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Editors' Choice

health care costs © Creatas Images/JupiterImages Corporation

The Basics

Public health plan? 29% have one now

Health coverage is shifting: Public health coverage is growing, and fewer Americans are covered by employer-sponsored plans, new census figures show.

By MarketWatch

The slice of the U.S. health insurance pie consumed by people in government programs grew last year as more Americans received coverage from Medicare and Medicaid and fewer were covered by private insurance, according to a new report.

True tales from the emergency room

True tales from the emergency room

The number of people with public health coverage of all types, including the State Children's Health Insurance Program, or S-Chip, ballooned to 87.4 million from 83 million in 2007, according to the U.S. Census Bureau. Twenty-nine percent of people were covered by government programs.

"There's been an increase in the number with government health insurance every year since 1999," said Matt Brault, a statistician with the Census Bureau, noting that part of the rise may be attributable to population growth.

"In all of our debate over whether the government does things well or not, this shows the value of the government safety-net programs," said Dr. Georges Benjamin, executive director of the American Public Health Association. "They're there when you need them."

At the same time, there was continued erosion in employer- and union-sponsored health insurance, which saw their share of the pie decline to 58.5% in 2008 from 59.3%. About 1 million people lost job-based coverage, leaving the number at 176 million. In 2000, employer-sponsored insurance covered 64.2% of people, or 179.4 million Americans.

The number of people buying private insurance for themselves remained steady at 26.8 million last year, the same as it's been since 2000. (See "How to buy your own health insurance.")

The number of people who lack health coverage ticked up to 46.3 million in 2008 from 45.7 million the previous year. (See "A survival guide for the uninsured.")

But fewer children went without coverage last year due largely to expansions in Medicaid and S-Chip. In 2008, nearly 10% of children under age 18 were without health insurance, down from 11% in 2007. There were 7.3 million uninsured kids last year, the lowest number and rate since 1987.

The findings come at a pivotal time for national health-reform efforts. President Barack Obama described the perils of maintaining health insurance when he recast his bid for sweeping legislation in a prime-time address to Congress on Sept. 9. (Read more on the Obama speech.)

"We are the only advanced democracy on Earth -- the only wealthy nation -- that allows such hardships for millions of its people," Obama said. "There are now more than 30 million American citizens who cannot get coverage. In just a two-year period, one in every three Americans goes without health care coverage at some point. And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone."

Connection to employment

People who don't have health insurance are among the most talked about and least visible groups in the push to overhaul the nation's health care system, and their ranks grew last year. Because of the patchwork way coverage is structured until a person ages into Medicare eligibility, the prospect of being uninsured is a problem confined to the early and middle parts of life. Last year, 20% of adults under age 65 were uninsured compared with less than 2% of people over 65.

"Without the public safety net, the number for 2008 would've been considerably higher than what (the report) portrayed," said Ron Pollack, executive director of Families USA, a health-care advocacy group in Washington.

The present uninsured rate is likely significantly higher as a result of the recession's escalating job-loss toll this year, Pollack said. Most working-age Americans get health insurance through their jobs. As the unemployment rate ratchets up, more people lose coverage they can afford.

In 2008, the unemployment rate ranged from a low of 4.8% to a high of 7.2%, according to the Labor Department. In January of this year, the jobless rate was 7.6%. It continued to rise over the next seven months, hitting 9.7% in August, the highest level in 26 years.

"Our assumption is the number of people who are uninsured at this moment probably comes close to 50 million," Pollack said. "Past studies show that for each 1% increase in the unemployment rate, approximately 1.1 million people are added to the ranks of the uninsured."

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The overall percentage of uninsured Americans was statistically unchanged at 15.4% last year.

Some analysts say the census numbers understate the problem because survey participants are asked whether they had coverage during any part of the calendar year. If someone had health insurance for the first quarter but then was without it for the next nine months, for example, they wouldn't be counted as uninsured.

Continued: Bracing for sticker shock

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Thursday, September 24, 2009 9:26:24 PM
The Veterans Administration, Tri-care (military families), military hospitals, Indian Health Service (native americans) all have NUMEROUS problems with mismanagement, overspending and under funding, poor services, AND bureaucrats covering up their failures.  Medicare is a growing disaster, with HUGE multi-TRILLION-dollar deficits developing and rampant cases of fraud and abuse.  Medicaide programs in most states are even worse.  Most government-run health plans are a disaster.  The Democratic health plans include diverting $500 BILLION from the already drowning Medicare program to other new proposed health programs, and a $3,800 FINE to be imposed by the IRS every year for those that do not carry health insurance -- big brother digging into our lives even more.  This (typically biased) article does not address all of the various shortfalls of the Democratic proposals, and fails to address a number of the solutions proposed by the Republicans.
Friday, September 25, 2009 4:38:17 AM

I appreciate the numbers.  Obama was all over the other day, saying how terrible it was that insurance rates went up 5.5%, despite negative inflation.

 

I may invite him over to dinner and explain it to him. Job losses had a lot to do with that, but indirectly.

