Sunday, November 04, 2007

47 Million

The American Health Choices Plan gives Americans the choice to preserve their existing coverage, while offering new choices to those with insurance, to the 47 million people in the United States without insurance, and the tens of millions more at risk of losing coverage.
47 million Americans - including nearly 9 million children - lack health insurance.
The American health care system is broken. It allows 47 million Americans to go uninsured and tens of millions more to remain at risk of losing coverage. It is needlessly expensive, burdening families and businesses without consistently delivering the high-quality care they need. [Census Bureau, 2006]
The lack of health insurance by 47 million Americans is a tragedy, Richardson said. He said a third of the cost of health care goes to administration of the HMOs and insurance companies.
So what about the Republicans? A cursory review of their websites seem not to mention this number.

Do these democratic candidates care about the numbers they quote?

Do they lack the staff to cross-check these data?

Or are they more interested in fear-based politics?

Remarkably, this morning's New York Times published a critical analysis of this number from a conservative economist, N. Gregory Mankiw. Mr. Mankiw is a professor of economics from Harvard and was an advisor to President Bush and is advising Mitt Romney, the former governor of Massachusetts, in the campaign for the Republican presidential nomination. Here was the breakdown, as he saw it, of the 47-million number:
Total: 47 million
  • 10 million illegal immigrants
  • The number includes millions of Medicaid-eligible people who have not yet applied for Medicaid
  • 18 million of the 47 million have household incomes over $50,000, which puts them in the top half of the income distribution nationally, suggesting they could buy insurance, but for unknown reasons, do not have insurance. He claims a quarter of the uninsured have been offered employer-based insurance, but have declined.
If 10 million of the disingenuous "47 million uninsured" are in fact illegal immigrants, are we to understand that all of these candidates are actually calling for nationalized health care coverage for illegal immigrants? Perhaps, in our beneficence, we should pay for healthcare for anyone worldwide who comes to our country. If this is what is being suggested in using these numbers, perhaps it needs to be on the table.

Do the candidates that use this number suggest that those who have elected not to have insurance for personal reasons must now purchase insurance? Given the expense of insurance today, should this personal decision now be subject to government mandates?

What has been done so far on providing health care coverage for illegal immigrants? Here's a list of legislation both passed and vetoed for illegal immigrants. Is this a controversial issue? Perhaps it is not. But if the "universal healthcare" imperative will include illegal immigrants, its cost to our system should be estimated as well.

The last time Congress and the public didn't pay attention to the accuracy of data succumbing to fear-based manipulation, we ended up in a war.



Margaret Polaneczky, MD (aka TBTAM) said...

Interesting - Thanks for this analysis.

Hsving the right numbers is the first step to finding the right answers.

Unfortnately, no matter why these folks have no insurance, you and I end up paying for their ehalthcare one way or another. The question is - which way is cheapest and best?

Anonymous said...

The comment about people making over $50,000 per year being able to buy insurance is crap. I am a healthy woman who spent two weeks in the hospital five years ago for depression. I have been turned down by every insuror I can find.

Its disgusting that our nation, one of the richest on earth, does not have a way for all its citizens to get affordable medical insurance. I wish America's Christian citizens would take up this cause because I don't think there's anything "christlike" in the current situation where families are bankrupted paying for medical care, or just don't get it because they can't afford it.

RoseAG said...

I too agree that assuming someone with $50K of income can get or afford health insurance is a stretch.

As far as I can tell most of the major candidates, particularly the leading Democrat has been on some kind of gov't funded health plan nearly their entire working lives. You can't expect them to know what it is like to be self-employed or run a small business and try to purchase health coverage.

Dino William Ramzi said...

I would take anything from a Bush adviser with a grain of salt. After all, as I have mentioned on my blog in the past, it is the interest of capital to deny the presence of the uninsured and to minimize their importance.

If the number is less than 47 million, that's good. They'll be cheap to cover and there is no reasonable moral objection for a civilized society to take care of their own. If the 47 million is to be believed then it is a major public health problem and something must be done.

shadowfax said...

I suspect the Democratic Candidates are using the 47 million number because, well, it's accurate: at least it's the number reported by the US census.

There's a fair argument over what it *means*. Some have asserted that it understates the extent of the problem. There are 47 million people uninsured for the entire year. There are 80 million people who, at some point during the course of the year, were uninsured.

And this Mankiw pinhead seems disingenuous at best. He recycles the old blame-society, we eat too many cheeseburgers and have too many guns and too much teenage sex arguments as if that somehow accounts for the entire difference, and as always implies that the uninsured (who don't qualify for Medicaid) made an unconstrained "choice" not to purchase insurance.

And to answer your question:
Do the candidates that use this number suggest that those who have elected not to have insurance for personal reasons must now purchase insurance?
Yes, that is exactly what they suggest, quite openly. All plans except Obama's include an "Individual Mandate." (As does Romney's Massachusetts plan.)

Monitoring and enforcement are not addressed, though.

DrWes said...


In some ways, your statement contradicts itself - is is 47 million or 80 million? Which is accurate? The point here is that it is a number - correct or not - that is used to manipulate, generate fear, and may be counter-productive when used out of context. Policy wonks will argue it is used to motivate people, but I would argue it is equally disingenuous to use values without properly defining their origins.

Anonymous said...

"The last time Congress and the public didn't pay attention to the accuracy of data succumbing to fear-based manipulation, we ended up in a war."

Wasn't it a 'conservative' administration who fed us, not only congress, that balogna about Iraq?
So you want us to fall in line and believe an economist who is an advisor to George Bush? I'm sure he will give us the true 'facts' on the wellness of health care in America.

"Fool me once, shame on you. Fool me twice, shame on me!

The only knowledgable people who know about the shape of our health care system are the American people, the voters, who have to struggle with it. We will get their input next November.