How many uninsured people need additional help from taxpayers?

How many uninsured people need additional help from taxpayers?

When discussing health insurance we frequently hear that there are “46 million uninsured” in America. This figure is from a monthly survey of about 50,000 households done by the Bureau of Labor Statistics and the Census Bureau. This Current Population Survey (CPS) then uses statistical techniques to paint a picture of the entire U.S. population.

Advocates for expanding taxpayer-subsidized health insurance, and their allies in the press, repeat this 46 million number constantly. It paints the following technically accurate but misleading picture:

insured v uninsured

This looks really bad. At least there are more than 250 million people with health insurance – that is clearly a good thing that we never hear it in the press. Still, there’s a lot of red there. It means that in 2007 (15%) of Americans lacked health insurance, according to the CPS. Advocates, some elected officials, and the press round that number up to “1 in 6 Americans.” We hear that there are “46 million uninsured,” and then we jump to the conclusion that government needs to help 46 million people buy health insurance, subsidized by taxpayers.

Let’s look inside that 45.7 million number and see what we can learn. Here is our key graph:

uninsured subpopulations

First, I need to make a technical disclaimer. I had this same detailed breakdown for 2005 data, done by health experts when I was part of the Bush Administration. I now have a 2007 total (45.7 million), and so I have proportionately adjusted the components to match that new total. It is a back-of-the-envelope calculation, but I am confident that it is solid, and it does not move any component by more than two hundred thousand. In addition, the expert analysis I am using ensures that the subdivisions shown above do not overlap. I will slightly oversimplify that point in the following description of the breakdown to make the explanation readable.

Let us walk through the graph from top to bottom.

  • There were 45.7 million uninsured people in the U.S. in 2007.
  • Of that amount, 6.4 million are the Medicaid undercount. These are people who are on one of two government health insurance programs, Medicaid or S-CHIP, but mistakenly (intentionally or not) tell the Census taker that they are uninsured. There is disagreement about the size of the Medicaid undercount. This figure is based on a 2005 analysis from the Department of Health and Human Services.
  • Another 4.3 million are eligible for free or heavily subsidized government health insurance (again, either Medcaid or SCHIP), but have not yet signed up. While these people are not pre-enrolled in a health insurance program and are therefore counted as uninsured, if they were to go to an emergency room (or a free clinic), they would be automatically enrolled in that program by the provider after receiving medical care. There’s an interesting philosophical question that I will skip about whether they are, in fact, uninsured, if technically they are protected from risk.
  • Another 9.3 million are non-citizens. I cannot break that down into documented vs. undocumented citizens.
  • Another 10.1 million do not fit into any of the above categories, and they have incomes more than 3X the poverty level. For a single person that means their income exceeded $30,600 in 2007, when the median income for a single male was $33,200 and for a female, $21,000. For a family of four, if your income was more than 3X the poverty level in 2007, you had $62,000 of income or more, and you were above the national median.
  • Of the remaining 15.6 million uninsured, 5 million are adults between ages 18 and 34 and without kids.
  • The remaining 10.6 million do not fit into any of the above categories, so they are:
    • U.S. citizens;
    • with income below 300% of poverty;
    • not on or eligible for a taxpayer-subsidized health insurance program;
    • and not a childless adult between age 18 and 34.

As a policy matter, we care not about the total number of uninsured, but about the subset of that group that we think “deserves” taxpayer-subsidized health insurance. That is a judgment call that involves some value choices.

I will make one value choice for you and boldly assert that, if you are already enrolled in or eligible for one free or heavily subsidized health insurance program, we can rule you out as needing a second. That simple statement reduces the 45.7 million number down to 35 million, by excluding the Medicaid undercount and Medicaid/SCHIP eligible from our potential target population.

I think most people would also say that the 10.6 million I have labeled as “remaining uninsured” and shaded in yellow above are the most sympathetic target population.

It then gets tricky.

