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What Obama 'left out' about the uninsured

Like Fred Hiatt, I noticed President Obama’s emotional reaction when Sen. John Barrasso (R-Wyo.) advocated health savings accounts and catastrophic coverage during the health-care summit.

The president essentially shot back that this might be good for well-heeled folks like Barrasso, but not for the uninsured, who are making “$40,000” and working two jobs and are “left out.” This, the president suggested, is the typical profile of the “vast majority” of the “30 million people that we’re talking about.”

Over the last year, Obama has offered three rationales for reform: cutting costs, curbing insurance industry “abuses” that undermine middle-class security, and insuring the uninsured. In his riposte to Barrasso, though, the old community organizer really seemed to be speaking from the heart. This was a case for health reform as social justice, and Obama made it with conviction.

Just one question: Does it correspond to the facts?

The actual number of nonelderly uninsured in America is harder to pin down than you might think. The Census Bureau puts out an estimate -- 45.7 million is the most recent -- but this may well overstate the policy challenge, in two ways.

First, the number includes 9.3 million non-citizens. Not all of them are undocumented aliens, but clearly a lot of them are. And neither the president’s proposal nor the House and Senate bills would make undocumented aliens eligible for subsidized coverage. They couldn’t pass if they did.

Second, the Census number fails to correct for the “Medicaid undercount” -- several million people who are actually covered by the federal government’s largest health program for the poor, but who don’t report that to the Census. It also includes some who are eligible for Medicaid but don’t enroll. Former Bush administration economist Keith Hennessey, drawing on calculations done by government experts when he was in office, puts the total of these two categories at 10.7 million

So, right there, we’ve got roughly 20 million people who are either a) presumptively ineligible for universal coverage because they’re in the country illegally, or b) already eligible for government aid under existing law.

That leaves 25.7 million people -- not 30 million, as the president said. Still, does this cohort match his description of the “left out?”

Hard to say. According to the White House, the president’s remark derives from a report by the influential Kaiser Commission on Medicaid and the Uninsured. The report estimates that “most of [the uninsured] come from working families and have low incomes,” noting that “two-thirds of the uninsured are poor or near-poor.”

Yet these statements do not appear to factor in either the Medicaid undercount or the heavy numbers of non-citizens (including undocumented aliens) among the uninsured. Non-citizens tend to be poorer than citizens.

Furthermore, young adults -- of all income levels -- are disproportionately represented among the uninsured. Hennessey estimated that 5 million of all uninsured U.S. citizens are childless adults ages 18 to 34. For these “young invincibles,” comprehensive first-dollar health insurance is not necessarily a good deal economically. In other words, it’s rational for them to be uninsured.

Another 10.1 million are individuals or families who make at least three times the federal poverty level, which is roughly the national median income, according to Hennessey.

So that leaves 10.6 million U.S. citizens with income below 300 percent of poverty, who are not on or eligible for a taxpayer-subsidized health insurance program and are not childless adults between age 18 and 34.

If anyone deserves government help, it would be this group of 10.6 million. But that is one-third, not “the vast majority,” of the 30 million figure President Obama used. And so the questions of social justice are more complicated than he let on.

This would be a more realistic summary: “We all agree that we’re going to leave out a huge segment of the uninsured because they are in this country illegally. Yes, they’re relatively poor. But, given their status, we as a country do not feel that we owe them this benefit.

“Now, we really do have a problem with about 10 or 11 million people who are working families of moderate means. What level of subsidy, if any, do they deserve, and what carrots and sticks do we have to offer others, if any, in the course of ensuring that these folks get coverage?

“In particular, should we make young invincibles buy a federally-regulated and subsidized package that probably covers much more than what they would have bought if left to their own devices -- and more than they actually need? Perhaps that will cross-subsidize older and sicker folks. But don’t forget that a lot of young adults will pay the penalty rather than sign up, and some of them may still buy insurance when and if they really do get sick, because insurance companies will have to take them.

“And is it right to subsidize first-dollar health insurance for people making at least the median national income, given that the resources devoted to them will not be available for other government purposes, including assistance to people who make less than the median?”

