseas friends came for a visit and broke their leg, I for sure would want them to recieve health care. Are Americans that xenophobic that they want tourists to fall through the gaps?

Oh and btw 18 Million (6%) between insurace during the survey means 6% without insurance when they happened to get hit by a car. That means every 20th person going into hospital, doctors surgery, clinic or pharmacy is refused treatment because they were “between insurance”.

Posted by philip on July 11, 2007 5:54 PM

one in eight may not have health insurance, but i bet another 4 can barely afford health insurance, and while it says that they are covered, they really aren’t. the expenses for their medical bills are way above what they can afford. i know this because my dad who is a poolman has health insurance, but after a tragic motor cycle accident he needed to be airlifted to a hospital for immediate medical attention. the insurance company covered net to nothing on the air lift and my dad got shipped to some shitty county hospital when he should have been at a mre experieced and competent hospital. they even fought him on covering his rehab costs. they said they’d only pay for a nursing home for rehab, which the nursing home just let my dad sit and did nothing to help improve his condition. my dad does not belong in that kind of place, he is only 48. so if u think that the health coverage system is fine the way it is, then you must be ignorant to the subject. i have experienced this first-hand and could not describe to you the struggles i’ve experienced. something needs to be done.

Posted by peachey on July 11, 2007 5:54 PM

you can stick your pie chart up your ass, the insurance companies need to be strictly regulated and the health care needs to be universal and payed for by the taxes

Posted by joe mom on July 11, 2007 5:55 PM

>>>Does “36 million” sound as impressive as “45 million?” I don’t think so.<<< You’re joking, right? Is that supposed to be a sound argument for not changing the health care system? 36 million people is plenty!

Posted by ihatethisblog on July 11, 2007 5:55 PM

Well, under this flawed logic, we should immediately get rid of public libraries, as the majority of us don’t use them. Also, let’s start charging fees for use of the public roadways. Those who can afford to pay for them can still drive, and for everyone else, you’ll have to stay off them and walk to where you need to go. While we’re at it, instead of providing universal healthcare to everyone and focusing on preventative care for those who need it most, we should also start charging parents for elementary school children’s textbooks and the teachers to teach them, as socialized learning is a bad thing, and only those who can afford it should be allowed to go to school. The rest should just stay home and pick cotton for a living.

Posted by Anonymous on July 11, 2007 5:55 PM

Who cares if 9.2 million are non-citizens? Don’t non-citizens have the need for a good health care system? I am a non-citizen. I am a legal resident alien. I pay taxes and obey all the laws. Why discriminate against legal non-citizens?

You sir are obviously an immature idiot. Please get off the internet and let others pass.

Posted by Ian on July 11, 2007 5:56 PM

You are also leaving out “Under Insured” citizens.

Posted by Markus Simms on July 11, 2007 5:56 PM

There are 45 million people in the US without health insurance. There should be no one. No, 36 million does not sound better. It means that you are not counting 9 million people. and 36 million is still 36 million too many. The fact that that is the best you can do to refute Michael Moore shows how good his argument is and how poor yours is.

Even taking your figures 12.5% is pretty high. Look out your window. If you can see 100 people 12 of them will have no health care on average. Is that really what a caring society should have? Of course if you have shares in the insurance company, I can see your point.

We are #37, we are #37, we are #37… does not have much of a ring to it does it!

If you live and work in the US you should have health coverage.

Posted by butcher99 on July 11, 2007 5:59 PM

I can’t believe this article. 36 million seems like a pretty big number to me. You are also forgetting all the people that actually DO have insurance that still get screwed over on a day to day basis and end up drowning in medical bills. It’s common sense, open your eyes.

Posted by Rob on July 11, 2007 6:00 PM

I’m between insurers because I’m between jobs. And because I sought treatment for something in college, I’ve got a “pre-existing condition” that prevents me from being able to afford to carry my own. I shouldn’t be punished for seeking treatment just because YOU happen to like YOUR insurance the way it is. And I’ll wager you’re pretty healthy, too. Wait ‘till something serious happens to you, you get denied something critical you need and see how fast you change your tune, pal.

I will agree that 36 million is not as many as 45 million, but it is still a huge number.

Posted by Auggie on July 11, 2007 6:02 PM

You’re a jackass. First off, those “7 out of 8” Americans WITH insurance aren’t as insured as they think they are. That’s the whole fallacy of “insurance”. Secondly — Republican tax laws have, for the last 6 years, benefitted 1% of the population. So if you’re going to use your absurd little argument: Should 99 out of 100 Americans support a system that benefits 1%?

