Re: Worse than we thought...


"George Z. Bush" <georgezbush@xxxxxxxxxxxxxxxxxx> wrote in message
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John Galt wrote:
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Study finds 89.6 million lacked health insurance
I'd like to see this report factoring out the illegal population. I
doubt it's any coincidence that the growth of uninsured Hispanics is
so
much larger than other minorities, and the the states with the
highest
number of uninsured are those with the larged illegal population.

JG

Well, yes, that would be interesting, but would not excuse the large
number of citizens who are not covered.

Well, I don't know how the word "excuse" factors into the discussion.

The report breaks down the
numbers by race and Hispanic origin (not to be confused with illegal
aliens) as follows:

Race and Hispanic Origin Number Uninsured As Percent of All Uninsured
White, Non-Hispanic 43,463,000 48.5%
Black, Non-Hispanic 14,579,000 16.3%
Hispanic 24,806,000 27.7%
Other* 6,711,000 7.5%
Total** 89,558,000 100.0%

Illegal or not, it is not surprising to me that the number of
Hispanics
is high since they seem to get the worst paying jobs, usually without
benefits. Note that Hispanics constitute 15% of the total population
as
of last year according to the US Census Bureau. Their poverty rate
was
21.8%. Compare this with African Americans who constitute 13% of the
population with a 24.9% poverty rate.

Bottom line is that this is not about illegal immigration. It is
purely
and simply about not providing effective health care to a very large
number of Americans.

It becomes about illegal immigration if they're being *used* to inflate
the figures. The discussion on health care needs to stand on its own
merits, those being the number of Americans who are chronically without
coverage. Inflating those figures through gimmicks makes it appear that
the pro-universal coverage group is insure about the strength of their
case.

It is essential, in order to understand the problem, to determine (1)
how
many Americans (and only Americans) are chronically without coverage
because of cost, plus (2) how many Americans (and only Americans) are
chronically without coverage because of an inability to obtain it.
According to statistics from Kaiser, it appears that even a third of
the
47 million quoted by Census are without coverage because of personal
choice.

But, isn't 26 million Americans without coverage enough of an issue so
statistic inflation is not required? I would think so. Let's stay
focused.

JG

You are attempting to discount the report as inflated which is, IMV,
avoiding the central issue. Yes, any number of Americans without
coverage
is a scandal and the numbers cited by the US Census for 2000 as well as
the numbers cited in this report indicate the scope of the scandal. As
George points out, subtract all the illegals and it is still a scandal.

George misread the article, and you appear to be doing so, as well. Let's
subtract (1) the illegals, (2) the people in that group who normally have
coverage, (3) the people who can afford it but don't want it, and (4) the
people who are currently eligible for a goverment health program, but
haven't enrolled. Then, we'd have a working number representative of the
problem.

OK, we agree that the illegals should be deducted from the total number of
uninsured. I'm not sure that I know who you're referring to as those "who
normally have coverage".....who would that cover and how would you measure
or estimate the size of that group?

Not too hard. The study counts as "uninsured" anyone who has not had
coverage for at least one month in a two year period. That's picking up a
LOT of job-changers who, in the course of their working careers, normally
have insurance. I'd say anyone who has lost insurance in the normal course
of a job change, but who otherwise have coverage, ought not be in that
number. So, the difference between the 47M from census and the 89M on this
study are people who either have a lot or a little down time from insurance
during a two year period. The latter group needs to be pulled out, as they
are not chronically uncovered.


As for those who can afford it but
don't want health insurance coverage, the wealthiest people in the nation
(who you presumably are referring to in this group) comprise some 1%-2% of
the population, which would put them at roughly 3-6 million people.

That is not to whom I refer. The Kaiser study says that 44% of the uninsured
(45M) are people who live in families making > 300% of poverty level, or
about 47K per year. See my response to Islander, but this is picking up a
lot of 20 somethings who think they're invunerable and would rather spend
the money on a better Beamer. You *may* be picking up the odd rich person
who self-funds, but I would think this to be a tiny number. On of the
reasons the rich stay rich is because they avail themselves of tools like
insurane.


If you
subtract them, that brings the total uncovered down to 70-73 million
people uncovered. As for those who may be eligible for government health
programs that they choose to not take part in, what makes you think
they're not already included among those not covered?

http://www.kff.org/uninsured/upload/7613.pdf. The number is 11 million.

I don't know if I misread the article, but 70 million or 60 or 50 million
people not covered by a health insurance program still represents an
appallingly high and scandalous number to me.

The article states clearly the difference between it's metholodology (one
month off from coverage over a two year period) and Census' (people who
simply don't have coverage, period.) I've had coverage 99% of the time in my
working life, but in my younger, job hopping years, there was an entire
decade and a half that I would have shown up on that statistic.