  • Should people with incomes near or above the national median get health insurance subsidized by taxpayers?
  • How about non-citizens? Should we distinguish between documented and undocumented non-citizens? Between those who pay taxes and those who do not? Remember that we are not talking about who should get emergency medical care, but instead who should get taxpayer subsidies to finance the purchase of pre-paid health insurance. Does that change your answer?
  • Many young adults and childless couples are in good to excellent health. Do they deserve subsidies, when they may be making what they believe to be a rational economic decision and using their financial resources for things other than buying health insurance? Should a 25-year old Yale graduate triathlete making $30K per year get his health insurance subsidized by taxpayers if he chooses not to buy it because his budget is tight?

There is no clear right or wrong answer to the above questions. You need to make your own value choices for them.

Now let us look at the effects on the totals for several hypothetical answers to these questions. Remember that the advocates, some elected officials, and press tell us that the numbers are: 46 million uninsured, 15% of the population, and 1 in 6 Americans “are uninsured.” I suggest you try to figure out which of the following is closest to your view.

  1. Ann wants to subsidize everybody, but agrees that we don’t need to double-subsidize. She excludes the Medicaid undercount and Medicaid/SHIP eligible from her target population and ends up with 35 million people. That is still an enormous amount, but it is 10.7 million less than the headline number she heard in the news. Her target population is now 11.7% of the total U.S. population, down from 15%. Put another way, she would like taxpayers to help between 1 in 8 and 1 in 9 Americans who she feels are deserving of subsidies to buy health insurance, rather than the 1 in 6 she heard in the press.
  2. Bob agrees with Ann, but thinks that subsidies should go to the poor, or at least not to those who have above the median (or near median) incomes. His target population is therefore about 25 million people, way down from 46 million. That is 8.4% of the total U.S. population, or 1 in 12 Americans. That is still a huge problem, but it is very different from 1 in 6.
  3. Carla agrees with Bob that subsidies should not go to those with incomes near or above the national median. She also thinks that undocumented citizens should get emergency medical care, but not taxpayer-subsidized pre-paid health insurance. I will guess a 50/50 split between documented and undocumented of the 9.3 million uninsured non-citizen, and I would appreciate it if someone could help me refine this. With this assumption, Carla’s target population is about 21 million, or 7% of the total U.S. population. That is roughly 1 in 14 Americans.
  4. Doug thinks only American citizens with incomes below the national median (and who are not already eligible for another program) should be eligible for additional aid. His target population is therefore the bottom two bars on the graph, or 15.6 million people. That is 5.2% of the U.S. population, or 1 in 19 Americans. If Doug were to further limit subsidies to those below 200% of poverty or 150%, his target population would be a few million people smaller.
  5. Edie agrees with Doug, but thinks that if you are a young adult without kids, you should fend for yourself. Her target population is 10.6 million people, or 3.5% of the total U.S. population. That is 1 in 28 Americans.

These are, of course, not the only possible answers, but I think they are a representative bunch. Even for the most “liberal” set of answers (Ann’s), the headline numbers we hear in the press overstate the extent of the problem by more than 10 million people.

Now even Edie’s narrowest 10.6 million target population is still a lot of people who lack health insurance. So why does it matter that the press gets the numbers wrong?

  1. If we misdiagnose the problem, we could easily design the wrong policy solution. A solid quantitative understanding of who we would like to help and why is important.
  2. Health insurance subsidies cost taxpayers tens of billions of dollars each year. If we target these funds well and prioritize, we can help more of the people whom we think are deserving of additional assistance, and fewer of those who need less help. If we target those funds poorly, we will waste a lot of money. This point is independent of the total amount we spend on subsidizing health insurance.
  3. Health insurance competes with other policy goals for an enormous but still ultimately limited pool of taxpayer funds. We should neither overstate nor understate the problem to be solved, so that the tradeoffs with other policy goals can be considered fairly.

When you hear “46 million uninsured,” or “1 in 6 Americans don’t have health insurance,” remember that this is technically correct but misleading. The more important question is, “How many uninsured people need additional help from taxpayers?”