I think not.

Posted by Popo on July 11, 2007 6:03 PM

Man, are you on the wrong side of an issue, and the wrong side of history. Babbling righties talk about how long the wait is to receive medical attention in Canada, or England. How long is forever? It’s a long, long time for the people who die because they can’t receive preventative care. I can wish you get cancer because clearly, you’re insured.

Posted by Richard on July 11, 2007 6:03 PM

So there is 10 million less people. I think the point is lost on this report.

The issue is still the same.…of the people who ARE insured, you must jump through burning hoops of fire just to get the damn medical attention that you’ve paid premiums to receive. Our health care system IS a disaster and will stay like that so long as the health care system is driven by charging as much as they can, and denying as many claims as they can.

Posted by Mr. TT on July 11, 2007 6:03 PM

Who cares if 9.2 million are non-citizens? Don’t non-citizens have the need for a good health care system? I am a non-citizen. I am a legal resident alien. I pay taxes and obey all the laws. Why discriminate against legal non-citizens?

You sir are obviously an immature idiot. Please get off the internet and let others pass.

Posted by Ian on July 11, 2007 6:04 PM

“Socialized health-care has serious flaws also.

The fact remains: NO MATTER WHAT THEY DO, THEY CANNOT CLOSE THE GAP RELATING LONGEVITY TO INCOME! Even in countries with fully socialized health care, the disparity between income and longevity exists.

I like the fact, that I’m a more educated individual, that I have better health care than someone working in a blue collar job. It gives me more insentive to pursue my education, and it gives other people that insentive too.

Why do all liberals wish they lived in Europe? Why don’t they just move there?”

More educated huh? Let’s start with some basic spelling and once you have that mastered you can come back and speak your mind. lol…

I work in health care and I’d be more then happy to see everyone have health care provided for them. Even if it means I have to put in a few bucks myself.

Posted by middle class worker on July 11, 2007 6:05 PM

If you can fight for your country as a non-citizen (http://usmilitary.about.com/od/joiningthemilitary/f/noncitizen.htm), your country should certainly help you with your health. Citizens or not, being American means you live in America. Also, if you are analyzing values, then you should interpolate the trend appropriately (at least linearly) which puts it at 11.5%. When you really take factors into account (like when healthcare was privatized) you can see it won’t be a linear interpolation but a exponential rise so it’s probably closer to 12-13%. Add that to the fact that your country makes laws based on lobbying for the 1% of the population (1 in a 100), making room for 1 in 8 or 1 in 15 or 1 in 50 shouldn’t be too much to ask for (i guess the difference is the 1% who make rules are the ones that control 1/5 of the money).

Posted by Cap on July 11, 2007 6:06 PM

I was thinking exactly the same as Marcaias.

The “chronically uninsured” argument you propose is bogus. If you are insured 1 of 365 days, you lose the status of “chronically uninsured,” as you define it. The idea of being “chronically uninsured” is irrelevant if you need medical attention on a day that you are in fact uninsured.

The more relevant question is:

How many people did not seek out medical care because they… A) did not have insurance B) had insurance but still could not afford the care (copays, non-covered expenses, etc.) C) had insurance but feared the insurance company would retroactively change their stance on covering the expenses D) had insurance but didn’t know how to handle the insurance claims process

Posted by Meh on July 11, 2007 6:06 PM

Your just a Biased idiot with a Blog.……

Posted by LouREBEL on July 11, 2007 6:07 PM

36 vs 45 million isn’t important IMHO.

What is relevant is that we somehow manage to pay more for our health care per capita than almost any other country. To me, at least partly, this is because, for tens of millions of people, the only access to health care is in the emergency room. So, what should be minor, inexpensive issues, become “crises” — and thus more expensive.

Those of us who have health insurance do pay to cover the uninsured. We just do it in an insanely expensive fashion because we aren’t willing to fork up what would probably be fewer dollars to provide insurance across the board.

Consider this: I would love to take the risk of starting my own business. The main reason I don’t do it is because I won’t be able to afford insurance on my own. (I’m mostly healthy, but at age 40, with a few bumps and bruises and extra pounds on my body, I’m not exactly on the insurance company A-list either.) So I hold on to my nice salaried job with the nice health insurance package.

How many other would-be entrepreneurs does our country lose for this reason?

