The Uninsured: Who Are They?

We continually hear of nearly 47 million uninsured people in America. Such reports convey a vision of the Cratchit family of Charles Dickens’ novel, “A Christmas Carol”. Bob Cratchit could not provide more than meager support for his loving family and crippled son Tiny Tim. The intent of these reports has been to influence us to resort to government-controlled healthcare to help those in need. Here are the facts that will put this issue and its possible solutions in perspective.

Who Are These Uninsured?

According to a survey published by the US Department of Health and Human Services, the 47 million uninsured is a statistical estimate. That could also be described as an educated guess. When compared with other statistical estimates that are just as valid, an interesting analysis emerges.

As a class, the estimated portion without insurance has remained fairly constant at about fifteen percent. However, the people involved in that category have not been constant. Membership churns, as individuals move into and out of it. Forty-five percent are uninsured for less than four months. Less than twenty percent are there for more than eighteen months.

Illegal Immigrants:

An estimated twelve million, or 26 percent, perhaps more, are illegal immigrants. Most don’t have and don’t want insurance because they conduct themselves in an undocumented, under-ground fashion. In the event of injury or illness, they can access taxpayer paid charitable emergency services, usually without having to identify themselves.

Freeloaders:

Seventeen million, or 36 percent, have an annual income of over $50,000. Nine million of those have an annual income in excess of $75,000. They could afford healthcare insurance, but elect not to buy it.

Eighteen million are young adults in the 18 to 34 year age range. Except for occasional injuries, most don’t have health issues, so they don’t want to pay for health insurance. Yet, on average they spend four times as much every month on alcohol, tobacco and dining out as health insurance would cost. It’s their choice. There is some overlap, maybe less than half, between the young adults and the over $50,000 income group.

The Cratchits:

We are left with an estimated quarter of the 47 million, perhaps twelve million. This is about four percent of legal US residents who may be the real uninsured. These people can not get health insurance because they can’t get approved or can’t afford the cost. It’s usually not their choice.

Many in this class are covered by Medicare or Medicaid or SCHIP (State Children’s Healthcare Insurance Plan) programs. However, some who would qualify for such assistance programs have fallen through the help nets due to bureaucratic mistake or their own inaction.

These are the real “Cratchits” who need help. Most Americans favor helping them.

A Smaller Solution For A Smaller Problem:

We do have an uninsured problem. But, it’s not at the magnitude of 47 million. Solving the issue for twelve million, most of whom are temporary members of the group, is a much smaller hill to climb. It does not require the radical system change that advocates of government-controlled universal healthcare would have us believe.

Eighty-five percent of Americans now have or provide for their healthcare insurance. It makes no sense to disrupt a system that is serving eighty-five percent of the people in order to provide services for the four percent who are the Cratchits. We should be able to relieve the Cratchit’s pain by expanding or duplicating existing assistance programs, like Medicaid or SCHIP, without penalizing everyone else.

American Values Solutions:

Instead of turning our system upside down and punishing the eighty-five percent who are generally satisfied, we should simply apply American values to resolve the uninsured problems. How?

1. Illegal Immigrants: This is a problem that needs solving for a host of reasons. National security. Political and cultural stability. Economic. And, healthcare and uninsured issues. If we require our political leaders to come to grips with a solution, the uninsured issues will be resolved. Until then, . .

2. Accountability: The uninsured who can qualify and can pay for health insurance but refuse to do so should not be permitted to call on the charity of taxpayers to pay their healthcare expenses. They should be held accountable for their actions. Require them to buy low-cost, high deductible insurance or waive rights to mandatory treatment or pay in cash for services. Just like states require auto liability insurance for drivers licenses or automobile license plates.

3. Cratchit Coverage: The Cratchits are the core group of uninsured who need help. Many qualify for existing assistance plans like Medicaid or SCHIP. To learn about SCHIP, go to [textlink] Childrens Health Insurance.

Politicians seek to expand those programs to include more people and to create huge new government-controlled healthcare programs, like Medicare, to cover as many as they can. All of those promise improvement, but are more likely to do three things – reduce quality of service, increase waiting periods for service and increase the overall cost.

As an alternative to sentencing the Cratchits to government health services, we should encourage and provide for maximum application of private charities to help the Cratchits. Before the government got into charitable assistance programs with taxpayer funds, those needs were mostly served by private, faith-based organizations. Their pocket were not as deep, but they did, and still do, a better job than governmental agencies.

We should turn private charities loose and assist them to do what they do well. If they need financial help, the government would be better served to assist through programs like Medicare Advantage than direct help. The service would be better and the overall cost would be less.

Learn about universal healthcare at National Health Insurance.