Re: Worse than we thought...


"NoName" <noname@xxxxxxxxxxx> wrote in message
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On Sat, 22 Sep 2007 07:16:28 -0500, "John Galt"
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"NoName" <noname@xxxxxxxxxxx> wrote in message
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On Sat, 22 Sep 2007 06:25:05 -0500, "John Galt"
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"George Z. Bush" <georgezbush@xxxxxxxxxxxxxxxxxx> wrote in message
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John Galt wrote:
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John Galt wrote:
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John Galt wrote:
"Islander" <nospam@xxxxxxxxxxx> wrote in message
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http://tinyurl.com/2uf9as

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.

Perhaps not "chronically" but in what you call "down time" from having
health insurance can be catastrophic to those who need treatment
during that period. COBRA is supposed to protect those who lose their
jobs from having their health insurance discontinued immediately and
gives them a window during which they can retain their health
insurance -- at a very stiff price. And then there is usually a
waiting period upon becoming re-employed by a company that offers
health insurance for that to go into effect. These folks are surely
at risk and so this situation is not exactly something to be brushed
off as insignificant.

Not my intent to brush it off. However, the expensive part of the problem
are the chronically uninsured who are so not by their own choice. The
"down
time" problem is much cheaper to solve, and those who can afford but don't
ought to not to have a goverment handout to get them insurance.

If you want to get the right solution, you have to understand the problem;
saying "we have 89M uninsured" masks the actual nature of the problem and
insures that we'll architect the incorrect solution.

JG

The right solution will make sure there are guarantees that no one
will spend any time at all without insurance. In other words, cradle
to grave health insurance. This does not necessarily mean a handout
to those who could afford it and won't carry it. Just as we have to
pay taxes whether we choose to or not the system could be designed to
make it mandatory for those above a certain income. As you have
pointed out, the healthy young who refuse to buy health insurance
but can afford it are a drag on the system. A viable program needs
100% participation by one means or another. I am very suspicious
of some in this group who aver they don't have health insurance but
are able to handle any costs that may arise for them. One illness can
incur amazingly high costs which could reduce them to pauperdom.

I am not arguing statistics be inflated by the way. But if some have
had health insurance in the past and may or may not be able to get it
in the future that is not exactly a sure thing or a reason for
counting them among the insured. They are not at the moment and the
future is always uncertain.

I concur.

JG







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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