Posted by Eric on July 11, 2007 6:07 PM

Ah, the health conglomerate lobby’s blog astroturfing campaign has finally started. Hey, how can I get paid to be a shill. The pay on disability is shit, and I need new shoes.

Posted by Corin Royal Drummond on July 11, 2007 6:08 PM

The author makes an irrational argument. His sophistry cannot be used to lower the figure from 36 million to 18 million uninsured Americans in the context of universal healthcare.

Assume that there is no fluctuation in rate at which Americans lose and gain health insurance. Assume also that illness strikes a person within a given timeframe with same probability regardless of whether they are insured or not.

Even if the survey was done to get point-of-time data, you will have the exact same number of uninsured persons at any given moment in time. This means that in order to calculate the expected number of illnesses that occur while being uninsured within the timeframe mentioned before, you would multiply 36 million by the probability mentioned before.

In fact, 36 million is the more accurate figure in the context of whether we should have universal healthcare. 18 million uninsured for the whole year does not mean there were only 18 million uninsured part of the time. For example, assume that for any given year there exists only people who have no insurance for the whole year and people who are missing insurance for a third of the year. That means that in addition to 18 million people who had no insurance for the whole year, there were 54 million people had no insurance for exactly a third of that year.

You do not suddenly have 0% probablility of getting sick while uninsured because you will have insurance again before the end of the year.

Unadulterated bullshit.

36 million is the better figure for the topic.

Also, just because a person is not a citizen doesn’t mean that they are illegal aliens. Any proposal of universal healthcare should cover tax-paying legal resident aliens and their family. I’m curious as to how many of the 9.2 million he subtracted falls into that category.

Posted by empraptor on July 11, 2007 6:08 PM

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Posted by deptaro on July 11, 2007 6:08 PM

I was going to post a comment because i was outraged at how you are twisting the facts to make it seem like leaving people out in the cold is a good thing.. but i see previous posters have already pointed out your glaring flaws and obvious bias.

Nice try tho.. i give you a b+ for troll effort.

Even if it is 36 million ..is that small ?? Is that insignificant ..Just making some pie charts from your imagination .Does the poster know there are 18000 people WHO DIE EVERY YEAR DUE TO LACK OF MEDICAL INSURANCE .. It is 36 million lives !!. but why do u care people u care about profits ..typical profit monger

Posted by max on July 11, 2007 6:12 PM

What the heck has being a citizen got to do with this. If you live, work and pay taxes here then you should be counted in this. I’d hazard a guess though that the percentage of legal permanent residents without health insurance is way less than that of citizens.

Posted by Nik on July 11, 2007 6:13 PM

Rights to healthcare? Their right is to live free and on their own terms, not to receive everything for free when they haven’t been able to pull together their own means, be it through fate or through laziness. Let’s start relying on the proven works of natural selection, and artificial selection too since thats as natural as anything else, and see where that takes us. Lets stop spending the majority of our healthcare money on the oldest people who contribute the least to society and have the least mobility and independence. Let’s see where all of THAT takes us…I guarantee the cost of healthcare could drop drastically if we stopped thinking that we need to prolong EVERY persons life until the point where they arent even with it enough to know who is talking to them. Cut out that cost and the rest of us, the masses, will have to pay less for our own healthcare.

Posted by Someone else on July 11, 2007 6:17 PM

Yes, I see tax-funded healthcare in the Bill of Rights. Why don’t you socialist all leave since it’s so bad here.

Posted by T.J. on July 11, 2007 6:28 PM

Wow, that was the most willful misunderstanding of the movie I’ve seen so far. Congratulations!

Posted by bob on July 11, 2007 6:34 PM

For the love of all that is holy (or… not, if that’s your thing), SHUT UP PLEASE! Arguing on the internet is ridiculous. It’s like playing in the special olympics: even if you win, you’re still retarded. Noncitizens are absolutely people, no one is arguing that, but if they’re not citizens, they’re not entitled to the same rights and priviledges as citizens. A lot of noncitizens are here illegally and aren’t paying income or property tax, money which would likely go to support Universal Coverage. Those that are here legally (such as students) almost universally have insurance from their home country or an international organization. Also, if all you can call out on someone is spelling errors, WHO CARES?! Einstein failed the 7th grade math but you don’t really see us ripping him apart for that! Also, the “pain-in-the-ass” argument is a very good one. Why don’t many of us recycle? Because it’s a pain in the ass (PITA from now on)! Why do so many of us want to pull out of Iraq, PITA! Why do we want to close the US-Mexico border? PITA! Why don’t we stop burning fossil feuls? Yet again, PITA… I honestly don’t care whether we adopt universal coverage or not, it makes little difference to me since I’ll be insured one way or the other, but to all of you, if you’re going to argue about something, anything, A) don’t do it on the internet and B) think first.