I don’t pretend to know the answers to these questions. But I do think they are more pertinent than sweeping generalizations about “the left out.”

By Charles Lane  | March 2, 2010; 4:43 PM ET
Categories:  Lane  | Tags:  Charles Lane  
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Comments

I guess I'm missing the writer's point. Is he saying that the President is overstating the health care problem?

In my opinion, he's understating it. We're leaving out the millions with basically what should be considered "catastophic" health care coverage. The kind that individuals only use for major health problems. With $2,000 and higher deductables, there is no preventive care and little care for serious, yet not life-threatening, illnesses.

Even if the writer's statistics are taken as true, I'm not sure what his point is. It merely scratches the surface of the problem.

Posted by: amaikovich | March 2, 2010 5:05 PM | Report abuse

Well said. It seems that there is an abundance of reason bubbling up lately -- many of the "Republican proposals" (HSAs, fee-for-quality instead of fee-for-service, pricing transparency) among them.

Why can't you, or any of the other people with the logical, sensible and -- importantly -- zero-cost plans be in power instead of Obama and the Democrats? Ach, and to think I voted for the president. Regrets, regrets.

Posted by: bstanman83 | March 2, 2010 5:09 PM | Report abuse

The obvious way to get the uninsured to pay for insurance is to introduce universal health country like every other civilized country in the world and have them pay for it with their taxes.

And is Lane really saying that one can wait to get insurance until he or she gets sick? There obviously must be something in the provisions of the pre-existing clause that requires past insurance or something like that. Otherwise the number who game the system will soar. Again universal health on the model of the rest of the world is the only real solution.

There are dozens of other difficult problems that just disappear with a civilized solution. For example, the question of whether gay (or heterosexual) unmarried partners get on each other's insurance is an utter non-problem in Canada.

What is so disgraceful about this country becoming civilized like the rest of the world? In every other country, the percentage of people who want to abolish universal care is the same as who want to abolish Medicare here. Our health system obviously means we do not have a democracy, but the Post cares only about democracy in Burma, Zimbabwe, and like countries

Posted by: jhough1 | March 2, 2010 5:22 PM | Report abuse

what no one seems to be considering is that every state has clinics that charge what you can afford, if you have no coverage. Hill-Burton and state programs mean that no one really HAS to go without care for routine health issues. These clinics are located primarily in lower-income areas, so transportation should not even be an issue. And of course, emergency rooms have to take everyone in case of an emergency. But getting people to go to clinics instead of emergency room INSTEAD is really a better answer, not having a new gov't entitlement that will surely cost more, unless you believe that the gov't that gives us $400 toilet seat covers can do health care for less. What no one wants to accept is that every health reform "answer" has a counterpoint. That is, if you allow people to buy insurance with pre-existing conditions, you allow them to wait until they have pre-existing conditions. If you force them to buy when they don't need it, they may, but they also are more likely to pay a fine. Unless the fine is onerous, it doesn't work. As long as we have a large country and the wish to have an "MRI or CT Scan around the corner" our health costs will be higher. And as one on Medicare, I can tell you it isn't free ($5300 per year for premiums including Medigap)after 45 years of paying medicare tax, and it doesn't even cover most of my medical expenses.

Posted by: weissler | March 2, 2010 5:24 PM | Report abuse

I would not worry about the possible 9.3 million illegal aliens. As word of the expanding social programs is getting out, many a getting into "pay for play" sham marriages with US citizens to legalize their presence in the US and become US citizans in the process. It is the gift that keeps on giving since once they legally become US citizens they can bring in the "real" family that they had left behind in their home countries (and of course the new entrants would soon be elgible to be US citizens).

We are soon going to have an explosion in population as a result of the social state that the US is on its way to becoming. A country where you have must work hard to advance is not as attractive as a country where you just stretch out your hand and everything is given to you. You do have one obligation, however, and that is to vote for the party who has made all this possible.

Posted by: strategiesinter | March 2, 2010 5:29 PM | Report abuse

It is interesting. I can find few people (democrat or republican) who like this Health plan. Nobody wants it, yet the government is determined to shove it down our throats. The public can't stop them. A 12 trillion deficit doesn't stop them. This country is in trouble. This bill is going to break us.

