How Many Millions Are Uninsured, Really?

(AP)  It is a central goal of the president's plan: Extending health care coverage to the millions of Americans who lack it. Question is, just how many million are uninsured?

The answer could make a huge difference in the billions of dollars it will cost to remake the national health care system.

President Barack Obama frequently cites last year's Census Bureau number of 46 million people with no health insurance. But some experts argue that figure is off by tens of millions - in one direction or the other.

The recession's continuing toll on jobs, a tendency to undercount people on a health care for the poor program and other factors make it hard to come up with an exact number. And the most widely accepted range - 40 million to 50 million - includes some 10 million non-citizens, a detail that is generally overlooked when Obama and others talk about "uninsured Americans."

The lack of certainty about such big numbers is one more question mark for Obama and members of Congress as they try to craft a plan that would cover most of the uninsured. Obama says his goal is to cover 97 percent to 98 percent of Americans, a target that would be reached by plans taking shape in the Senate - if you do not count illegal immigrants. A bill crafted by House Democrats comes in closer to 94 percent.

All the plans would exclude illegal immigrants, who account for as much as 17 percent of the uninsured, according to the Pew Hispanic Center.

"I want to cover everybody," Obama said at a news conference last month. "Now, the truth is that unless you have a what's called a single-payer system in which everybody is automatically covered, then you're probably not going to reach every single individual."

Some people do not want health insurance or just do not bother to get it, but most people who do not have it cannot afford it, Obama said.

"So I think that the basic idea should be that in this country, if you want health care, you should be able to get affordable health care," he said.

New Census Bureau figures expected next month could scramble the equation, adding billions in costs if the numbers come in higher than expected, or reducing costs if the numbers are lower.

There could be serious implications "if we all of a sudden found that instead of 45 million uninsured there are 35 million," said Michael O'Grady, a senior fellow at the University of Chicago's health policy and evaluation department and a former assistant secretary at the Department of Health and Human Services.

A lower figure could cut two ways: making Congress' job cheaper, but also making the country's health care woes seem less pressing.

Even if there are fewer uninsured than now estimated, health experts emphasize that it is still a lot of people, and being uninsured has consequences. The Institute of Medicine has found that uninsured people are more likely to succumb to illness and suffer premature death.

Still, some overhaul foes are accusing the media of overreporting the number of uninsured in order to frighten the public and "bolster calls for universal government-run insurance coverage," as a report by the conservative media watchdog Media Research Center's Business and Media Institute put it.

The 46 million number (actually 45.7 million) cited by Obama and others comes from the Census Bureau's annual Current Population Survey for 2007. It's the consensus figure, but some researchers believe the CPS overstates the number of uninsured people, partly by undercounting how many people are on Medicaid, the federal-state program for the poor.

Another government survey, the Medical Expenditure Panel Survey done by the Department of Health and Human Services, says that about 40 million people were uninsured for all of 2007, and about 70 million were uninsured for part of the year.

All those numbers are out-of-date. Taking into account the effects of the recession, with widespread job losses cutting into employer-provided health care - more than 5 million jobs have been lost since last August - researchers at the Urban Institute and elsewhere estimate that the present-day number of uninsured is closer to 50 million. That's the number used by the Congressional Budget Office.

The Census Bureau is releasing its Current Population Survey for 2008 on Sept. 10. Then, later in September, for the first time, it's releasing health coverage information collected by the American Community Survey, which has a much larger sample size than the CPS. Some researchers are expecting that number to be more precise.

[mary-miami]

The amount of people who have no access to a doctor, dentist, optometrist is staggering. Some people who are lucky enough to have a job, don't have the opportunity to have healthcare because their employers don't offer it as a benefit, and if they are earning a miserable minimum wage (which is not a livable one) they cannot pay for healthcare, because eating is necessary for survival. Healthcare must be FREE. Many people will not be able to pay even a reduced amount for insurance, because sometimes they count coins to buy a loaf of bread. No exageration. Reality...We need a livable wage to eliminate the majority of problems society has. My opinion...no less than 10 dollars an hour.

[flsunjnky]

Most Americans want a national health care plan with a government run option. The GOP wants to hold at status quo. But we are tired of big business insurance companies and big business drug companies that have driven our health care system to the brink and we are also sick and tired of congressmen and senators that support them instead of their constituents. That's about "it" in a nutshell.

[ibsteve2u]

I would say something about righties here being crazy with all of their ranting about the government lying...

On the other hand, their guys lied us right into a war that has killed 4300+ Americans, a bunch of our allies, and who knows how many Iraqis.

So the fact is the righties ARE the experts on lying governments; heck, some of 'em may have knowingly helped promulgate lies themselves!

Here's hoping the righties here are wrong, and the Democrats in Congress remember that they aren't Republicans!

[6591Hou]

The health-care delivery system cannot be fixed, because there is no system.
System (from Latin syst?ma, in turn from Greek ??????? syst?ma) is a set of interacting or interdependent entities forming an integrated whole. In place of a true system, because it is most definitely not 'an integrated whole', is an alphabet soup of insurance companies, a patchwork quilt of regulations and guidelines, a hodgepodge of different hospitals and clinics, and an overworked and frustrated population of care providers.