What’s your answer?

144 responses

  1. I am bored by this topic. What is the reason for the $65 Billion (or whatever the number is) that is set aside by the Obama administration? Is it to overhaul the health care financing system or to cover the uninsured? As a small business health insurance broker for 30 years I can tell you that business owners and employees are fed up with the high cost of health care and insurance. They experience continual15-30% annual cost increases in the form of either premium hikes or benefit downgrades. The insurers tell us that it is because of provider cost shifting, technology, increased utilization as we age…this explanation has been the same for 30 years. While this may be true, employers want solutions and want them right away! The hospitals and MD associations, insurance companies and state insurance departments and federal government officials need to resolve this NOW. Personally I think this is the main issue we are facing. How do we get costs to decrease? We can limit usage voluntarily by making the people more responsible for their health care purchases. If the government mandates that everyone must be covered by a $5000 deductible plan and then opens up the competition between states and also includes a federal plan as as option, this will create the same buying habits that apply to all other major purchases and cut consumption and increase competitiveness by health care providers. Anything less than $5,000 can be self-insured with non-tax deductible plans if the person or employer chooses…

  2. There are uninsured that are temporarily uninsured but become insured within a year. The 45.7 million uninsured include people who have a health insurance waiting period (includes new hires), uninsured people who find employment during the year and get health insurance, or people who purchase insurance after the survey.

    The US Dept of Health and Human Services Medical Expenditure Panel Survey and the US Census Bureau Survey of Income and Program Participation capture the number of people in the population who are temporarily uninsured. These people get health insurance within a year and often in a much shorter time. The number of long term uninsured is much smaller than the oft-cited figure of the uninsured.

    "About 30 percent of non-elderly people who become uninsured in a given year remain so for more than 12 months. Nearly 50 percent regain health insurance within four months. Long uninsured spells occur less frequently than do short spells." ( Statement and numbers from Health Care News published in 2003, http://www.heartland.org/publications/health%20ca

  3. I agree with Edie. Subsidy should only be given to those that really, really need it. Not those who don't really need it, or those who kind of need it. I'm very tired of seeing people in the grocery store ahead of me (those that supposedly would need health insurance) buying all kinds of expensive, unhealthy food with their food stamp card, then paying cash for their 48 pack of Keystone Light. That Keystone money should be what's being used for their healthcare, not my taxes.

    • They came from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at HHS. They’re based on the 2005 CPS.

  4. Mickle,

    You better get unbored with this topic because you are going to be impacted with the "solution" whether you like it or not.

    There are a lot of uninsured people for sure but it's by design. Congress torpedoed our non-profit health insurance system in 1979-1980 ERISA Act. They allowed the large corporations to become self-insured. That killed health insurance. Why would they do that? The straightforward answer is Eugenics by stealth.

    You can read this history here:
    http://www.channelingreality.com/Genome/Human_Gen

    And you can get more background here:
    http://www.channelingreality.com/Idx_health_care….

    As I've learned over the last decade, the only thing you can depend on to be true about the American government is that they don't do anything in the interest of the American people. In fact, just the opposite.

  5. Very good analysis, if one is interested in actually rationally addressing the problem. I believe however, that it is not the administration’s goal to address the problem in the least cost way. I believe that the goal is to implement nationalized health care, in large part because they know that the part that is already under government control – Medicare – is economically unsound. Solution – take over the whole thing, under the guise of addressing the "problem" of uninsured. I would encourage you to continue this series with further analysis on where health expenditures are actually made. So much of the focus is on trying to save money on routine health care, when I believe a large share, the bulk I believe, is spent in the last few months of life. No one dares say we should look at saving money there. I believe restricting care of that sort, by things like long waiting times for procedures, is how countries like Canada spend less. Question – does anyone know what percent of Canadian's who need a heart procedure do not survive the wait to receive the procedure, and how many of them come to the U.S. because they are unwilling to wait?

