Thursday, August 30, 2007

Uninsured Rates Creeping Up

Earlier this week, the U.S. Census Bureau released the latest statistics on income, poverty, and health insurance coverage (gathered in 2006). The message: more people had health insurance in 2005 than in 2006.

Although the poverty rate fell .3% from 2005 to 2006, the number of people without health care coverage increased .5% to 47 million in 2006. This may be due to a decline in employment-based health insurance, the type of coverage that most Americans have. The number of people receiving employment-based health insurance fell .5% from 2005 to 2006, while the number receiving government health insurance, such as Medicare and CHAMPVA, fell .3%.

Children and certain minorities are especially likely to be uninsured. The number of uninsured children increased 9%, from 8 million to 8.7 million, between 2005 and 2006. Among the entire population, Hispanics are most likely to be uninsured (34.1%), followed by American Indians/Alaska Natives (31.4%), Native Hawaiians/Other Pacific Islanders (21.7%) and African-Americans (20.5%).

Mark Twain famously wrote that "there are three kinds of lies: lies, damned lies, and statistics" (inaccurately attributing Disraeli as the source of the quote), so these statistics need some context. The Census Bureau notes, for example, that they surveyed previously unrepresented populations in 2006, including prison and college dorm residents, which could skew comparisons between 2005 and 2006 data.

Still, I think that children, the middle class, and the largest minority group in the country (Hispanics), among others, deserve some better health care options. A pediatric ER doctor told me recently that there is a tacit understanding between parents and ER physicians that the ER has, by necessity, replaced primary care for uninsured pediatric patients. These parents know that many of their visits are not medical emergencies, and the physicians understand that the parents have no other option for health care. That is what health care has become for many people: these silent bargains and unspoken apologies.