Wednesday, September 26, 2007

How big a problem is lack of health insurance?

Dick Morris has a question for Hillary Clinton:

You base your healthcare proposal on the need to cover 47 million "uninsured Americans." Since about a third of them are illegal immigrants and another third are eligible for Medicaid right now and just don't apply for it, aren't you overstating the problem?

His one-third figures seem a bit high to me, but he is right that 47 million substantially overestimates the magnitude of the problem. A serious estimate would take out both illegal immigrants and those who are eligible for Medicaid but have not applied. Those eligible for Medicaid can always enroll once they need significant medical care.

In addition, I would exclude those who were offered employer-provided health insurance but declined coverage, and those that are healthy and making more than, say, $50,000 a year. These two groups are choosing to roll the dice. According to estimates I have seen, they make up more than a quarter of the uninsured.*

What is the right figure for the number of Americans who do not have access to health insurance? I don't know, but it is much less than 47 million. If anyone knows of a reliable estimate, let me know.

* See the Economic Report of the President, 2004, page 197.