  6. State Legislators contribute significantly to the cost of health insurance. A Legislator's mother was helped by acupuncture, and that is added to health insurance benefits; naturopathy is added, all sorts of things that one should be forced to pay for themselves, unless tested results measure up as better than a placebo.

    Advertising, MSM articles and television dramas have emphasized illness and discomfort to such a degree that we have become, at least somewhat, a nation of hypochondriacs, unwilling to tolerate discomfort of any kind. We had an insurance commissioner here in Washington State who whittled the number of insurance providers down so far that insurance costs skyrocketed. COBRA costs are so high that many people forego it when between jobs. It would be interesting to see to what extent completely portable insurance policies would lower the number of uninsured, and cost. And there has never been a business, an organization, or an enterprise that has not been improved by competition.

  7. The insurance model for health care is that Americans do WTF they want until something goes wrong. Then they have insurance pay most of the costs of really expensive remedial treatment. Insurance companies have to compete for customers with affordable premiums so they nickel and dime policy holders for preventative care and turf them when they get expensive "pre-existing conditions".

    The insurance model has perverse incentives that lead directly to sub-optimal outcomes. It needs to be replaced with a system that emphasizes prevention and optimal outcomes. This will reduce expenses and improve the system. The special interests are powerful and will work to defeat health care reform as always. Getting rid of the special interest parasites is always difficult.

  8. This analysis is also limited in understanding the scope of the problem. Consider:

    * The medical cost burden of the uninsured adds an estimated $1,100 to the cost of existing family policies (http://www.americanprogressaction.org/issues/2009

    * The medical cost burden of the uninsured can shut hospitals down (http://archives.chicagotribune.com/2008/apr/03/bu

    * According to the American College of Emergency Physicians, the medical cost burden of the uninsured is "threatening the ability of emergency physicians to continue to provide high-quality care to everyone." (http://www3.acep.org/patients.aspx?id=25932)

    * Health care spending in 2008 in the US was 17% of GDP, and is projected to be 20% of GDP by 2017. As reference, health care spending in other countries (countries that insure all of their citizens): 10.9% of the GDP in Switzerland, 10.7% in Germany, 9.7% in Canada and 9.5 percent in France. (http://www.nchc.org/facts/cost.shtml)

    * McKinsey Global Institute found that the United States spends approximately $480 billion ($1,600 per capita) more on health care than other OECD countries and that additional spending is not explained by a higher disease burden; the research shows that the U.S. population is not significantly sicker than the other countries studied. Instead, MGI found that the overriding cause of high U.S. health care costs is the failure of the intermediation system — payors, employers, and government — to provide sufficient incentives to patients and consumers to be value–conscious in their demand decisions, and to regulate the necessary incentives to promote rational use by providers and suppliers. (http://www.mckinsey.com/mgi/rp/healthcare/account

    At the most basic level, the issue is fairly straightforward. The total medical costs in the US currently includes a significant added burden to account for the insurance companies' profits and lack of bureaucratic efficiency. This ignores any cost benefit to the system that would be generated by preventative treatment to the currently uninsured. While the government's bureaucratic efficiency isn't perfect, it is sure to be far better than the current private insurance system's profit and duplication inefficiencies.

    If you doubt that, consider a recent example of a US governmental takeover of a formerly private industry: airline security screening. A recent GAO report (http://www.gao.gov/htext/d0927r.html) found that "screening at SPP [private security] airports currently costs approximately
    17.4 percent more to operate than at airports with federal screeners, and that SPP airports fell within the “average performer” category for the performance measures included in its analysis."

    I don't know if we'll be able to get there politically, but the only real answer to the abnormal healthcare burden in this country is leave the private insurance system and allow the government to pool medical cost burdens across the entire populace.

  9. Who exactly provided those original numbers, ie: Childless Adults and Remaining Uninsured? "Health Experts"? Those numbers are critical.

