Slowly, inexorably, inevitably, the government is becoming the nation’s health insurer.
The latest report from the US Census Bureau indicates the number of Americans without health insurance dropped from 2006 (15.8 percent) to 2007 (15.3 percent) – good news, especially for those who finally got coverage. The source of the expanded coverage – government programs, especially for kids. Almost half of the 1.3 million folks who found coverage in 2007 were children; 600,000 more kids were covered in 2007 than the previous year, largely due to expanded efforts to enroll them in the SCHIP programs.
And another 400,000+ were from a single state – Massachusetts, that adopted a controversial plan to expand coverage.
But that’s just the tip of the iceberg. The real story is the expanded role of governmental programs, primarily Medicaid. The percentage of Americans covered by governmental programs increased from 27 percent in 2006 to 27.8 percent in 2007; while the Medicare population grew (we are getting older…), Medicaid alone added 1.3 million lives.
Employment-based health insurance continues to erode (59.7 percent of Americans covered through work in 2006, 59.3% in 2007), as employers seek to reduce costs they slash jobs, drop health insurance, reduce benefits, and increase employee contributions. Employment continues to decline, with expectations that it will hit 6.0% later this year.
The number of folks who lost coverage over the last seven years now stands at 5.9 million. And those with coverage have seen the ‘quality’ of that coverage decline – deductibles/coinsurance/copays have increased dramatically while limits on coverage have expanded. Couple that with the lack of coverage available for individuals with pre-existing conditions (only 5 states offer guarantee issue on all products – Maine, Massachusetts, New Jersey, New York and Vermont) and the full scope of the insurance crisis starts to become apparent.
Many employers can’t afford to provide insurance and many families can’t afford individual plans or can only get coverage for conditions they don’t already have (try getting full coverage if you’re on lipitor, paxil, or insulin…) or with deductibles that require them to pay upwards of $5000 out of pocket.
What does this mean for you?
The market is not solving the problem of the uninsured. That’s why government, in its bumbling, stumbling, inefficient, messy way, is becoming the answer for more and more Americans.
Aug
28
Just think. What would have been the figures if Bush had not vetoed the expansion of the SCHIP bill for children.
The figure that have been used for the uninsured at 47 million might have been wrong. Some figures that I had seen was closer to 49.5 million people who cannot get any insurance or cannot afford insurance.
Joe
Is it possible as well that there is a subtle crowd out effect, ie, due to more outreach and press, folks are flipping into public programs. Probably not a huge number, but even a few tenths of a percent may make a difference.
I know Cato, Heritage, etc., will probably advance this theory (have not seen it yet), but possible contributor?
Thanks
Re: “The market is not solving the problem of the uninsured. That’s why government, in its bumbling, stumbling, inefficient, messy way, is becoming the answer for more and more Americans.”
The first sentence is absolutely correct, however, the second sentence is nonsense. Government run Medicare averages a 3-5% overhead, far less than the supposedly more efficient private sector. How does a “bumbling, stumbling” government provide care for 20% less than private Medicare Advantage plans (GAO reports)?
The only thing these private companies are efficient at is maximizing profits by denying care and shifting it’s risk to the federal taxpayer.
I see it in my family practice office every single day.
In the health care stocks, for insurance to be affordability priced. Only CEOs and those who have a lot of options and stocks are making the money. Most of us are paying the costs.
it’s kinda like we’re (……the politicos, think tank ideologues, the “clueless public”, and the usual suspects at the health care feeding trough, etc.,) are all sitting in this wide body cockpit, describing in exacting detail, based on our refined dashboard indicators (i.e., the cockpit instrumentation) the imminent encounter with “tera firma” in 9,8,7,6,5,4……..seconds.
My God, will somebody please pull back on that yoke??
And so it is……
Is it possible as well that there is a subtle crowd out effect, ie, due to more outreach and press, folks are flipping into public programs. Probably not a huge number, but even a few tenths of a percent may make a difference.
I know Cato, Heritage, etc., will probably advance this theory (have not seen it yet), but possible contributor?
Joe:
“Employment continues to decline, with expectations that it will hit 6.0% later this year.”
I think you mean rate unemployment not total employment which will continue to rise as the population increases from illegal immigration alone.
Also you have made the point in the past most people can afford health insurance if they want too! They don’t want to pay the price. How many people could pay for health insurance out of what they pay for dining out or Starbucks coffee. A $5000.00 fund for health care costs is not hard to save if you want.
What people want is a $10.00 copay plan that they don’t have to pay for out of pocket. If they really understood what could be in their paycheck if the employer let them make health care decisions there would be nobody in any company paid plan.
The extant “health insurance market” is fundamentally flawed. Individuals with “preexisting conditions” living in a state with no high risk pool, are not likely to find carriers to cover them. If the carrier deigns to issue a contract, the premiums will be high and the coverage will be minimal, with exception riders galore. I pay $600/mo plus a $1,500 deductible (plus absurd copays for drugs based mainly on percentage of negotiated price). I can’t necessarily afford this insurance, nor can I afford the prospect of medical bankruptcy. Decoupling health insurance from employment, and requiring all to purchase some level of health insurance could benefit all by increasing group size to prevent exclusion, dramatically lowering the bewildering number of “products” offered by the health insurance industry, and provide more transparent pricing. We also might see a lowering of the inordinately high level of health insurance company BS fed to consumers, providers, et al. I hope the next president looks at the model used by the Netherlands as an instructive example.