Posted by: kc14 | March 2, 2010 5:52 PM | Report abuse

If what the writer says is true then the cost will wind up being a lot cheaper than originally thought.

Posted by: JRM2 | March 2, 2010 5:53 PM | Report abuse

"his bill is going to break us.

Posted by: kc14 | March 2, 2010 5:52 PM | "
----
No it won't, but what will break us is letting insurance agencies raise their rates whenever they see fit.

39% for hundreds of thousands of Californian's alone just this year.

Posted by: JRM2 | March 2, 2010 5:57 PM | Report abuse

We could quibble about the number of uninsured. The author fails to account for the number of"insured" who have minimal, poor, and expensive coverage with high deductables. Our country has the most inefficient healthcare system in the world.

Posted by: paul444 | March 2, 2010 5:59 PM | Report abuse

Let's look at what is happening with 401K programs.

They are mainly for upper middle income people.

If you are earning $40,000 and have a spouse and 2 children, you do not have much money to put in your 401K.

The statistics show 50% or more people have less than $60,000 in a 401K. Not much "retirement income" from those 401 Ks.

However, when you look at higher income people there is a much larger amount in a 401K.

This would be the same problem for health care "savings plans." When you have limited income there just is not enough to Save!

Posted by: Robe2 | March 2, 2010 6:18 PM | Report abuse

As an MD in a small community I cannot believe the stats this guy is putting out. I also practiced in a community of 125,000 and in Detroit and St. Louis, and the people there did not fit the profile of this blogger at all. His stats may be publishered and he can name sources.
But I am reminded of a prof in Med school who has been important to me. *Statistics do not mean anything to the patient sitting on your exam table. If the chances are only one in a thousand and they have the problem they are one hundred per cent of a problem.

Posted by: sauerkraut | March 2, 2010 6:41 PM | Report abuse

Is it just me, or did the author double subtract the illegals and the Medicare undercount? He starts with 45, subtracts the best estimates of both to get to 25.7, (which is close enough to 30 for a rhetorical point) and starts over with the Kaiser Foundation report and brings up the undocumented as being poor and subtracts them again, as he does with the Medicare undercount, to get to 10 million or so.

fuzzy math.

Posted by: JoeT1 | March 2, 2010 6:43 PM | Report abuse

Help me out here...a family member is a 25 yr old musician. He's considered "self-employed". He barely makes enough to eat and pay rent. Of course he doesn't make enough money to have health insurace. As I understand it, if the bill passes, he'll HAVE to buy insurance, (again,HE DOESN'T MAKE ENOUGH MONEY to pay for it), or else he'll be FINED by the government? Does this make sense?

Posted by: scmonty1 | March 2, 2010 6:45 PM | Report abuse

I would say two things. One is that HSA's are a sham. They are part of this phony baloney idea of "ownership" that republicons use as a ruse to be as stingy as possible to working people while making sure insuance companies are protected along with their massive unconsionable profits and bonuses.

Two, despite the silliness of this method of providing a minor benefit, Presidnet Obama sad today he is going to include expanded use of HSA's as a compromise with republicons from the summit meeting.

So this author is upset about nothing. Like all the other gop complaints about the health care legislation this is all bluster and no substance.

Posted by: John1263 | March 2, 2010 6:46 PM | Report abuse

The author subtracted the same group twice. Then, subtracted from that total the 10 million uninsured young adults that he admits Obama included because, in his determination, being insured is irrational for them. So, the leaders of tomorrow have no health insurance - nor do they need it - today?

Posted by: Luvleelox | March 2, 2010 6:50 PM | Report abuse

My son graduated college 2 years ago. He has no job and no insurance. Is this writer saying he doesn't need it. Because if he is why doesn't he drop his insurance that the washington post is most of. He shouldn't need it either.