  10. Even if we take the “1 in 6″ number (although UHC advocates were talking about “1 in 7″ as recently as ’06) as consisting entirely of people who, in a “reasonable” estimation are worthy of SOME sort of assistance in getting coverage (public/private/whatever), any change in policy designed to address that 16% is going to completely billy-jack the other 80-85% of the country who HAS coverage already. Is anyone really willing to drastically change the nature, not to mention cost, of health care in this country just to take care of 15-20% of the population? Assuming that there is some threshold of “unmet needs” that we’ll allow to go unmet, and it’s clear that there is, sacrificing 85% of the country to pat ourselves on the back about how we saved that 15-20% is suicidal. Lowering the availability and quality of health care (which is what will happen when the government increases demand by subsidizing it) doesn’t benefit the majority (if you care about that kind of thing), and it doesn’t even benefit the recipients of taxpayer largesse.

  11. Pingback: Who needs help with health insurance? - Economics -

  12. I choose option 6: The government covers nobody's health insurance. If someone is unable to purchase their own health insurance (which I believe everyone should buy as individuals — not receive as a "benefit" from an employer), then they are a charity case. There are charitable organizations to deal with this situation — assuming the government lets them. Instead of coercing everyone to pay for a system run by the government, why not encourage everyone to donate to the charity of their choosing. Get the government out of the way for charities to provide this service — including making changes to the tax law. Americans are extremely charitable — even when already being heavily taxed.

    • Why should the example of an uninsured tourist drive policy for 300 million citizens? Why don’t you regard it as irresponsible for your acquaintance to not have prepared for visiting the US by acquiring insurance coverage prior to arrival? When I travel abroad I do.

    • Why should we be liable for your European friend? Why did his insurance coverage / government system not pay for his care? How would you define 'basic care'? Such a naive comment highlights a key problem in rationally and economically achieving meaningful health care reform. An overabundance of ignorance. By the way– the very premise of the comment is false given existing laws and regulations for emergency rooms at non-profit hospitals. Finally, I suppose he could have pulled out his own wallet and paid for his care instead of expecting others to do so– since he was able to pay for a trip across the world. Does he value his health less than his ability to travel abroad?

  13. I think medical care is so expensive people should simply go without it.

    When I had insurance, I went to the emergency room because my business partner feared I had a heart problem. They did a whole bunch of tests and discovered I had low-intensity diabetes. These tests resulted in a bill for $8,500, which was negotiated down to $3,000 by my insurance company. This included absolutely nothing for my disease; it was just for tests and overnight lodging in a place that made Motel 6 look like the Four Seasons.

    If I had any idea how much this would cost, especially how little was done for so much money, I would have never even dreamed of visiting a hospital for any reason.

    In my 47 years on this planet, I have never had the health care system do anything for me but say "Here are some painkillers" or "you have to change your diet and exercise". I can get my mother to do that stuff for me for free.

    I don't have health insurance now and have no interest in getting it to feed this parasitic healthcare establishment.

    D

  14. The question is not how many are uninsured, but how to lower the costs of medical care for everyone. The fact is that if someone needs medical care, they will get it eventually, even if forced to go to an emergency room. Unless we make the policy decision to let people die on the sidewalks outside hospitals, we need to find out how to make the economics work. The system right now is too expensive.

  15. Great analysis ! Clear and fair IMO.

    The feds just insured another 4.1 million kids via S-chip for like $7.1 Billion per year. That works out to $1750 per kid.

    If we assume Obama takes that extra $63 Billion he wants to pay the premiums for let's use 15 million uninsured, that would be about $4,000 per person! I think that sounds like plenty of money per person? Right?

    Not that Obama or the feds will actually do that with the extra $63 Billion. Heh.

    • Here, here! It is so unfortunate that in this political climate of entitlement, our proposal is the "moral" equivalent of drowning orphans. Try again.

