America's uninsured: How bad do the numbers have to get?

Lynn Blewett, Director of the State Health Access Data Assistance Center (SHADAC), writes about the latest numbers on Americans who lack health insurance.  The Alliance for Health Reform sponsored a lunchtime briefing on the new figures today.

Every year, the US Census Bureau releases estimates of how many Americans lack health insurance, and this number then becomes embedded in numerous media reports and speeches that focus on health reform.  The most recent estimates from the US Census Bureau show that the number of uninsured Americans continues to grow, increasing by 600,000 individuals between 2007 and 2008.  There are now 46.3 million individuals in the US without any health insurance coverage.   The estimates also show the continued deterioration in employer-based coverage.  The number of individuals receiving health insurance coverage through their employer dropped from 177.4 million to 176.3 million individuals. 

The news was not all bad.  The estimates showed  a continued increase in coverage for children—thanks in part to the Children’s Health Insurance Program (CHIP).   The number of uninsured children in the US declined 10 percent, from 8.1 million to 7.3 million in the past year – the lowest rate since 1987.  

But the question that gets raised again and again is, how bad do the uninsured numbers have to get, anyway, before we as a country take meaningful action to address this problem?  We are the only developed country in the world that does not provide universal coverage to our citizens.  And yet, any attempt to talk about what this failure actually means, in terms of people’s lives and our economic health as a country, and what we could actually do to solve this problem, leads to accusations about doing harm—like government take-overs of medicine, and the like.  The point is, health reform to cover more Americans is not about doing harm.  We are already doing harm by letting this problem continue.  

The uninsured problem, whether it’s 40 million or 46 million, is not the sort of mess we can quietly shove aside with our feet and hope that no one notices.  It’s a problem that begets all sorts of consequences—working Americans who end up getting sicker than they should or getting wiped out financially by one catastrophic health care system, doctors and nurses and hospitals who struggle to provide uncompensated care.  And the latest uninsured estimates are not even reflecting the full effects of the economic down turn but these estimates are the first indication of the likely impact that we will see in future estimates.  The trend line in rates of uninsurance has not changed in over 20 years and will not change without significant reform of the health care system. 

Unfortunately, history has taught us that the windows of opportunity for true health reform are rare and infrequent, yet we are undeniably in one now.   We don’t need the latest uninsured numbers to tell us that now is the right time for reform to finally reverse the trend of growing uninsurance in America.