Posted by: danklemann1 | March 2, 2010 6:58 PM | Report abuse

Most people, including the author, are missing the point. #1. A major reason that U.S. industry has a higher production cost is company health insurance costs (think Japan vs. U.S.). Blaming this on unions is ludicrous! Other countries have national health insurance, and their industries are quite competitive. If the critics are correct about the cost of national health insurance, then these countries should be less competitive. It seems many critics of national health insurance can't reconcile their philosphy with the success of national health insurance in making the industries of Japan and Germany (to name but two countries) quite internationally competitive. #2. Without eliminating the "pre-existing condition" problem, everything is for naught. Insurance executives in California have admitted that this disqualifer is "immoral." But they will keep it because their competitors have it. Eliminate it for all companies, and everyone is on an equal footing. #3. Wouldn't it be nice to buy life insurance after you die (or are close to death). Sounds crazy? But that's basically what people who complain about mandatory health insurance are asking for! If the overwhelming majority of the country had health insurance, and you choose not to have it, then your costs would/should be exorbitant. I pay $5 for three bottles of Nasaril. The cost without a health plan is $60 per bottle! You do the numbers on more complicated medical costs. And are we going to refuse medical care to people who claim to not need health insurance, when their unconscious body appears in a hospital emergency room after an auto accident. How amny of them are wearing a DNR (do not resusitate)bracelet. They'll be the first ones to want free medical care!

Posted by: kenarmy | March 2, 2010 7:02 PM | Report abuse

I question the numbers of uninsured because of the methodology used. They are a snapshot at a specific point in time. Maybe last week I left my job (for whatever reason) to start another which begins next week. So last week and next week I have health insurance; this week I have none.

The number of uninsured is a moving target so the number of chronically uninsured is even smaller than 10 million. And for those few million we need to radically change the whole system? There are simpler, faster and more effective ways of attacking the problem but none of the proposals in Congress is it.

Posted by: MrBethesda | March 2, 2010 7:03 PM | Report abuse

This article is considerable ado about nothing. As if Republicans never give "sweeping generalizations." His math is fuzzy too, as many of the 9.3 million supposed non-citizens he acknowledges are legal residents, but Lane includes them anyway in his twenty million who do not need or will quality for health care benefits with the Obama/Reid/Pelosi health care plan.

Posted by: Aprogressiveindependent | March 2, 2010 7:10 PM | Report abuse

President Obama has got to Stop catering to the GOP Ideas, Knowing they'll Still Vote [No] Even if it Included 99.9% of what they Want Added to Health Care Reform.

___________________


President Obama likes the idea from Sen. Tom Coburn (R-OK), who's also a doctor, to fight fraud by using medical professionals "to conduct random undercover investigations" on payments by Medicare and Medicaid.

Obama would also add $50 million in grants for dealing with medical malpractice. And the president says he would ask for the money to be appropriated, rather than simply authorized. In other words, it would be guaranteed rather than merely suggested.

President Obama also says he wants to make sure doctors are paid enough to take care of Medicaid patients, addressing a concern raised by Sen. Charles Grassley (R-IA). An expansion of Medicaid, one part of the proposed overhaul, could lead doctors to refuse to accept more Medicaid patients because payments are so low. Obama wrote, "I'm open to exploring ways to address this issue in a fiscally responsible manner."

Finally, in a promise likely to anger some Democrats, the president said he was open to a suggestion from Wyoming Republican Sen. John Barrasso, another doctor, that would let people buy high-deductible plans in combination with health savings accounts on the proposed insurance exchanges.

Obama's peacemaking only went so far, though. He didn't yield on the Republicans' principal demands, such as starting over with a new bill and taking on health overhaul a step at a time. "Piecemeal reform is not the best way to effectively reduce premiums, end the exclusion of people with preexisting conditions or offer Americans the security of knowing that they will never lose coverage, even if they lose or change jobs," he wrote.

Posted by: omaarsblade | March 2, 2010 7:13 PM | Report abuse

Thanks for posting the break out of the composition of the 45 million. I've always been curious as to the make up. While there are many items to be addressed in any HCR measure, the continued use of 45 million (or even 30 million) certainly overstates the problem. It will be interesting how the bill handles potential "gaming" of the system as an earlier poster mentioned. Lot of details to work out if HCR is truly (if it even passes) going to work.

