Tracking the uninsured

Waterbury Republican-American ^ | 01/11/04 | Editorial

[Holly_P]

Economist Thomas Sowell is one of the most articulate and thoughtful voices on the issue of poverty. It is said the poor will always be with us, but Dr. Sowell has demonstrated irrefutably how poverty for most Americans is only temporary, that today's poor are tomorrow's middle class or better.

Dr. Sowell's principle also has been applied to the unemployed. The latest occasion was last year when research by William Conerly, a senior fellow at the National Center for Policy Analysis, showed there "is no stagnant pool of unemployed who cannot find work ... . Instead, there are people entering and leaving the job market — some seeking work for the first time in their lives and some retiring or choosing to stay home with their families." Unemployment today may be about 6 percent, but it's not all the same people as last year.

This logic is unassailable, so it was only a matter of time before it was applied to the issue of the uninsured. The findings of Pamela Short and Deborah Graefe of Pennsylvania State University call into question whether socialized medicine, as advocated by liberal politicians, social activists and even the researchers, is necessary or advisable.

In "Battery-Powered Health Insurance?" in the November/December issue of the journal Health Affairs, they attempted to assess the state of health insurance in America from 1996-99. They found that 85 million Americans under 65 were uninsured for at least one month during that period, but only 10.1 million were without insurance for the entire four years, and more than half were uninsured for a year or less. "Ten million Americans moved from being uninsured to some form of insurance and remained insured for the remainder of the 4 years; conversely, 7.3 million people were covered at the start of the survey and moved out of coverage for the rest of the four years."

Statistics dating to 1977 similarly revealed this "considerable turnover in the uninsured population over time," they wrote. The churn is so predictable and pronounced — "half to two-thirds of the people who are uninsured over the course of any year move into or out of coverage during (the next) year" — they estimated that more than 40 million uninsured Americans today will have insurance before the end of 2004.

From a public-policy standpoint, Professors Short and Graefe said their findings point to a need for stability in health-insurance coverage. They called on the government to target the gaps in coverage instead of focusing on how many people are uninsured at any given time. That could be achieved, they said, by moving toward universal health insurance, which they envision would be paid for through "employer contributions ... to cover the costs of covering individuals who cycle in and out of employer plans... ."

But their own data showed that most of the "repeatedly uninsured" were low-income workers whose coverage gaps were "caused mainly by the instability of employer-sponsored health insurance." Rather than attack that symptom, it makes more sense to try to stabilize or reduce the cost of health insurance to keep it affordable for employer and worker alike.

That would be a lot easier and less expensive to achieve. A good first step would be to begin to roll back insurance mandates that unnecessarily lard up policies and dramatically increase the cost of basic coverage. Tort reforms to restrain capricious medical-malpractice awards that drive up health costs also would go a long way toward attaining stability and reducing the ranks of the repeatedly uninsured.