Posted by A College Student on July 11, 2007 6:34 PM

Funny the author doesn’t mention the underinsured - just because you have insurance doesn’t mean you are fully covered, the uninsured is just part of the problem - meaningless article.

Posted by angel on July 11, 2007 6:35 PM

You lost me at:

Does “36 million” sound as impressive as “45 million?” I don’t think so.

Posted by focher on July 11, 2007 6:37 PM

Thank God for comments! I feel so much better after reading them. Consider yourself PWNED.

Posted by Joe Felice on July 11, 2007 6:38 PM

Again:

EVEN IN EUROPEAN COUNTRIES, THE DISPARITY BETWEEN INCOME AND HEALTH REMAINS!!!!

There are OTHER factors involved with making people “healthier”. Even with 100% free health care, the rich tend to live longer than the poor.

Providing health care, to people who haven’t earned it, will not fix that.

And yes, I said it. Those with out health care probably haven’t earned it. Tough luck, you chose that life, not I. I’m not covering your ass.

Posted by Jai on July 11, 2007 6:38 PM

I can’t wait until every American gets the same health care our honored veterans receive.

I am excited about our health care system becoming as top notch as our public school system.

I welcome the day that eliminates forever the lawsuits against careless doctors.

I welcome the day when I can receive health care as high quality as other government services I enjoy today, such as the DMV, the IRS and the Post Office.

It excites me to think that one day, our heath care system might run as smoothly as the border patrol and as quickly as the justice system.

Best of all, I welcome the day when I can trade an ignorant greedy corporation for an honest, selfless politician.

“Those who trade liberty for security are destined to receive neither.”

Posted by A Proposal on July 11, 2007 6:46 PM

The first time Hilary got elected President Washington state turned its health care system upside down to implement the “Hilarycare Plan” that was introduced in her first 100 days in office. You know, the same kind of “everyone will have health care, even if everyone else has to pay for it” plan being so loudly discussed now.

It has been far less than a success and the healthcare in this state has suffered for it. I’ve gotten better quality healthcare on main land China than I’ve gotten in Washington State.

Posted by Scotty on July 11, 2007 6:46 PM

Well, I see the socialists found this blog (probably many by way of Digg).

There is no “right” to health care, much less an inalienable right. Additional government interference in health care will make it worse, not better.

Well, next time you go spouting 36 million as not that many people, you should get a clue as to the number of people in the different states. IOW, state census.

http://www.factmonster.com/ipka/A0004986.html

Yes, you could take about half the union and basically none of those people have care. FACTS FTW!

Posted by ThirtySix on July 11, 2007 6:50 PM

thank god (can i still say that in the u.s) for the u.s. health system. montreal, a major city in a country with national healthcare , got there 1st CT scan in 2002. think about that, a routine procedure in the u.s. not available in a city the size of montreal. thats how wonderful national healthcare is. the government health system has still not bought a CT machine for montreal. the one that is in montreal was donated by the “saku koivu foundation”. a hockey player who had cancer and had to leave canada to get a CT scan! hockey players have enough wealth to travel to another country to find decent healthcare. i read comments about 1 of 8 don’t have healthcare. my opinion that is better than 8 of 8 having poor healhcare, where things like CT scans aren’t available.

Posted by candian living in u.s on July 11, 2007 6:51 PM

I think we are barking on a wrong tree.…we first need to understand that “people should not need insurance to go talk to a doctor”. Health care should be the right of every citizen.

Moore is right. Remove the middleman between the doctor and patient. The middleman is the insurance. They are the ones who goad patients to file frivolous lawsuits and then scare doctors to take up insurance, raising costs for everybody else but filling up their pockets.

I wonder why people cannot see the middleman and its practices.

Posted by AlexK on July 11, 2007 6:51 PM

@Jai

You said “And yes, I said it. Those with out health care probably haven’t earned it. Tough luck, you chose that life, not I. I’m not covering your ass.”

You have no idea what you’re talking about.

There are many people who are uninsured in this country who have MORE than earned it. I have worked hard all my life, and I am uninsured, and have been for years. I currently have a pretty nice job - I make more than enough money to live comfortably on my own, even including my huge hospital payments that I’ve incurred since I don’t have insurance.

I don’t have insurance because I am a contract worker and it is not offered by my “employer”.