 

 As doctors and hospitals recoup their Medicare losses by charging more to the privately insured, there are now fewer privately insured to spread thos losses around.   Even without job losses, Medicare underpayments have long been a major factor in forcing insurance rates upward.

 

We also had several states where regulatory changes caused massive rate increases, like the growing debacle in Mass.

 

And, of course, an aging population.

 

On those three factors alone, 5.5% may be the very least each year.

 

If you think it's bad now, wait til you see rates skyrocket in the unlikely event Obamacare passes.

 

http://PoliticallyHomeless.net

For the New American Majority, anti-partisan independents.

 

 

 

 

 

 

 

 

 

 

Friday, September 25, 2009 4:46:18 AM

>>>>But there are plenty of other cost-saving proposals that have been put forth by Congress and the Obama administration.

 

Can you name just one?

 

I still recall when Democrats sabotaged HMOs, destroyed them totally as a viable competitor to insurance.  They said they were INCREASING competition!  These are the same folks who caused the subprime mortgage meltdown, so let's not hold our breaths.

 

PoliticallyHomeless.net

 

 

 

Friday, September 25, 2009 6:51:20 AM

I arrived at this point in the article:

 

"In all of our debate over whether the government does things well or not, this shows the value of the government safety-net programs," said Dr. Georges Benjamin, executive director of the American Public Health Association. "They're there when you need them."

 

And I couldn't read any further. That's nice that "they're there", but at what cost? Just because "they're there" doesn't mean they are a net benefit to society. After the Berlin Wall was built, any sane person could see that wasting all those resources building / defending a wall was a net negative to society....yet the Soviet Government decided to build it anyways.

 

Even the title of this article should be telling...29% of people are in a public program, all of which are going broke. The CBO expects these programs to be deeper in the red over the next few years than they are already. And we want to cover the rest of the population with the same type of programs? Is this actually market failure or interventionalist failure....

 

One thing about insurance is that whoever provides it must be financially sound so as to actually be able to make the payments... Does anyone think our government won't have to inflate and print a bunch of money to make the payments on any new publicly funded options or plans?

Friday, September 25, 2009 7:48:46 AM

The people who don't qualify for a gov't program but can't afford premiums are going up every month. My premiums are going up $150 a month Oct 1- renewal.  So, with well over 23% of our family (two income) GROSS going to health ins premiums with a $5K ded, I'm getting priced out of insurance. With dh's hours being cut and the threat of layoff, I really shouldn't be spending the money now, but I have two kids with asthma. It's not about personal respondsibility. It's about food on the table.

I need surgery, and since I'm almost met the deductible this year, I'm having it done as soon as possible. No time for alternatives, no time for second opinions. And there will be NO going to the doctor after the 1st of the year. New deductible, and I just don't have it.

The end of December I will go get my kids asthma meds renewed and get enough to get me through as long as possible.

As long as health insurance is a BIG PROFIT ONLY industry, nothing will change.

 

Friday, September 25, 2009 8:04:27 AM
A recent headline read "Americans lacking health insurance rose in '08". Could it be because so many Americans lost their jobs in '08? This is not rocket science! It amazes me that so many people fail to realize that we need to put America back to work in order to get out of this economic morass. The government publishes a statement that our unemployment rate is at 9.7% when in fact it is considerably higher than that. The government only counts those Americans currently collecting unemployment benefits. The problem with this is that once unemployment benefits are exhausted for an individual, he or she simply drops off the unemployment rolls regardless of whether or not they have found employment. Another group that is not counted is those who are self-employed but cannot find work. Those individuals are not eligible to collect unemployment benefits at all. There are also a number of people who for other reasons are ineligible to collect unemployment benefits or just do not know how to go about collecting unemployment benefits. Figures have been published by various entities placing the real unemployment rate at anywhere between 15% and 22%. What we do know is this: In order for our economy to begin growing again, people need to begin spending again. In order for people to begin spending again, they need to have discretionary income. In order for people to have discretionary income, they need to have permanent full time jobs. In order for people to have permanent full time jobs, those jobs need to exist. Now here is the sad part: We continue to lose far more permanent full time jobs every day than are being created. Sadder still, the current administration is focused elsewhere . . . on Cap and Trade, Healthcare, card check, buying-up banks, financial institutions, and Auto Companies, and actually doing just about anything but helping to create jobs. Rather than expend time, energy, and taxpayer dollars on these non-productive potential bills and issues, they should be promoting legislation that will help to create more jobs in America, keep more jobs in America, and bring jobs back to America. It certainly would not hurt to begin with promoting legislation that would help create a fair and equal balance of trade with reciprocal trade tariffs. Every day that the current administration focuses their time, energy, and taxpayer dollars elsewhere means that more American families lose their homes, face unnecessary hardships, watch their savings disappear, see their chance to attend college fall by the wayside, and possibly even see the family unit itself be destroyed. It would be sheer idiocy to believe that no one in our government recognizes this, so what will it take to get the current administration to focus on helping to create the jobs that America needs so badly? The American Taxpayer needs a champion and so far, there is none in sight!
Friday, September 25, 2009 8:04:53 AM

