The first thing I need in the morning is my favorite blend of Starbucks coffee in my Grande cup.
The last thing I need is a tasteless blend of misinformation served up “Grande” by Starbucks and disguised as a “public service” announcement.
If you missed the full-page ads in the May 5 issue of USA Today and other newspapers promoting this year’s “Cover the Uninsured Week,” you missed a classic example of Orwellian newspeak.
This is not to say our health care finance system is perfect. It isn’t. But the solutions embedded in the Cover the Uninsured Week project suggest more government involvement rather than less and ignore the rapidly growing trend away from bureaucratic health care and toward consumer-directed care.
44 Million Uninsured?
“Cover the Uninsured Week” is another product from The Robert Wood Johnson Foundation (RWJ), the liberal advocacy group that has done so much to confuse and cripple the health care reform movement. This year’s lead spokesperson Noah Wyle, the actor who plays Dr. Carter on the TV drama “ER,” recites the questionable data supplied by RWJ, claiming “nearly 44 million Americans go without health care coverage of any kind.”
Wyle refers to his TV scripts as if they were fact, saying, “I’ve spent the last decade playing the role of a doctor on a program that depicts the plight of uninsured people who arrive in a Chicago emergency room, seeking medical care they can find nowhere else.” Make-believe is rarely a reliable guide for making real-world public policy.
According to the nonpartisan Congressional Budget Office (CBO), the uninsured figure most often cited in news media reports and television series is inflated by counting people who are uninsured only temporarily. According to the CBO, roughly 25 million Americans go without health insurance for 12 months or more.
A sizeable part of the increase in the number of uninsured people in the U.S. in recent years is the result of illegal immigration. Roughly 9 million documented and undocumented aliens are generally included in the uninsured estimates. Many hesitate to participate in a government-program that could establish a paper trail for immigration authorities. Cultural mores, folkways, and language barriers also conspire to keep these people uninsured.
Far Cry from a Crisis
Data from three federally sponsored national surveys–the Survey of Income and Program Participation (SIPP), the Medical Expenditure Panel Survey (MEPS), and the National Health Interview Survey (NHIS)–reveal the number of uninsured at a particular point in time.
All three surveys conclude that at any given time during a year, uninsurance is a much smaller problem than we are led to believe. For example, only about 30 percent of non-elderly people who become uninsured in a given year remain uninsured for more than 12 months. Nearly 50 percent regain health insurance within four months.
In other words, even the CBO estimate is too high by nearly half. While 44 million Americans might be without insurance for at least a day, somewhere in the neighborhood of 20 million are uninsured for four months or less. Only 14.6 million go for more than 12 months without insurance. We can say that’s still too many uninsured … but it’s a far cry from the crisis we’re led to believe exists.
Notoriously Inaccurate
Population surveys are prone to reporting and statistical errors, making data derived from them inherently unreliable. Controversy regularly attends reports from the decennial Census Bureau surveys for exactly that reason.
Some segments of the population may be under-represented in surveys, leading to the possibility of an undercount. Over-stating is also a possibility, if estimates are extrapolated from samples too small or insufficiently representative of the population as a whole. And even when populations are properly surveyed, their answers may not be accurate. Misstatements, intentional or not, plague population surveys.
Research I conducted while at the Center for Advanced Social Research at the University of Missouri-Columbia discovered many Medicaid recipients say they don’t have insurance coverage, when in fact they do–they just don’t consider Medicaid to be insurance. Some people counted among the uninsured are eligible for insurance through Medicaid and the State Children’s Health Insurance Programs, but have not applied. They will be enrolled when they arrive at a clinic or hospital seeking treatment.
Uninsured Have Access to Care
RWJ would have us believe that being without health insurance is the same as being without health care “of any kind.” They might as well tell us being without car insurance means we are without transportation. Just as there are many ways to get around that don’t require insuring an automobile, so too is there public access to medical care without health insurance.
Public and private hospitals, community health centers, local health departments, free clinics, faith-based programs, emergency rooms, and Veterans Administration hospitals provide billions of dollars’ worth of free care to the uninsured every year. Private and public care-givers provide billions of dollars a year more in services to uninsured patients who pay cash for care, a growing trend.
Starbucks somehow got snookered into sponsoring this year’s Cover the Uninsured week. It’s time for them to wake up and smell the coffee.
Conrad F. Meier is managing editor of Health Care News. His email address is [email protected].
