Sunday, January 28, 2007

Health Insurance Blithering: "47 Million Uninsured"

The Bush health-insurance proposal has not been on the table for a week, and it's drawn more partisan fire than the War on Terror.

That's an accomplishment!

Some of that partisanship spills into "news" stories and it significantly distorts what should be a reasoned debate.

For example, in Saturday's JSOnline, we see the following:

The administration estimates that the average tax bill for families who now buy their own health insurance will go down by more than $3,650 in 2009, the year the tax break would be enacted. President Bush estimates that 3 million more people would get health insurance as a result.

That is a small percentage of the estimated 47 million people without health insurance, most of them lacking coverage for a year or longer.

That number--"47 million"--is pure horseapples.

The Congressional Budget Office ran the numbers (2003 report) and found that it is a wild exaggeration--not just a 'high-end guess.'

The key to understanding the legerdemain is separating "uninsured for a WHOLE year" from "uninsured at SOME POINT during a year." The numbers change dramatically:

CBO found that there are up to 40 million (non-elderly) people who are uninsured at "some point" during the year, but only 21 to 31 million who are uninsured for a "whole year or more." They also found that up to 59 million are uninsured "at any time" during a year.

Naturally, that 59 million figure is a totaling of the other two categories.

There are a number of other facts which are significant. Among them:

Many children (3 million or so) are eligible for Medicaid, but are not covered because their parent(s) have not applied for the coverage on behalf of the children;

Over 75% of the uninsured state that their health is "good", "very good", or "excellent."

HALF of the "uninsured spells" lasted 4 months or LESS.

People with less education are more likely than higher-educated people to experience long uninsured spells. Some 23 percent of spells among people in families in which no one graduated from high school last more than two years, compared with a figure of only 8 percent among people in families in which at least one person has a bachelor's degree

Obviously, a reflection of "employability."

About 19% of those who were un-covered for a year or more state that they "do not need insurance" (!!) or "don't believe in insurance" (!!!!)

Finally, about 23% of those who are un-covered are Hispanics. The CBO does not break down that category, but it is certain that some proportion of that group are illegals.

Unfortunately, some people are more interested in throwing political bombs than in rational discourse:

"You got to take this proposal for what it is," said Paul Fronstin, a health care economist with Employee Benefit Research Institute, a policy research organization. "It's not about insurance reform and it's not about health care reform. It's about premiums and taxes. And it's about ideology."

The "I-word" is code for irrational. Perhaps a mirror would help Mr. Fronstin.

There's a reason that Wisconsin liberals are not interested in Bush's proposal: it's called "politics."

Bush wants to make other federal health programs more flexible so that they complement, rather than hinder, state reform efforts. For instance, instead of sending billions to hospital emergency rooms and other providers to treat the uninsured after they get sick (the current practice), states could use the funds to help the poor obtain the sort of private coverage available to the rest of us.

In general, moving decision-making closer to the problem (i.e., to the State) is a good thing. It's called 'the principle of subsidiarity,' and is a matter of common sense. But States wish to avoid the responsibility which goes with the authority, because it's much easier to point fingers at "the Feds" than to actually be responsible. State deficits matter, and States have "other priorities."

Ironically, Bush's plan does what most liberals want: it will increase taxes on those who have exceptionally good plans--the OTHER source of State recalcitrance, particularly in States with strong public employee/teachers' union presence.

Briefly, the Bush $15K cap will make many teachers' health-plans partially taxable. This is absolutely anathema to Jim Doyle (among others.)

So how to address this problem while ignoring the obvious? Simple. Go to "the future."

The president proposed creating a standard deduction - $15,000 for families, $7,500 for individuals - for health insurance starting in 2009. If the cost of a health insurance policy exceeded the standard deduction, the amount above the limit would be taxable.

...The deduction would be pegged to the Consumer Price Index, not the rise in health care costs or in health insurance. The difference is significant. Since 2000, the cost of health insurance offered by employers rose an estimated 87%, compared with an 18% increase in the price index, according to the Kaiser Family Foundation.

This means that more people's health benefits eventually will exceed the deduction - about 40% of health plans in 10 years, by one estimate.

"It doesn't matter how many people we are talking about today," Fronstin said. "The fact is, six, seven years from now, you are talking about a big number."

Fronstin demonstrates how "ideology" really works with his projection. It's no different from the AlGore "Inconvenience:" find a cataclysmic possibility in the future, and flog it.

Let's settle down and start with germane facts; accept responsibility, and design a plan which works. Bush's proposal is an excellent start, if only the Ideologue Left would stop their screeching and spitting long enough to work with it.

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