I cannot buy my own insurance because no company will insured me - I have been denied by them all due to preexisting medical conditions (see above “huge hospital payments.”) What am I supposed to do? What do you propose?

Should I quit my good, well-paying job that I like, and go work somewhere else for less money so that I can get insurance? Why should I have to change jobs to get insurance? And if I do, someone else will just take my place here, and then they won’t have insurance either. Nice plan.

Posted by Chronically Uninsured #1 on July 11, 2007 6:54 PM

The chronically uninsured is a problem. These people either for financial reasons, legal reasons, or health reasons cannot acquire insurance. However, the temporarily uninsured is the more pervasive problem. In spite of your argument of “snapshot statistics”, if 36 M people are uninsured today, 36 M will likely be uninsured next week. Not the same 36 million - as some gain insurance, others lose it. This fluctuates seasonally, but the real tend to watch is the rate of employment vs the rate of insured. These are steadily diverging.

I live in an area that has relatively high unemployment (for the US). Jobs here are hard to find and tend to be short-lived. Increasingly we are seeing jobs offered with no health benefits. It is very common that health benefits, if offered, do not kick in for 3-6 months. Since jobs are difficult to find here, a job search typically lasts three to six months, which when followed by another three to six months probation period, usually means no insurance for a good chunk of a year. Given that we are likely to be out of job again in another year or two, we look forward to doing it all again.

The other problem with this temporarily uninsured model is COBRA. This legislation is supposed to allow those who lose their jobs to maintain insurance coverage while seeking new employment (or while waiting out the “probation” period in their new job). However, costs to the recently unemployed of maintaining COBRA coverage are typically very high $500-$900 per month, and in most cases you cannot opt for a reduced insurance package when transitioning from the employer’s package to COBRA. Of course, this is a direct result of the extremely high insurance premiums in the US.

For those that need affordable coverage for less than a year, there are basically no options.

Posted by Brett Johnson on July 11, 2007 7:01 PM

Chronically Uninsured, if you make enough money to cover your huge hospital bills, why do you need insurance? Don’t get me wrong, I understand the point you’re trying to make. Not everyone who doesn’t have insurance, hasn’t earned it, I agree with that. But using yourself is a rather poor example since you clearly make enough money to negate the need for insurance. Just something you might want to consider.

Posted by A College Student on July 11, 2007 7:02 PM

What motivates you to defend the current health care system in the united states?

Interesting point, but there are some inaccuracies in your analysis.

1.) In your section, “Uninsured for how long?”, you’re combining figures from the 2005 Census report to 1998 numbers in the CBO report. It’s similar to an apples and oranges comparison, so your 2nd pie chart is inaccurate.

2.) From the 2005 Census report (page 23): “Most people (59.5 percent) were covered by a health insurance plan related to employment for some or all of 2005, a smaller proportion than in the previous year (59.8 percent).” Contrary to your argument, the people who have health coverage for “some or all of” 2005 are included in the insured category. In other words, the people whom you term “in between insurance” are actually part of the “insured”, and your 2nd pie chart is inaccurate.

3.) While you correctly observe that non-citizens are included in the survey, you did not note that “People in institutions, such as prisons, long-term care hospitals, and nursing homes, are therefore not eligible to be interviewed in the CPS.” (page 28 of the 2005 Census report)I am not an expert on the topic, but I think it is a reasonable assumption that people in long-term care hospitals and nursing homes have higher rates if non-insurance. Of course, it could be a mistaken assumption.

I can understand your concern (about misrepresentation by politicians: 45 million American citizens vs. 45 million of people in America), but it seems like the main crux of your argument is this: “Does “36 million” sound as impressive as “45 million?” I don’t think so.”

To be honest, this is a subjective argument. I personally believe 36 million is pretty impressive, myself.

Posted by Astyanax on July 11, 2007 7:07 PM

Can someone clarify something for me?

What, EXACTLY, are the you (those who disagree with the post) proposing be done for the people without steady health care(be it 45m, 36m or 18m of them)?

Are you proposing that the government pay for their healthcare?

Are you wanting the government to dictate what drugs to take when?

Are you wanting the government to “take care” of them?

Are you wanting the government to bugger off and leave the US people alone?

And, most pressing, why does every person living in America NEED healthcare? Shouldn’t they be responsible for their own? Why do people want the government to take care of them from cradle to grave?

Please answer me these - I am willing to listen to any reasonable argument, and would like to debate the topic. I don’t want to be in the middle of a Flame War though. =(

Thanks!