Posted by: notamullethead | March 2, 2010 7:30 PM | Report abuse

It is ridiculous to talk about the number of uninsured. It is also ridiculous to talk markets or competition with respect to health care. Health care will never behave like a market. The consumer of medical services is by definition uninformed which is why they are seeing a doctor. How can you have a market when the purchaser is uninformed and does not pay for the services they consume. If people were not being hurt it would be funny.

I have noticed that neither the republicans (of which I am a member of) nor the democrats have actually focused on cost. With out cost control, not only will there be no extra coverage for the poor, there will be less and less coverage for the middle class. The bottom line is Doctors, Hospitals, Insurance Companies, and Drug Companies are driving cost for their own gain. They are having no problem getting favorable legislation through our congress and appear to be succeeding in keeping the kind of debate that could actually create progress out of congress.

Our "retail" democracy provides too much political access for existing interests which stifles meaningful and beneficial change.

Posted by: LAterrapin | March 2, 2010 7:37 PM | Report abuse

Aside from the simple fact that national health care is the right thing to do we need to decide if we want to join counries like Canada, The United Kingdom (England, Scotland, etc.), Ireland, The Netherlands Fance, Germany or do we want to stay with the Ivory Coast, The Congo, Botswana, etc. and not provide our citizens with basic human rights.
The USA does have the best health care in the world, if you can afford it.

Posted by: kimmsr | March 2, 2010 8:04 PM | Report abuse

Here's the real question: Are there people who do not have healthcare insurance in America?....ABSOLUTELY! That fact can't be spun away by talking points and manufactured data courtesy of the insurance lobbyists.

Posted by: TruthHurts2 | March 2, 2010 8:11 PM | Report abuse

Deciding that the young and healthyshould avoid health insurance because it doesn't make economic semse is a nice republican farce.

It doesn't make sense for a single yopung person to carry personal health insurance, ONLY because it is so hideously expensive at any age. NOT carrying it, though, under the current system means that the first time he gets sick he may NEVER again have a chance to buy into a plan. (Pre-existing conditions)

Just one word of warning, though, to you all americans who speak for those of us who think health Care is an obligation of both individuals, to have it, and society, to provide it:

When you cget your way with this latest tantrum, we start over all right, and vote ANY candidate who doesn't fully back single payer out of office. There is actuaslly a majority of us, and we can do it. AND, we vote your Republicans totally out of the way.

75% of Americans think we need some kind of health care for all system. That has been the number for years. Less than one American in three agrees with the Republican Party on health care, and those numbers can be made to stand up on election day.

Keep gloating, because you are headed off into the nether world of marginal parties, like the Communists, and the Know Nothings.

Posted by: ceflynline | March 2, 2010 8:14 PM | Report abuse

What is so disgraceful about this country becoming civilized like the rest of the world? In every other country, the percentage of people who want to abolish universal care is the same as who want to abolish Medicare here. Our health system obviously means we do not have a democracy, but the Post cares only about democracy in Burma, Zimbabwe, and like countries"

Your right buddy, we don't have a democracy, we live in a Republic. You are exactly what is wrong with our Country!

Posted by: SiIvfm | March 2, 2010 8:18 PM | Report abuse

And the kicker is, those young healthy people that are forced to buy insurance will have no real assurance that the program instituted will still be around in 40 years when they really need it.

Posted by: Georgetowner1 | March 2, 2010 8:25 PM | Report abuse

One must remember the person who keeps quoting this number is the very same person whose minions reported fake jobs in fake congressional districts with real stimulus money.

Obama's tirade is all about cooking the books and making outrageous claims.

Only the gullible or completely cynical believes this man without a fact checker present.

The simple truth is most Americans do not want this health care plan. That's why Obama has to falsify his claims.

Posted by: krankyman | March 2, 2010 8:29 PM | Report abuse

Several good points brought up in this article. Better understanding of the size of the problem will lead to better policy and if the number of uninsured is actually as small as stated in the article, the overall bill goes down as well. I don't know how long it would take to get the right number of eligible uninsured, but it does seem like it would be worth the effort to get a handle on that number.

Posted by: rmarmstr | March 2, 2010 8:50 PM | Report abuse

I know plenty of people who could afford health insurance, but choose not to be covered because they're spending their money on other things, like...