  16. (Part One)

    Great to see an informed Blogger. This is the second one I have seen this week that breaks down the real numbers. Thank you for posting this!
    Unfortunately we still see half the country pushing for "Universal Health Care". What has our government done, to convince people to hand over our very health freedoms for it to govern over?
    Katrina……..?
    Fannie Mae – bailout? (this is a government entity who's employee's receive bonuses!) What other government employee receives bonuses for doing their jobs?
    Social security – bankrupt ? (robbed for other expenditures)
    Medicaid – ? (robbed for other expenditures)
    $2 trillion Porkulus bill – ? (and growing)
    AIG – bail out, yet nobody knows where's the money gone? No committee of oversight in place (was promised by our representatives to be in place immediately)
    Gas prices – ?(50% of every dollar at the pump goes to Washington) But who did you point your finger at as the problem????
    Since our government "cannot" be sued, how will one be able to be recompensed for its malfeasance or neglect? How will the government, once it tells 300 million people "go see the doctor" we will pay all the bills, be able to control the consequences? By overwhelming our medical profession or break it, will come another grand government solution," we need more money to fix it"! You are already familiar and have accepted this excuse for too long, and know this to be their power solution. Our government has impoverished our families' financial freedom to pay our own way, by immoral taxation.

    Furthermore how has Government run health care worked in other countries? Let's get past the emotions and examine the facts. A common example used to further the cause of "socialized medicine" in the United States is to point out how well it is working in countries such as France and Canada. However, those living in Canada know full well that their government run health care program is most certainly not working. As a matter of fact, many Canadian citizens choose to hire high priced brokers to find them quality health care right here in the United States because of the terrible bureaucracy that controls all forms of health care in Canada.

    For more about what is really going on with the Canadian health care system please watch these short but very informative documentary videos:
    http://www.freemarketcure.com/brainsurgery.php http://www.freemarketcure.com/twowomen.php http://www.freemarketcure.com/thelemon.php http://www.youtube.com/watch?v=KiXT0P3edfs
    The number of actual uninsured's in the US has also been grossly inflated as well. For the real numbers: http://www.freemarketcure.com/uninsuredinamerica….
    http://www.youtube.com/watch?v=aE-I0ombIEY&eu

    (too be continued…in part two)

  17. continued from Part One….
    Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers and academics alike are beating the drum for a far larger government role in health care. Much of the public assumes their arguments are sound because the calls for change are so ubiquitous and the topic so complex. However, before turning to government as the solution, some unheralded facts about America's health care system should be considered, says Scott W. Atlas, a senior fellow at the Hoover Institution and a professor at the Stanford University Medical Center.

    Americans have better survival rates than Europeans for common cancers:

    * Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom.
    * Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway.
    * The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

    Americans have better access to treatment for chronic diseases than patients in other developed countries:

    * Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease.
    * By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them.

    Lower income Americans are in better health than comparable Canadians:

    * Twice as many American seniors with below-median incomes self-report "excellent" health compared to Canadian seniors (11.7 percent versus 5.8 percent).
    * Conversely, white Canadian young adults with below-median incomes are 20 percent more likely than lower income Americans to describe their health as "fair or poor."

    Americans spend less time waiting for care than patients in Canada and the United Kingdom:

    * Canadian and British patients wait about twice as long — sometimes more than a year — to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer.
    * All told, 827,429 people are waiting for some type of procedure in Canada.
    * In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.
    – Source: Scott W. Atlas, "10 Surprising Facts About American Health Care," National Center for Policy Analysis, Brief Analysis No. 649, 3/24/09 http://www.ncpa.org/sub/dpd/index.php?Article_ID=… (….concluded in Part 3)

  18. ….(continued from Part 2)

    Because of how the Single Payer System is designed Canadian citizens have NO WHERE NEAR the choices that we as American citizens do. As a matter of fact, until very recently (2005) it was simply not possible for a Canadian citizen to pay for their own health care or to purchase private medical insurance that would "bump them up the long waiting list" for medical treatments. The reason Canadian citizens now have the right to do so (and it is still limited) is a direct result of long hard battles (many that are still being fought) that have been waged by brave Canadian citizens like Dr. Jacques Chaoulli who took his clients case all the way to the Canadian supreme court and won! Dr. Chaoulli (http://www.healthcoalition.ca/chaoulli.html) and his patient, George Zeliotis, launched their legal challenge to the Canadian government's monopolized healthcare system after waiting more than a year for hip-replacement surgery.