The chronically uninsured number is more like 27M per Kaiser. My point is
that 27M should be plenty to get some poitical action. Some political
operatives believe in "floating" numbers whenever possible in the (mistaken)
belief that they'll get more action faster. What they forget is that
inflated numbers get that way by including people under debatable
conditions, and when political opponents raise those objections (as I have
above) then they get the upper hand and have a shot at convincing the
populace that the whole matter is overblown. If you've got persuasive
numbers, keep them modest and defensible. Running around talking about 89M
plays right into the health care oppositions hands. Use a number full of
subgroups that reasonable people can contest, and the whole house of cards
can come tumbling down.

Just as an example, CAIR does this all the time, btw. They always quote the
"6M muslims" in the US in an attempt to stoke their power. There are two
scientifically done religious identification surveys done in the US, and
neither pegs the number of muslims greater than 1.6M, and both show that
Hinduism and Buddhism are growing at faster rates.

JG





As to personal choice, doesn't an inability to afford
the cost result in a "choice" to not purchase insurance instead of, say,
food or lodging?

Sure, but that's a dangerous assumption to make. One of the "issues" in
this mess is the large number of 20 somethings who forgo insurance
because
they think they're immortal and would rather spend it on a 5 series
Beamer
instead of a 3. That's an extremely important statistic, because an
effective insurance model requires as many low risk customers as you can
get
so you can spread the risk around, and lower rate for the mid and high
risk.
The more low risk folks that choose to opt out, the higher the costs are
for
everyone else. Point is that you can't assume somebody's not enrolling
because they want food; they might want to spend money on cheap women.
(Since the stat deals with uninsured people who are in families making >
300% of poverty level, I suspect we could hone done who is who by looking
at
the size of those families. If the family has four uninsured individuals,
I'd grant that they're probably thinking about lodging or food. If the
family is one or two adults, I'd bet otherwise.)

Kaiser's report breaks the uninsured down by income AND (interestingly)
by
eligibility. Here's some interesting stats:

(1) 44.6M uninsured in 2004
(2) 11 Million are ELIGIBLE FOR A CURRENT GOVERNMENT PROGRAM, BUT ARE NOT
ENROLLED
(3) Of the 11M uninsured who are children, 75% are elgible for Medicare
or
SCHIP, but are not enrolled
(4) 44% of all uninsured have incomes GREATER THAN 300% of POVERTY
(implying
that they likely could have coverage, but do not.)

http://www.kff.org/uninsured/upload/7613.pdf

Like you, I am of the opinion that a mechanism ought to be put in place
to
insure that all Americans have coverage. However, I believe because the
stakes are so large, and a mistake could be so costly, I am of the
opinion
that the least intrusive means ought to be used first. Let's start by
requiring, like Switzerland, that all people have to have their own
policy.
Let's put some funds aside to make sure that everyone can do that, and
for
those who aren't able to obtain coverage because of bad health, require
the
insurers to take them and flow some funds to offset risk.

Then, let's sit back and see what effect that has on coverage costs.

In that sense, everything is a "choice," but not an
excuse for the scandal.

Well, the cause of the scandal is that almost 50% of all medical care in
the
US is already being paid for by a goverment check from someplace, written
by
a computer that has no interest in cost control. That's it in a nutshell.

JG



One-third of people in the U.S. under 65 went without coverage for
some or all of the last two years, reports an advocacy group.
By Jordy Yager, Los Angeles Times Staff Writer
September 21, 2007

WASHINGTON -- -- More than one-third of the people in the United
States under the age of 65 had no health insurance for some or all
of
2006 and 2007, according to a study released Thursday by Families
USA,
an advocacy group for the uninsured.

The 89.6 million individuals identifying themselves as lacking
insurance for at least a month, according to the advocacy group, was
almost double the number of uninsured reported by the Census Bureau
for 2006.

"It's simply unacceptable that for lack of basic health coverage,
nearly 90 million Americans had to live in fear of illness and
injury
in the last two years," said Sen. Max Baucus (D-Mont.), chairman of
the Senate Finance Committee, which oversees national healthcare
programs.

California had the largest number of individuals uninsured during
some
or all of that two-year period -- 13 million, or nearly 41% of state
residents younger than 65. Texas was second, with 9.3 million.
Americans older than 65 are eligible for Medicare and were not
considered in the Families USA study.

More than 70% of those without insurance in part or all of 2006 and
2007 were employed full time, the report said.

Half lacked insurance for nine months or more.

--------------------

Unfortunately, the study does not include Americans over 65. One
wonders what the total would be if they were included.

Full report at:
http://familiesusa.org/assets/pdfs/wrong-direction.pdf




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