Weed: $150/week
Two packs of cigs a day: $70/ week
Case of beer every day: $100/week

Altogether, over 16K/ year. And now, we'll be asked to subsidize their unfortunate lifestyle choices.

Posted by: Regis09 | March 2, 2010 9:16 PM | Report abuse

Frankly, when I was 25, and my Federal COBRA (Temporary Continuation of Coverage, TCC) ran out, neither I nor my parents knew where to turn.

My dad knew where not to turn: high deductible low coverage health insurance with wide exclusions. In response to my question about health insurance, he said not to waste money on a plan with a $10,000 deductible. Compared to the Federal BCBS we or the Mail Handlers' I was used to, it was a swindle, not insurance.

When I did develop a rarely fatal form of cancer roughly six months after dad died (of a more fatal form of cancer), I found out how elusive WV Medicaid could be. I wanted my hearing date and I was ready to make a presentation. I did not even get my hearing date which was my right. Maybe Medicaid was damned if it was going to coddle some Master of Arts (more educated than the average Medicaid population nearly by a factor of two).

Medicaid missed the party in which $12K of bills were racked up in a matter of weeks (cancer surgery, radiation). Fortunately, both hospitals and a doctor were in a forgiving mood. The rest were in a patient mood to be repaid some $3K or $4K, and that took a little over two years.

It is not as simple as you are lead to believe, that young people deliberately skip insurance (I did not, I carried insurance when I could find it, I carried some in my last year of graduate school) or that Medicaid will take care of you (it might not).

And when I was a Federal employee later, and had the opportunity for TCC again, I jumped at the chance. It carried me over to the salaried job I have held for 10 1/2 years.

I recommend as a compromise on public option maybe letting the public unconditionally buy into Federal employee-grade health insurance, either with or without subsidy. Those are decently priced plans with decent deductibles and coverage.

And let high deductible health insurance rot from abandonment.

Posted by: cmarshdtihqcom | March 2, 2010 9:18 PM | Report abuse

Propaganda. That's the point to which this healthcare debate has been dissolved.
Propaganda. Support my side, and surely you will win. Support their side, and surely you will lose.
Propaganda. The enrichment of legislators by lobbyists, and the nightmare of those not so inured.
Propaganda.
Instead of reforming consumers, let's reform insurers, instead.
It's a novel thought in this healthcare debate.

Posted by: mtpeaks | March 2, 2010 9:19 PM | Report abuse

Correction: Testicular cancer is rarely fatal when detected and treated. I was warned that it was fatal within a year if untreated (could spread to other organs).

Multiple myleoma got out of control within 3 to 5 years and in dad's case he finally decided on hospice to die comfortably.


Posted by: cmarshdtihqcom | March 2, 2010 9:25 PM | Report abuse

"his bill is going to break us.

Posted by: kc14 | March 2, 2010 5:52 PM | "
----
No it won't, but what will break us is letting insurance agencies raise their rates whenever they see fit.

39% for hundreds of thousands of Californian's alone just this year.

*********
I'm not sure whether the bill will "break us" or not. The CBO hasn't scored it, because there aren't enough specifics to be able to render a judgment on it. But folks like yourself--who I believe are genuinely well-intentioned--might give some thought to what that 39% premium increase means. As Anthem/California explained (but not many people have bothered to hear) people are dropping their coverage because of the bad economy. The ones who are holding on to their coverage for dear life are the really sick ones, going without other things to keep paying premiums. That raises the cost pool. How, exactly, is an insurance company to pay out on claims when the pool is shrinking, and the members of the pool who are left are costing the system even more? It's at least a legitimate question.

Posted by: SavingGrace | March 2, 2010 9:42 PM | Report abuse

There's some meat in this Charles Lane post, as you'd expect from a Washington Post editor. I think, though, that Mr. Lane's main argument rests on a fallacy.

First the meat.

"Over the last year, Obama has offered three rationales for reform: cutting costs, curbing insurance industry “abuses” that undermine middle-class security, and insuring the uninsured."

That's an excellent, remarkably concise (26 word) summary of the wide ranging rationales the president has offered for his policy. Further, he may be right in suggesting that the president overstates by a factor of two the number of involuntarily uninsured who have children, hold down jobs, and are citizens.

