September 1, 2006

September 1, 2006 | Commentary on Health Care

Solutions for the Uninsured

It wasn't exactly man-bites-dog news when word came this week that the number of Americans without health insurance has continued to climb.

The number reached 46.6 million in 2005 --- up from 45.3 million in 2004 --- according to the Census Bureau. At the same time, the percentage of workers with employer-based coverage continues to decline. These trends will continue until Congress comes to grips with the changing dynamics of the health insurance market.

The current system, which is dominated by tax-favored coverage offered through the workplace, has made health insurance affordable for middle-class Americans and made practical sense when workers stayed with one employer until retirement.

But today's workforce is much different. Fewer of us stick with one job or work for one employer throughout our careers. Meaning, each time we change jobs, our health plan changes, and probably so do our doctors. Fewer employers, especially those with small businesses, can afford or offer coverage.

Some argue for expanding government-run health care programs, such as Medicaid. But not only do most workers prefer private coverage over public coverage, public programs already find themselves overextended and fiscally unsustainable. Medicaid is the largest line item in state budgets and is squeezing out other important state services, such as education and transportation. Plus, the more people depend on government-run health programs, the more control the government has in the personal health care decisions of its citizens.

Ignoring the trends and the millions of uninsured won't solve the problem. The uninsured do get medical care, but often they wait too long to seek treatment or use the emergency room as a doctor's office. Either way places a costly and inefficient burden on taxpayers.

To fill in the gaps of the current health care system and prevent more workers from joining the ranks of the uninsured, we need to create an alternative for those who don't have employer-based coverage. A system of health care tax credits would give those workers a tax break, similar to the one given for employer-based coverage, to purchase private health care coverage of their own.

Those who own their coverage can take their plan with them when they change jobs or quit working. They choose the plan and doctors and services they want. And insurers and providers are accountable to them, not to their employer or government bureaucrats. The Tax Equity and Affordability Act, proposed by U.S. Sen. Mel Martinez (R-Fla.), would put in place such a system.

Another option, if political gridlock continues to stymie change at the federal level, is to follow the lead of U.S. Rep. Tom Price (R-Ga.). He and a bipartisan group of members have proposed legislation to encourage the states to experiment with solutions for the uninsured.

Both of these proposals are practical and viable. The status quo is not. The picture is changing, and the number of uninsured is increasing.

Nina Owcharenko is a senior analyst in the Center for Health Policy Studies at The Heritage Foundation.

About the Author

Nina Owcharenko Director, Center for Health Policy Studies and Preston A. Wells, Jr. Fellow
Center for Health Policy Studies

First Appeared in The Atlanta Journal-Constitution