Nobody really knows how many uninsured there are: Two different Census Bureau surveys conducted in the same year identify the number of uninsured as A) 45 million or B) 19 million. The first figure is the one you hear about, the second figure apparently entered the Witness Protection Program. Of those 45 million uninsured Americans, the Census Bureau itself says over 9 million arent Americans at all, but foreign nationals. They have various health care back-ups: If youre an uninsured Canadian in Detroit, and you get an expensive chronic disease, you can go over the border to Windsor, Ontario, and re-embrace the delights of socialized health care; if youre an uninsured Uzbek, it might be more complicated. Of the remaining 36 million, a 2005 Actuarial Research analysis for the Department of Health and Human Services says that another 9 million did, in fact, have health coverage through Medicare.
Where are we now? 27 million? So who are they? Bud and Mabel and a vast mountain of emaciated husks of twisted limbs and shriveled skin covered in boils and pustules? No, its a rotating population: People who had health insurance but changed jobs, people who are between jobs, young guys who feel theyre fit and healthy and at this stage of their lives would rather put a monthly health-insurance tab towards buying a home or starting a business or blowing it on booze n chicks.
That last category is the one to watch: Americans 18-34 account for 18 million of the army of the uninsured. Look, theres a 22-year-old, and he doesnt have health insurance! Oh, the horror and the shame! What an indictment of America!
Well, he doesnt have life insurance, either, or homeowners insurance. He lives a life blessedly free of the tedious bet-hedging paperwork of middle age. Hes 22, and he thinks hes immortal and any day now Hillary will propose garnishing his wages for her new affordable mandatory life-insurance plan.
So, out of 45 million uninsured Americans, 9 million arent American, 9 million are insured, 18 million are young and healthy. And the rest of these poor helpless waifs trapped in Uninsured Hell waiting for Hillary to rescue them are, in fact, wealthier than the general population. According to the Census Bureaus August 2006 report on Income, Poverty and Health Insurance Coverage, 37 percent of those without health insurance thats 17 million people come from households earning more than $50,000. Nineteen percent 8.7 million people of those downtrodden paupers crushed by the brutal inequities of capitalism come from households earning more than $75,000.
In other words, if they fall off the roof, they can write a check. Indeed, the so-called explosion of the uninsured has been driven entirely by wealthy households opting out of health insurance. In the decade after 1995 i.e., since the last round of coercive health reform the proportion of the uninsured earning less than $25,000 has fallen by 20 percent, and the proportion earning more than 75 grand has increased by 155 percent. The story of the past decade is that the poor are getting sucked into the maw of coverage, and the rich are fleeing it. And, given that the cost of health insurance bears increasingly little relationship to either the cost of treatment or the actuarial reality of you ever getting any particular illness, its entirely rational to say: You know what? Ill worry about that when it happens. In the meantime, I want to start a business and send my kid to school. Freedom is the desire of my human heart even if my arteries get all clogged and hardened.
