September 8, 2004
By Derek Hunter
Let's face it: Everybody needs health insurance.
As someone who spent my college years uninsured, I learned what
it's like to feel ill, yet wait as long as possible to go to see
the doctor, hoping it will pass. Luckily I never had a serious
health problem -- but millions of people aren't as fortunate. They
need help. But Congress still hasn't done the obvious: Target help
directly to the working uninsured so they can buy the health
coverage of their choice.
Unreliable numbers hobble the current debate. The
Census Bureau recently released its count of the uninsured in the
United States: nearly 45 million people last year. This number will
be repeated countless times over the next few months as one
candidate accuses another of not doing enough to provide health
insurance to these people. But that figure is way too high.
How do we know? For one thing, the Census last year "counted"
roughly 35 million people on Medicaid, the joint federal-state
program to provide health insurance to the poor and indigent. But
the Centers for Medicare and Medicaid Services (CMS), the agency
that actually runs Medicaid, says there are 53 million people in
the program. Since CMS actually pays the bills, its number, one
assumes, is more accurate.
That 18 million-person difference ought to raise a few eyebrows.
And it did -- at the Census Bureau itself.
In its report, the bureau writes, "Health insurance is likely to be
underreported." Well, if health insurance is underreported, the
number of people without health insurance has to be over-reported.
Census admits this, saying the survey on which federal research and
federal policies are based is largely a labor force survey. It
admits its interviewers receive less training on health insurance
Plus, "many people may not be aware that they or their children are
covered by a health insurance program if they have not used covered
services recently, and therefore, they would fail to report
Unfortunately the Census Bureau doesn't seem to be making much of
an attempt to correct this problem. Virtually the same disclaimer
appeared in last year's study.
Obviously, these numbers are grossly inflated. Yet because they
come from Census, they become part of the national discourse and
the basis of sensational press releases by groups who want the
government to take over the health-care system, either immediately
or on the installment plan.
But these groups and their political allies in Congress are
actually advocating a radical solution to a problem that is far
more manageable than they want us to believe. Every report, study
or policy proposal that uses these inflated numbers does a
disservice, not only to the uninsured, but also to the American
public as a whole, because it brings us no closer to a sensible
Serious policy-makers from both sides of the aisle need an accurate
number so a responsible solution can target those in need without
resorting to the failed policies of socialism.
In any case, we must solve the problem, because the plight of the
uninsured touches everyone's lives. Even if you have insurance,
you're paying higher insurance premiums and higher taxes because of
the rising costs of uncompensated care administered to the
uninsured. We never turn anyone away untreated, but somebody, often
the taxpayer, ends up paying the bills.
Today, the vast majority of the uninsured are in working families,
mostly employed by businesses that don't provide health
This should be the focus of members of Congress and state
legislators. They should target help to working families with tax
credits or subsidies for the poor to help offset the costs of
health insurance. We could also broaden and improve the insurance
market beyond employers, enabling associations, ethnic and
fraternal organizations, faith-based organizations or other groups
to sponsor coverage for their members. Meanwhile, Congress needs to
pressure the bureaucrats at the Census Bureau to provide a complete
and accurate picture of just who the uninsured are.
There are far fewer than 45 million Americans uninsured today. But
there are still too many millions lacking coverage. This problem
can be addressed efficiently through a generous, but targeted,
health-care tax-credit system that is not dependent simply upon the
vagaries of your place of employment.
Americans deserve better. Lawmakers should help uninsured families
who need help, so no one else ever has to wait to seek treatment,
or hope a medical problem goes away on its own.
Derek Hunter is a researcher in the Center for Health Policy
Studies at The Heritage Foundation.
Distributed nationally on the Knight-Ridder Tribune Wire
Americans deserve better. Lawmakers should help uninsured families who need help, so no one else ever has to wait to seek treatment, or hope a medical problem goes away on its own.
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