Depending evidently on the day of the week and similarly arbitrary factors, Barack Obama and other Democrats eager to pass health care reform will tell you there are anywhere between 45 million and 47 million Americans without health insurance. Even though those numbers are almost certainly an exaggeration, taken at face value they represent approximately 15 and 16 percent of the population respectively. That’s a lot of Americans who can’t afford routine visits to the doctor, let alone — God forbid — hospitalization and/or treatment for a serious illness. Health care, moreover, the administration and Democrat leaders in Congress will tell you is a right, not a privilege. That, too, is a debatable point.
Let me for the moment play devil’s advocate. Let’s take Obama and company at their word and assume that 40-odd million Americans lack health insurance and that all of them want to be insured. In fact, let’s say all are desperate to be insured. Let’s imagine, finally, that H.R. 3200 were currently the law of the land, public option and all. It stands to reason that every uninsured American would be beating a path to the government’s door to claim their prize, right?
Maybe not. Not if we extrapolate findings from a report published by the Urban Institute titled “Medicaid-Eligible Adults Who Are Not Enrolled: Who Are They and Do They Get the Care They Need?” In the interest of full disclosure, let me note at the outset that the report was published October 1, 2001. Most of the data, moreover, were gleaned from the 1997 National Health Interview Survey (NHIS), a large, nationally representative sample of the U.S. noninstitutionalized civilian population. That means the findings are at least 12 years old.
Nevertheless, the report contains comprehensive statistics on the number of Medicaid-eligible adults who are enrolled in the program and those who are not. And the findings are surprising, to say the least. Of more than 3.2 million Americans surveyed, 51.4 percent who were eligible for Medicaid coverage not enrolled in the program.
The details broken out by age, ethnicity, poverty level, and other demographic factors are captured in the table below.
This report is limited to adults, but children fare no better. A second study, completed more recently, in September, 2007, indicates that better than 6 out of 10 uninsured children qualify for Medicaid or the State Children’s Health Insurance Program (SCHIP) but are not enrolled.
Neither report addresses the question of why individuals who qualify for government-assisted health care fail to avail themselves of it. One possible answer may be adduced from the education data contained in the above table. Notice that as education level increases, so does the percentage of Medicaid-eligible individuals who take advantage of the program.
But then this poses a whole new problem for an administration bent on providing nationalized health care to a population many times larger. To understand the dilemma they face, consider the amount of bureaucratic red tape that was part and parcel of the Cash for Clunkers program that has some cars dealers wondering if the government will ever reimburse them for sales they made. For that matter, when has the federal government ever been successful at simplifying even the most trivial of its dealings with the American people?
Nationalized health care may pass. I’m keeping my fingers crossed that it won’t. But it does, expect the resulting boondoggle to be of a magnitude that dwarfs the Big Dig in Boston.
Comments 1
I have a point about private health insurance plans that you might not be aware of. The creation of the network model HMO, (which displaced the Staff model HMO nationally),was created by the largess of the Federal Government. In order to stimulate the rapid growth of the HMO industry,the Feds eliminated the capital requirements of a standard health insurance company. The HMOs responded to the lack of capital requirements by quickly raising much smaller amounts of venture capital,and then they went public. If the standard Insurance capital umbrella had remained,the Network model HMO would today be a rarity,as would its offspring,the PPO. The Staff model HMO like Kaiser Permanente,is capital intensive,but it is a “real” health care center meaning it had buildings,actual doctors,equipment etc etc,the Network models were only administrative offices designed to keep the Health Care cheap. They have a very bad reputation with their users,but they’re cheaper,so corporations keep them in business. When the Government tried to ram the HMOs down the throats of Medicare recepients,they failed horribly. I’m not aware of any HMO-Medicare joint ventures that are active at this time.
September 2nd, 2009 at 5:12 pm