[quote tomesnyder] Well, I see the socialists found this blog (probably many by way of Digg).

There is no “right” to health care, much less an inalienable right. Additional government interference in health care will make it worse, not better.[/quote]

YEEESSS!! That is SOOO RIGHT!!

Posted by USA, Not SSA!! on July 11, 2007 7:14 PM

You are so fucking careless and ignorant.

Posted by Forrest James on July 11, 2007 7:21 PM

@A College Student

I make just enough money to cover the payments for my huge hospital bill, which were worked out by the hospital’s financial aid department and will be payed off completely in about 5 years at this rate.

I was not saying that I am rich or anything, as I am certainly not. I make enough to pay for my apartment and bills, and I have a little bit leftover for fun stuff. I’m not digging around for change, but I am not living in a luxury apartment either.

Point being, I make decent money, I’ve worked hard all my life, I’ve worked at this job for three years and plan on working here much longer, and I have no insurance. I am not someone who “doesn’t deserve” insurance because I haven’t worked for it or something.

EVERYONE deserves to be able to see a doctor if they are ill.

Posted by Chronically Uninsured #1 on July 11, 2007 7:26 PM

Even those with insurance are often getting screwed, overpaying for insurance, overpaying for meds, and getting refused for treatments. Getting everyone covered is a benefit to everyone, not just the people who are newly covered. It helps to identify and control epidemics, increase work productivity and so on.

Posted by Bing on July 11, 2007 7:38 PM

I’m sure the germs will check passports and ask if you’re between jobs before jumping from one person to another in this country.

Posted by Seth Resler on July 11, 2007 7:39 PM

An Open Mind: Ok, obviously not everyone here is an economic/medical analyst or a statistician. But we’re pissed off about this basic fact: The healthcare system (including insurance et al) is incredibly inefficient. That’s undisputable. It’s insanely expense, and provides low quality care for the money you pay per person. No two ways about it: The free market isn’t working here. You just have to accept it. If you argue that point then we can’t have any kind of discussion, because it’s a statistical reality when you compare the US to other countries. This means that even those people that don’t think that the government should coddle people, and that people should fend for themselves should be angry, because they’re literally getting screwed.

If I want to go all bleeding heart on you, then I’d mention the… and I’m pulling this number out of my memory, and don’t remember where I heard it, so if I’m wrong don’t kill me: 12000 people that die a year because they had no care. Or the fact that babies die because their care isn’t as good as that of babies in Cuba. Should the babies take care of themselves? Is it the parent’s fault? Is it legitimate to blaim the baby for the parent’s inability to provide enough money or insurance to make sure the baby survives? If the system doesn’t cover everyone, is too expensive, and provides low quality care, doesn’t that mean something is wrong? And if we do look at the other countries, and we see that they do have higher quality care, at lower prices with coverage for everyone, shouldn’t we copy that? I mean, it’ll obviously do the economy good. Hell, it’ll probably do you good. Yes, you. It might take time to transfer over, but don’t you think it’ll be a worthwhile endevour for your children to get good quality care? Your argument has no weight because you’re literally defending a system that sucks balls. You can hate socialism all you want but it doesn’t change reality. The reality is that socialized healthcare is better, cheaper, more efficient, and gives broader coverage. Period.

Posted by Another one on July 11, 2007 7:42 PM

“Tyranny of the minority.”

HAHAHAHAHAHHAHAHAHAHAHAHAHAHAH

Posted by Ron Paul for Pres on July 11, 2007 7:45 PM

I seem to remember something in our history about people being endowed by their creator with certain inalienable rights. While healthcare wasn’t specifically mentioned I’m sure it could be easily considered and extension under the “life” clause and possibly the “pursuit of happiness”. Along a similar line I don’t recall that the definition of “people” was limited to “only those with citizenship” or “7 out of 8 people with citizenship” or “those that can afford it.”

I work for a healthcare company. We’d like nothing more than to claim that other 36-40 million PEOPLE as our customers. For the record, even if it were 3 million, it wouldn’t be any less significant. These are PEOPLE we’re talking about, not statistics. These are mothers, fathers, sons, daughters, grandfathers, grandmothers, family and friends. That means that the 50 or so people you know relatively well at least 6 are struggling with the lack of healthcare insurance. Many more than that are struggling with the FACT of benefits at greatly reduced coverage. Even those with supposedly great insurance are starting to feel the burden of “consumer driven health plans” and HRAs and getting squeezed into donut holes in coverage even though they’ve only had relatively minor use of their benefits. Let us also not forget the significant amount of people who are “covered” under Medicare and Medicaid. Many of these government insured have to decide to put off a doctors visit or not renew one or more of their ten plus medications because they’ll need that money for food, rent, or electricity.