Here's where his argument goes off the rails:

"This was a case for health reform as social justice, and Obama made it with conviction.

"Just one question: Does it correspond to the facts?"

What counts as justice to any given person is a matter of values, and the relationship of "facts" to acts of valuation is complex.

Suppose for a moment that I know every fact. Before I can help you solve a question about values you must tell me what you want most.

If what you want is to save the most possible lives, I can give you facts that will help you decide what to do.

If what you want is to reduce taxation as much as possible for as many people as possible, I can give you facts that will help you decide what to do.

Facts will be of no use, though, in helping you decide whether you prefer saving lives to reducing taxes. That is an act of valuation that you must make before it's possible for facts to be useful in evaluating possible courses of action.

President Obama has made this a very confused argument by most often suggesting that the main reason we should insure a single mother who works 60 hours a week for $8 per hour with no health insurance is because it will help us balance the budget and hold down taxes in the future.

I'd suggest that even one such American citizen - and there are at least tens of millions - is an injustice that cries out for remediation.


Posted by: douglaslbarber | March 2, 2010 9:45 PM | Report abuse

I think the writer is using the same calculator John Ashcroft used when he said the Iraq war would only cost us 20 billion. Here we are two trillion dollars later and still counting.

Posted by: rodneythecat | March 2, 2010 9:54 PM | Report abuse

Charles,
I suggest you play reporter and make a few phone calls, or better yet, invest 2-4 hours in the field. Go to an HR manager who is hiring people and ask to follow up with job candidates. You'll be shocked who doesn't have insurance these days.

I'm co-founder of a startup in medical device space. As I interview prospective employees I meet a lot of people who are excited to work in medical space because they assume we'll have great health benefits. Of course, many of our positions require advanced degrees in life sciences, but many require tech skills, software, electronics, documentation, etc. common here in Silicon Valley.

I tell prospects in all candor that we'll have fewer than 25 employees for some time, so that our coverage is a lot more expensive and won't match a big company for a couple years.

I've had several people with families admit they'd like to leave their big company, but can't take the risk of losing good insurance, even though our work would be more meaningful.

We also have operations, including R&D, in Europe, and health package question NEVER COMES UP! In short the Europeans are out-competing us for experienced people with families.

US IS BECOMING LESS COMPETITIVE BECAUSE WE DON'T HAVE GOOD NATIONAL HEALTH PROGRAM

Neighbors in real estate mortgage business here in California tell me that people are having to choose between paying mortgage or paying rising health care rates. Many are "electing" to drop health insurance. I'm certain these people are not reflected in the published stats.

Additionally, Anthem Blue Cross of California is raising rates specifically because, "In a bad economy, the people most likely to cancel their health insurance are healthy people." I'm certain that some of those people are my prospective employees who were laid off from their tech jobs 6-24 months ago.

I assert that Single Payer with everyone paying into the system is both the cheapest, but also the most cost effective solution for the US.

Posted by: boscobobb | March 2, 2010 10:04 PM | Report abuse

You lost me when you started pandering to the non-documented aliens issue.

I have cancer. I've been in the workforce for over thirty years, all of them paying insurance premiums. Rarely have I been ill.

Thirty days after cancer diagnosis I received a letter from my insurance company canceling my coverage. I have no legal right to appeal in this matter.

When I pose this issue, Republican posters on this forum have strongly suggested they want me to die.

How can I support Republican fear mongering, if they want me to die?

Why does a convicted killer on death row have more appeal rights than me?

It seems Republicans are more supportive of death row killers than working people.

Posted by: colonelpanic | March 2, 2010 10:12 PM | Report abuse

boy I must have been living in a bubble since i delivered the wash. post years ago we're talking nixon years, what I want to know is what republican't bought or has control over what I have been reading why is it so important that we know the president smoking habits?Now I can see if he was sneeking out the west portico and fireing a doobie now and then and even then we dont need to know about it .it's not that important. I agree wholeheartedly with cdbind and moore40 and I will be watching because I think the wash post has been taken over. who knows maybe by aliens

Posted by: denhobbs | March 2, 2010 10:13 PM | Report abuse

Oh, so the number of uninsured might be 25 million and not 30 million? Well, whats the big deal? 25 million, who cares? (Jerk)

Posted by: rkerg | March 2, 2010 10:14 PM | Report abuse

The authors math is overcooked & inaccurate.