[ianlou]

Five out of six of my brother-in-laws have no health insurance.
They are all Redneck Republicans who care more about supporting the NRA than their families health care needs. They complain about their tax dollars being waisted on welfare recipients, even though they have avoided paying income taxes their entire lives by working for cash under the table. Three of them have recently lost their houses and blame the Democrats because Obama was in office when the bills finally caught up with them. Life is not all bad for them, though; they still have their hand guns, Bud Light and NASCAR.

[xlib]

And they are ever so lucky to have such an enlightened elitist like yourself to show them the way. And, btw, I do believe you may have meant to say "wasted" instead of "waisted".
Just how did you ever lift yourself out of such a miserable life?? My, my, you are a beacon of hope.

[panhandlpete]

So we short-term memory loss folks have forgotten that the enormous price gouging of OIL is really the culprit that sent our economy toward the pitts. And, even a sentence of a falsehood sent over the wires can make its cost go up or down via the stockmarket. The past administration took us to WAR for OIL. Don't say it was because of 9/11 connections for none have been shown that Iraq had anything to do with this dastardly act. So, why doesn't the government make a drastic change in the stock market so that oil, or any other commodity, must be accepted/delivered if bought. This would limit speculators who live off others.....all of us. The original purpose of the SM was for businesses to sell shares in their company to raise capital......not to become the world's largest casino. Through dividends paid annually to its stockholders after a reasonable profit realized, it started out with great expectations.

And now, we are buying into the 'glorious song' being sung that we need a complete reform of the health care system to off all access to HEALTH INSURANCE. Having health insurance may help some folks get better health CARE than they do now simply because payment will be assured to those rendering the care....hospitals, drs, and nursing homes. The second question asked at a hospital is "...the name of your insurance company?"
When all the costs get tallied up, and the insurance companies add their profits(an amount as high as possible) exactly how does an intelligent person think the costs will go down? They will not unless strict laws are passed which CONTROL/REGULATE/PROTECT the public against premium increases and service charges by those healthcare providers.

This healthcare reform is being pushed as a method to create that data bank on every person living in the US.....???? Can you think of a better way to do it than this?

[Snowhare]

1. Lets wait for the census and see what number of uninsured comes up. My guess: it will prove the necessity for a reform.
2. The opponents of health care reform are either operating with lies or are simply misinformed. However honest the outrage of some people is, the information on which they act isfalse - and in my opinion it is actually incredible how you can even start to assume euthanasia or denying necessary procedures could be part of any program.
3. Even if the number of uninsured is lower than expected, one problem remains: Insurance companies make a lot of profit and are still raising premiums - how does that go together? - reform is needed! Regulation and why not a government-run competitor?

[Solarrays247]

I agree. Nice post. This issue goes much deeper than simply covering the uninsured.

Have a nice night!

[rhs648]

If you cut premiums by 50% many of us would jump on reform. Until that happens, many of us prefer the coverage that we already have. Saving us money with the same or equal coverasge would be real reform. Heck, every department store offers 10% off but that is really piddly considering the 100% or more markup they add to their cost. President Obama chose to turn things upside down instead of tweaking the system which most Americans would prefer. We are a nation of moderates, not revolutionaries. Excepting the extremes on the left and right, most of us fall in the middle. Knowing that, it is unwise to turn things upside down. Further, many of us are waiting to see what happens with the bailouts, the stimulous package, social security, medicare, medicaide, and taxes before even more debt is created. Health care reform is probably contigent on Americans having confidence in the Obama adminstration. You might not like the answers in my post but the concerns are very real.

[start99]

DUHHH!! Go figure why there are so many comments to this!! Why pay our Reps and Dems as in contributions when they are already being paid to represent US!!! Helloooo!! This is all about greed!!! Nothing else! This is why we are in the situation we are in now....We will always pay for their greed until there is a gather of people that are tired of this crap.

[Aldymac]

I had a Dr. appointment yesterday and asked the doc about the number the administration keeps spouting, he said the true number is in the 8 million range. If the polititions and lobbiests weren't going to make millions in kick backs there wouldn't be such a panic to get the legislation passed as quickly as they want.

[Solarrays247]

Please disclose the source from which your doctor received his/her information? 'Cause I don't believe you at all!!!!

[jsd330]

solarrays247
Thats because you only believe what Obama and company tell you, if it could be proven you would say it was funded by the repubs or big insurance.

[SublimeWoody]

I've been wondering a lot about that number, which seemed to have appeared out of thin air some weeks ago. Does anyone have a factual answer to the question of who put it forth? To this moment I simply have to reject any number, irrespective of party affiliation, being thrown around so irresponsibility.

Though I doubt anyone will actually check it out, there's a terrific book by a couple of BBC folks, called "The Numbers Game." Absolutely fascinating stuff, that shows empirically how organizations [the media, governments, corporations, NGOs, etc] put up bogus numbers to support whatever hobby horse they're riding. The book is so good it's required reading for British Government employees.

[Solarrays247]

SublimeWoody, actually, the article does cite their sources for the numbers quoted. You can check them out at your leisure.