There can be no doubt that there is waste and fraud within our healthcare system. NONE.

Example of Waste: My wife and I have 5 children. For each child, prior to it’s birth, we went to the hospital for check-ups 20+ times. Each time we had to fill out the same forms as if we’d never been there before, as if they didn’t already know us by name, and as if we weren’t already well logged in the computer system. That paperwork takes time to fill out, takes time to process, requires storage both electronically and physically, and that costs money.

Example of Fraud: A medical supply vendor approaches a medical coder and lets the coder know that instead of using code “XXX” for this stint or suture or what-have-you they would like the coder to use code “YYY”. The coder knows that “XXX” is for a specific listed device while “YYY” is a “miscellaneous instrument” and bills at a higher rate. When management is presented with this ethical dilemma they tell the coder to do it as the vendor requested, they’re very good suppliers after all and give deep discounts for small hospitals.

Insurance companies are finding more and more ways to deny or limit coverage; Pre-existing conditions, probation periods, CDHP, HRA, Donut Holes, Tiered Indemnity, Step Therapy, Customized Formulary, Life-time-limits, etc. Not only do they deny benefits to patients but also to doctors who aren’t “part of the network”. There are side deals, negotiated rates, write-offs, rebates, and a host of other legal but questionable practices that allow the insurance companies, pharmaceutical companies, and I’m sure the other larger healthcare providers to pull in a tidy sum. All the while stiffing a variety of other people. People’s rates shoot higher and higher and employers begin to share the burden of those rates by choosing higher copays and passing more of the cost onto employees.

Doctors are spending less time with patients and more time with paperwork. Patients are spending more time with nurses and nurse practitioners and still paying higher and higher copays even though their not getting the same specialized care as before. Doctors are having to see more and more patients each day to stay under contract and be able to pay the bills. Sometimes they are even abandoning their beloved practices for more viable specialty work in consulting, teaching, or hospital management. The happy-go-lucky success stories about healthcare here in the United States are far and few between. You can’t dismiss that, and you can’t say that it’s just the media. It’s reality and I’m sure that most of the people here in these comments has had first hand experience.

Posted by nhavar on July 11, 2007 7:50 PM

Universal healthcare insurance will address two problems: 1) uninsured Americans 2) low usage of healthcare IT in hospitals

#2 would happen because with a single insurance payer we would not need as many IT workers in the healthcare insurance industry. This would cause a minor flood of healthcare experienced IT talent in the labor market. This increase in supply would slow wage growth and for experienced healthcare IT workers and allow more projects focusing on healthcare quality (which are starving for experienced employees). Most of the healthcare insurance workers have limited knowledge of clinical systems, but they are better than trying to train a clinician that little aptitude.

Posted by HIT Man on July 11, 2007 7:52 PM

you are an idiot

plus

50% of the people with insurance have such shitty coverage that they might as well not have a fucking policy.

plus

you are an idiot

Posted by john on July 11, 2007 8:00 PM

If we have money to kill, we have money to heal.

Posted by Alex on July 11, 2007 8:03 PM

Heres a fun exercise. Lets pretend every person without health insurance is a shiny penny. You now have 45,000,000 pennies. Lets exclude non-citizen pennies, because thats how the author presented this. Now you only have 35,000,000 pennies. Lets not count pennies that aren’t “chronically uninsured”. You now have only 18,000,000 pennies.

Now, give me all those pennies.

What? You don’t want to? I thought 18,000,000 pennies is a reasonable amount for you to give me, after all, I’m only asking for 40% of the original amount. By your logic this is a trivial amount and I fail to see what the problem is.

After all, We are talking about something far more important that pennies, and that is the health and welfare of the citizens and other members of this country. Maybe we should just help out this trivial 6% of the population. Or, maybe, and I know this is going out on a limb, just have health care for everyone like every other leading country.

between insurance?

what the fuck?

it’s a wonder you still know how to breathe, idiot.

extremist (aka right wing) propaganda.

A

Posted by Aaron Fidler on July 11, 2007 8:11 PM

I know it’s been noted, but it stands repeating. It’s pretty hilarious the hypocrisy of Jai claiming he deserves his health care due to the “insentive” (x2) he has to be more educated than us poor ignorant liberals advocating universal health care.

