Today I'm going to let you in on a nasty little secret about health reform. Pay attention. This could be shocking.

Question: How many politicians, think tanks, business coalitions, etc., do you know who seriously advocate universal access to health care?

Answer: None, actually. Unless you count the National Center for Policy Analysis and a few academics scattered here and there who are mainly connected to us.

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At least 44% of the uninsured are uninsured by choice, and the number could be much higher than that. An Urban Institute study found that:

• One in every four uninsured persons is eligible for Medicaid or SChip, but has not enrolled.
• One in five has a family income in excess of $58,000 and presumably can afford coverage.

This is a minimum estimate. Of those who earn less than $58,000, there are undoubtedly many who can afford coverage because: Continue reading »

Like many plant species, the uninsured numbers bloom once a year, giving pundits an opportunity to spout another round of nonsense. The numbers do not change very much from year to year. Neither does the nonsense. Here for your reading pleasure are four items: Brief Analyses by Greg Scandlen and Devon Herrick, an editorial by me, and Herrick's calculation of the amount of free care consumed each year by the uninsured. Combined, they make the following points:

1. The official estimate overstates the actual number of uninsured by as much as twofold.
2. Despite claims that the uninsured do not get health care, they get about $1,500 of free care per person per year, on top of the amount they pay for out-of-pocket.
3. From one-fifth to one-third of the uninsured are de facto insured - they can enroll in free government programs at the drop of a hat - often months after care has been delivered!
4. The vast majority of remaining uninsured are also probably de facto insured, considering how easy we have made it to become insured even after people get sick.
5. Another one-third, have above-average incomes and presumably can afford to purchase insurance.
6. Once people see a doctor, they get roughly the same care whether insured or not - so says RAND.
7. Medical debts need not cause bankruptcy in most cases because hospitals rarely ever take people to court to force payment and credit bureaus often do not even list unpaid medical bills.
8. Individual mandates are no solution - auto insurance is mandated almost everywhere and auto uninsurance rates are very similar to health uninsurance rates nationwide.

With the recent Census Bureau report showing a marginal increase in the number of uninsured, now is a good time to take action in expanding health care coverage. Read the news release detailing our free care money solution.

In all my years of interest in health economics, I cannot recall a study quite as stunning as the one that appeared last week in the New England Journal of Medicine.

The conventional wisdom among health experts across the ideological spectrum is that people need health insurance to get good health care.  Indeed, to some politicians the terms "no health care" and "no health insurance" are interchangeable.  Almost as widely accepted is the view that some health plans deliver better health care than others.  But the new study shatters those assumptions.

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