COMMENTARY:

We recently were the recipient of a fairly aggressive comment, which we have chosen not to post, but to which we will respond.  It is well known to every health care worker that faces the daily trials of caring for those showing up in emergency rooms across America as well as large inner city and county hospitals that lack of education, lack of compliance and poor lifestyle/dietary/domestic choices are the leading contributors to illness, injury, trauma and death in those populations.  We were labeled ‘misanthropic’ because we pointed that out.  Yes, we know that many of the uninsured are young, employed (at least part time) and healthy.  We also know that many make a CHOICE not to be insured but do make other choices which can hardly be considered essential. We also know that many of the uninsured are not citizens of the United States.

We have not only argued for Real Health Reform, but have presented our own plan for consideration since day one.  We have been critical of the current proposals from Congress for many reasons, which we have outlined.  We have not been critical at attempts to extend opportunities for health insurance coverage to more American citizens, as that has been our goal from the beginning.

We were also tasked for lack of credible references – something we have NEVER been charged with.  So in the interest of self-policing we have undertaken to review again (as we have in earlier posts, see the short list below) this subject.  The ‘facts’ are that when one actually chooses to look at all of the data, as we have before, and chooses to do so with an open mind, and from a health perspective, the take away is very much what we have commented on in the past.  There is not a health care crisis in America.  There is a health insurance problem as well as a personal responsibility problem (which certainly extends beyond the health care arena).  Allow us to quote from just a few of the many and varied sources we have reviewed on this topic . . . obi jo and jomaxx

Roughly one quarter of those counted as uninsured – 12 million people – are eligible for Medicaid and the State Children’s Health Insurance Program (S-CHIP), but haven’t enrolled. This includes 64 % of all uninsured children, and 29 % of parents with children. Since these people would be enrolled in those programs automatically if they went to the hospital for care, calling them uninsured is really a smokescreen. (August 2009) (http://www.realclearpolitics.com/articles/2009/08/18/who_are_the_uninsured_97934.html)

Another 10 million uninsured “Americans” are, at least technically, not Americans. Approximately 5.6 million are illegal immigrants, and another 4.4 million are legal immigrants but not citizens. (August 2009) (http://www.realclearpolitics.com/articles/2009/08/18/who_are_the_uninsured_97934.html)

About two-thirds of uninsured adults in all three surveys have no college education and more than one-quarter of the uninsured did not graduate from high school. These groups tend to be less able to get high-skill jobs that come with health benefits. Those with less education are also more likely to be uninsured for longer periods. (August 2006) (http://www.kff.org/uninsured/upload/7553.pdf)

Across all three surveys, more than half of the non elderly uninsured come from low-income families, ranging from 52% to 59% of the uninsured across the surveys (Figure 3). Those with low incomes (less than 200% of the poverty level; or $37,620 for a family of four in 2003) are less likely to have jobs that offer employer-sponsored coverage and are also less likely to be able to afford their share of the premium. Roughly a third of the non elderly population comes from low-income families, but they are disproportionately represented among the uninsured because their chances of being uninsured are over three times greater than those with higher incomes (August 2006)  (http://www.kff.org/uninsured/upload/7553.pdf)

(The first group to consider in the 46 million number stated by President Obama ) consisting of about 6.5 million, actually is insured.  They are enrolled in Medicaid or S-CHIP but didn’t tell the census taker. This is called the “Medicaid undercount.” The second group, about 4.5 million, consists of people who are eligible for Medicaid or S-CHIP but have not enrolled. If they need care, the hospital or clinic generally enrolls them. In other words, they do not (as Obama claims) go bankrupt or without treatment. In any case, it would be ridiculous to overhaul our healthcare system to provide insurance to people who are already eligible for government assistance but have failed to avail themselves of it. The third group, about 9.5 million, is comprised of non-citizens. People will disagree about what portion of this group should receive government subsidized health insurance. In my view, none should. The fourth group, another 10 million, earns an income more than three times the poverty line. As such, they can afford to buy medical insurance. Taxpayers should not be required to buy it for them. This leaves about 15.5 million (one-third of Obama’s 46 million) who actually are uninsured, cannot become insured simply by enrolling in a free program, are U.S. citizens, and cannot easily afford to purchase insurance. About 5 million members of this cohort are childless adults. (August 2009) ( http://www.powerlineblog.com/archives/2009/08/024280.php)

American citizens — especially native-born citizens — are much more likely to have health insurance than immigrants are. In 2005, about 13 % of native-born citizens lacked health insurance, while 43 % of noncitizens (legal and illegal) did, according to the census bureau.  (Some sources) site statistics showing that immigration accounted for about 85 % of the increase in uninsured rates between 1998 and 2003. (April 2007)  (http://www.pbs.org/newshour/indepth_coverage/health/uninsured/whoaretheuninsured.html)