    Canada's high court found for the plaintiffs and in doing so issued the following statement: "The evidence in this case shows that delays in the public healthcare system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public healthcare. The evidence also demonstrates that the prohibition against private health insurance and its consequence of denying people vital healthcare result in physical and psychological suffering that meets a threshold test of seriousness." Furthermore, Justice Marie Deschamps said, "Many patients on non-urgent waiting lists are in pain and cannot fully enjoy any real quality of life. The right to life and to personal inviolability is therefore affected by the waiting times."

    Furthermore, the Vancouver, British Columbia-based Fraser Institute which keeps track of Canadian waiting times for various medical procedures. According to the Fraser Institute's 14th annual edition of "Waiting Your Turn: Hospital Waiting Lists in Canada (2006)," total waiting time between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, rose from 17.7 weeks in 2003 to 17.9 weeks in 2006. Depending on which Canadian province you live in, a simple MRI requires a wait between 7 and 33 weeks! Orthopedic surgery could require a wait of 14 weeks for a referral from a general practitioner to the specialist and then another 24 weeks from the specialist to treatment! For even more real life horror stories about Canadian citizens left in the lurch by the Canadian healthcare system read the well researched and fact based Wall Street Journal article entitled "Too Old For Hip Surgery" here: http://online.wsj.com/article/SB12341370103266144… This is what happens when you put government in control of your health care decisions. Doing so in this country, would be nothing short of a train wreck. Anyone who thinks otherwise is simply uninformed or "willfully ignorant".

    Real healthcare reform can be accomplished through consumer education, weeding out abuse of existing Federal entitlement programs (via a legitimate needs assessment) and continued funding of State sponsored Risk Pools so that people who are declined for insurance have an affordable option to continue coverage if declined on the individual major medical market. Following these few simple steps will go a long way towards not only maintaining our current health care system, but also towards keeping the bulk of our nations risk where it belongs, namely with the private health insurance sector. In light of the recent multi Trillion Dollar "Bail Outs" and many other failing corporations coming to the table with their hats in their hands (and their private jets on the tarmac) the last thing our government should do is start cutting more blind "bail out" checks in an effort to "reform" the U.S. health care system.

    • Hilarious. Exactly what I'd expect to hear from somebody who doesn't really understand treatment advances. We need to realize that we are at a point of DECREASING MARGINAL RETURN for some healthcare treatments. The revolutionary new drug-eluting stent that may give you a .001% better chance at perfect outcome, but it triples your cost. Of course, everybody wants it… in fact, they are ENTITLED to it. No wonder costs increase- the largest driver of increasing costs is BY FAR technology.

    • I have an individual policy, and I gripe every year when the premium goes up – but the question of this article is, how many are we really insuring with the proposed $1.6T over ten years? If it's the full 45.7M, then the cost is $ 3500/year /person insured. This is comparable to what I'm paying now – not the great saving that is being advertised. Personally, I would not want my taxes to pay for any uninsured person who makes >300% of the poverty level, so $1.6T / 35.6M/10 years = $4494/year /person insured. Suddenly the single payer plan looks less enticing. And I'm not too keen on paying for non-citizens, so the number goes to 26.3M.
      Now the cost goes to $1.6T/26.3M/10 years = $6084/year /person insured. I won't even go into the error due to Medicaid under count.
      Keep in mind that these numbers assume that the govt's. estimates are accurate. Medicare is now costing 6 TIMES what was originally estimated. Like Glenn Beck says – it all boils down to trust. Do you trust the government to do anything efficiently?

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