I trust he’ll have the “insentive” to turn down evil socialist programs like Medicare when his day comes.

Posted by hoghug on July 11, 2007 8:15 PM

I love this post…

“Should I quit my good, well-paying job that I like, and go work somewhere else for less money so that I can get insurance? Why should I have to change jobs to get insurance? And if I do, someone else will just take my place here, and then they won’t have insurance either. Nice plan.”

Cost benefit analysis…you would rather continue to pocket your money than pay for insurance…or in this case “work somewhere else for less money”

I paid for my family’s insurance for a year, between jobs…why? because I felt it was worth the sacrifice to have that safety net. The job I went to had immediate coverage with no issues about pre-existing conditions. (so much for that excuse)

Freedom means you get to choose what is important for you…cruise, new car, nice TV, cable, broadband, PDA, cellphone, retire at age 50, insurance, safe neighborhood, well educated kids, running water, air conditioning…you get to choose.

For me, I gave up everything else on that list to get insurance, a safe neighborhood, and air conditioning. (100 deg is ridiculous)

Posted by Pay for my own insurance on July 11, 2007 8:16 PM

[quote tomesnyder] Well, I see the socialists found this blog (probably many by way of Digg).

There is no “right” to health care, much less an inalienable right. Additional government interference in health care will make it worse, not better.[/quote]

YEEESSS!! That is SOOO RIGHT!!

Posted by USA, Not SSA!! on July 11, 2007 7:14 PM

And there is also no “Right” to policeman, fireman, roads, housing, education, food, childcare, jobs, transportation, etc., etc.

Posted by angel on July 11, 2007 8:25 PM

The government already controls all of your money, and look at the wonderful job they are doing. Do you really want to trust them with your health ?

Posted by killthawabbit on July 11, 2007 8:36 PM

I think articles like this once again are exactly the reason your health care has degraded to the level it is. Everyone arguing over irrelevant numbers.

The point isn’t that X number are uninsured. The point is currently the health system is about profit. A government run system is not for profit. And as for throwing around words like tyranny and minority get with the times. You make it sound like omfg ‘communism’ which it’s not. It’s providing a service that is availiable to all people like other government run services paid for by tax like i dunno…the police etc.

Wish everyone would quit bitching about numbers and look at the reality of how it is. Americans far behind the Western world. Why…could be any number of reasons but its about time we fixed it.

Posted by Chris on July 11, 2007 8:45 PM

Personally I don’t care about the un-insured. I want to be able to retire and not leave my kids in debt because of my medical bills. I have health insurance, good insurance actually. But it’s going away when I retire. Right when I’ll be getting old and moving into heart attack age. Falling down and breaking hips, developing lung problems and if i’m lucky a good case of dementia.

I say lucky because the choices are to grow old sick, or get hit by a bus and die suddenly. One way or another, death will catches everyone. The only difference is how big are the medical bills before you go.

So my choices in that arena are an agency like medicare/medicaid or private insurance companies. They both do the same thing, they both defer the cost of medical bills across a large number of people to make it cheaper. Private companies have to make money, so they refuse service and raise prices to keep profits up. Private companies also compete with each other for customers so will never have the entire population to defer the costs across.

Medicare/Medicaid has a lower overhead cost because they don’t make a profit. They have the maximum customer base (everyone) insuring that maximum spliting of cost. And the size of the customer base also allows better haggling for prices.

Put simply, no private company can ever provide better base coverage than a government system. There may be private options for advanced/expirmental/extreme care. But for the problems that everyone is going face, private companies cost more and are likely to provide worse service.

Posted by Corvidae on July 11, 2007 9:01 PM

@Pay for my own insurance

You said “Freedom means you get to choose what is important for you…cruise, new car, nice TV, cable, broadband, PDA, cellphone, retire at age 50, insurance, safe neighborhood, well educated kids, running water, air conditioning…you get to choose. For me, I gave up everything else on that list to get insurance, a safe neighborhood, and air conditioning. (100 deg is ridiculous)”

As I pointed out in that same post, I cannot do those things. I cannot pay for my own insurance company, because no insurance company will insure me. Why won’t they insure me? Because I actually NEED INSURANCE. They only insure people who won’t most likely use the insurance.

And I don’t have the choice of “giving up” things like “cruise, new car, nice TV, cable, broadband, PDA, cellphone, retire at age 50, insurance, safe neighborhood, well educated kids, running water, air conditioning…” because