Many young, single people make a perfectly rational decision not to buy health insurance. Accidents are the biggest threat to their health; car accidents are covered by automobile insurance and work-related accidents are covered by workmen’s comp. The chance of a young person contracting a catastrophic disease (leukemia, say) is remote, and people aren’t stupid: they know that if they contract such a disease they will be treated whether they can pay or not. And young, single people have not acquired a substantial net worth that they could lose to medical bills. This is why, when Pizza Hut made cheap health insurance available to its part-time employees a few years ago, hardly any of them chose to take advantage of it. (August 2009) (http://www.powerlineblog.com/archives/2009/08/024280.php)

A productive conversation about health policy must also separate the concept of a lack of health coverage from a lack of healthcare. Individuals without adequate health insurance still receive medical care from a variety of sources. (June 2009) (http://www.epionline.org/study_detail.cfm?sid=122)

A lack of care is particularly troubling if it leads to differences in mortality based on insurance status. Using data from the Health and Retirement Survey, the authors estimate differences in mortality rates for individuals based on whether they are privately insured, voluntarily uninsured, or involuntarily uninsured. Overall, they find that a lack of health insurance is not likely to be the major factor causing higher mortality rates among the uninsured. The uninsured—particularly the involuntarily uninsured— have multiple disadvantages that are associated with poor health. (June 2009) (http://www.epionline.org/study_detail.cfm?sid=122)

This study shows that a large fraction of the uninsured could likely afford health coverage. In addition, it shows that the involuntarily uninsured are demonstrably different from the privately insured. Finally, the authors show that while the uninsured use fewer health services, they still receive a large amount of care, and there is little discernible difference in mortality based on insurance status. (June 2009) (http://www.epionline.org/study_detail.cfm?sid=122)

PREVIOUS POSTS BY US ON THIS AND RELATED TOPICS:

Only rule changes can really change the system and = Real Health Reform – http://realhealthreform.wordpress.com/2009/02/02/only-rule-changes-can-really-change-the-system-and-real-health-reform/

Health Insurance Reform needed to achieve Real Health Reform – http://realhealthreform.wordpress.com/2009/02/08/health-insurance-reform-needed-to-achieve-real-health-reform/

Is healthcare really a cost? – http://realhealthreform.wordpress.com/2009/02/19/is-healthcare-really-a-cost/

Pre-Existing Conditions: End the Game, Health Coverage for All Now – http://realhealthreform.wordpress.com/2009/04/22/pre-existing-conditions-end-the-game-health-coverage-for-all-now/

Health Insurance: An Individual Responsibility – http://realhealthreform.wordpress.com/2009/06/23/health-insurance-an-indivdual-responsibility/

Mr President: Real Health Reform chances are slipping away – http://realhealthreform.wordpress.com/2009/07/23/mr-president-real-health-reform-chances-are-slipping-away/

Vodoo Health Economics? – http://realhealthreform.wordpress.com/2009/08/04/vodoo-health-economics/

47 Million Uninsured: What is the Truth? – http://realhealthreform.wordpress.com/2009/08/09/47-million-uninsured-what-is-the-truth/

Massachusetts has highest health insurance premiums . . . model for U.S. ? – http://realhealthreform.wordpress.com/2009/08/25/massachusetts-has-highest-health-insurance-premiums-model-for-u-s/

Who Are The Uninsured? – http://www.realclearpolitics.com/articles/2009/08/18/who_are_the_uninsured_97934.html

Who Are The Uninsured? A Consistent Profile Across National Surveys – http://www.kff.org/uninsured/upload/7553.pdf

WHO ARE THE UNINSURED AND SHOULD WE PAY TO COVER THEM? – http://www.powerlineblog.com/archives/2009/08/024280.php

QUICK FACTS ON THE UNINSURED – http://covertheuninsured.org/content/quick-facts-uninsured

EDITORIAL: Who are the uninsured? A closer look at the 46 million reasons for ObamaCare – http://www.washingtontimes.com/news/2009/jun/25/who-are-the-uninsured/

The Uninsured in America – http://www.pbs.org/newshour/indepth_coverage/health/uninsured/whoaretheuninsured.html

Poor education = poor health – http://benkazie.wordpress.com/2009/07/05/poor-education-poor-health/

New State-by-State Report Shows Gaps in Health Strongly Linked to Education Levels – http://www.rwjf.org/pr/product.jsp?id=42418

www.condron.us     www.clusty.com     www.bloglines.com     www.blogburst.com     www.blogcatalog.com