So far, the current administration has displayed their willingness to spend taxpayer dollars at a rate never before seen in the history of our country. It is projected that we will go from a deficit of almost 2 trillion dollars (which took us 233 years to reach) to almost 13 trillion dollars in less than 10 years. The positive results resulting from this insane level of spending have been so little as to be considered almost immeasurable. Every day, more jobs are being lost in our country than are being created. Every day, more American Taxpayers lose their homes to foreclosure. Every day more American families are destroyed as a direct result of financial hardship and the pressures it brings to bear. It is almost as if the current administration refuses to view the world through anything but rose-colored glasses. They steadfastly refuse to admit the most basic and logical economic truths. Spending your way into prosperity is just not possible . . . especially when most of that spending is for executive bonuses or entitlements. What this does, is to increase the deficit, increase the burden on taxpayers, increase our debt, increase our dependence on foreign powers, and decrease our independence. This is certainly a very slippery slope we are treading on here. The big question at this point is how much worse shape will we be in once the impact of the inflation resulting from the insane spending we are doing, hits . . . and it will. This inflationary effect will happen folks. It is only a question of when, not if. Some economists say that we could actually experience hyperinflation. Wouldn't we be better advised to stop this power-dive into an economic hell now, before it is too late!

Friday, September 25, 2009 8:05:15 AM

Once again, we see strong evidence that our elected officials are turning a blind-eye toward the poorest demographic segment of Americans . . . those living on Social Security. This administration is too busy putting plans in place that will cost all Americans more tax dollars every year, to help the average taxpaying American. Cap and Trade, Healthcare reform, Card-Check, Bank and Auto Company buyouts, and Stimulus will all result in every taxpaying American taking a harder hit come tax time. The well-known problems with Social Security and Medicare are being ignored. When LBJ moved Social Security monies (1968) from the lock-box type trust that FDR placed them in (1934), he knowingly made those monies accessible to every Congressional Representative, Senator, and President who could garner a vote to do so. Those individuals then began working overtime to do just that. They were only too happy to divert those monies contributed by taxpaying Americans for their retirement into projects near and dear to the hearts of every special interest group who contributed large sums of money to their respective election and re-election campaigns. This behind the scenes thievery has been going on for 41 years now and has drained what was a healthy trust fund down to near bankruptcy. Your elected representatives have knowingly placed their respective constituents in harm’s way to assure their own ride on the gravy train that American politics has become. Liaisons are built between our elected officials and special interest groups over time. As we keep re-electing these same officials (incumbents) the liaisons become stronger and stronger and favors owed to these same special interest groups continue to mount up. As those favors are repaid, our retirement funds are drained for purposes other than what they were meant for leaving us and our heirs high-and-dry. We can only put a stop to this corrupt practice by eliminating all incumbents at every election opportunity. Now here is the kicker . . . if you believe that your favorite political party was not involved in this fiscal slight-of-hand, you are sadly mistaken. Both major political parties have been guilty of this type of activity from day one! Our social security monies have paid for politically motivated wars (Viet Nam, Gulf-war I, Bosnia, Gulf War II. They have also paid for the foggy now-you-see-it now-you-don't magical surplus Clinton imagined he had found. Folks, we need to band together and clean our political house in Washington, D.C. before this band of thieves sell our country right out from under us. One more thing folks: These corrupt politicians neither contribute to nor collect from Social Security or Medicare. You see, they have a plan which, they voted in for themselves, that is fully paid for by the American Taxpayer and which any one of us would love to have because is it so superior to anything we have ever been offered. Isn’t it time we showed these crooks the door in a traditional bums-rush fashion?

Friday, September 25, 2009 8:33:50 AM

People paid into Medicare (Tax withholding) before they were eligible to use it.  People paid into Social Security before they were eligible to use it (Tax withholding).  People have health insurance from their companies in LIEU of higher salaries.  People who want to buy and can afford to buy their own health insurance, do so.  People who can afford it but would rather not spend their money on it, shouldn't have that right as long as they don't seek money from others if they need medical help.  Illegal immigrants should receive NO benefits and, if ill, be sent back to their own countries IMMEDIATELY.  Medicaid is the most abused system in history.  "Oh, I have a hang nail.  Get me an ambulance to go to the emergency room."  "Oh, my tooth hurts. Get me an ambulance". 

It's not health insurance that's the problem.  It's a society that has become soft and lazy.   And now we have a commie president who just loves the idea of controlling everything.  Interesting, Quadafi endorsed Obama before the UN.  That should be grounds enough for impeachment.  This country is getting worse by the minute.

Friday, September 25, 2009 8:41:47 AM
I personally know a person that is supposedly disabled, collects social security disability, has medicare and medicaid as a result, has a business and makes much more than is permitted, and goes to the ER several times a week because it doesn't cost anything.  She doesn't like her primary care physician - so get another one.  She doesn't have time!  People on medicaid should have to pay a large ER co-pay just like those of us with insurance.  Then they wouldn't go to the ER for non-emergencies.  The way I see it, she goes to the ER when she has a bad hair day.  This is a prime example of our tax dollars at work!!!
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