That aside, this debate is all about protecting the profits of the few at the expense of the many. That's where the rubber hits the road, and everything else is smoke and lies from the GOP corporate government representatives.

Posted by: Nymous | March 2, 2010 10:26 PM | Report abuse

It is a fact that our health system - "the greatest health system in the world" results in an infant death rate about 40th of all nations in the world. In other words, there are about 40 countries, more or less, depending on whose numbers you use, where a baby born today is more likely to survive the first few weeks than a baby born this very day in this great - greatest of all- nations.

For reasons that elude me, the "conservatives" are proud of this. It proves that we believe in "freedom."

Oh, and by the way, they believe that every egg that is fertilized has a right to be born. Just not to live past 10 days.

Go figure.

Posted by: pgr31 | March 2, 2010 11:02 PM | Report abuse

It is a fact that our health system - "the greatest health system in the world" results in an infant death rate about 40th of all nations in the world. In other words, there are about 40 countries, more or less, depending on whose numbers you use, where a baby born today is more likely to survive the first few weeks than a baby born this very day in this great - greatest of all- nations.

For reasons that elude me, the "conservatives" are proud of this. It proves that we believe in "freedom."

Oh, and by the way, they believe that every egg that is fertilized has a right to be born. Just not to live past 10 days.

Go figure.

Posted by: pgr31 | March 2, 2010 11:05 PM | Report abuse

Really desperate to prove the prez wrong aren't you. After all, you are the one that admonished Ezra for saying that people who don't want healthcare will be responsible for 47,000 deaths each yr. Now get busy and figure out how your going to disprove they really die. Then you can write a snotty column about that.

Posted by: carolerae48 | March 2, 2010 11:07 PM | Report abuse

Let's look at what is happening with 401K programs.

They are mainly for upper middle income people.

If you are earning $40,000 and have a spouse and 2 children, you do not have much money to put in your 401K.

The statistics show 50% or more people have less than $60,000 in a 401K. Not much "retirement income" from those 401 Ks.

However, when you look at higher income people there is a much larger amount in a 401K.

This would be the same problem for health care "savings plans." When you have limited income there just is not enough to Save!
))))))))))))0000000000000000)))))))))))))

Another person that does not know the facts. If you invest in a 401K, the take home pay is about the same as if you did not invest. With the taxes that the govt takes out of the paycheck, it almost equals the amount that you put into a saving program. The taxes are not collected until you retire and start drawing out. Check it out and then write your comment. Get the facts before you show your intellect or lack there of

Posted by: dy19spider57 | March 2, 2010 11:21 PM | Report abuse

Gee, if there are so few uninsured, it won't cost nearly as much as estimated to cover them, right? So Obama could easily claim, using Lane's figures, that the bill will cost 1/3rd to 1/2 of what the CBO says.

What Lane leaves out is that those most likely to be underinsured (or not insured) are those with pre-existing conditions (aside from the young). There are close to a million "medical" bankruptcies per year, which is extreme underinsurance. We can estimate the number uninsured from this, so, there are
probably 50-60 million in this category. They live a life of hell--always having to decide whether to fill medication or pay the rent.

Lane also leaves out estimates of 20,000 deaths a year from lack of insurance. That means (of the 20 million non-young Lane estimates), a death rate of 1 in a 1,000. Per year.

It charming that Lane actually tries to make some calculations--he just needs to include the total costs of our current health environment, not just one of the costs. When he does that, he can be taken seriously, rather than as the right-wing hack (and the WaPo is full of them) he is writing as.

Posted by: garbage1 | March 2, 2010 11:30 PM | Report abuse

It is interesting. I can find few people (democrat or republican) who like this Health plan. Nobody wants it, yet the government is determined to shove it down our throats. The public can't stop them. A 12 trillion deficit doesn't stop them. This country is in trouble. This bill is going to break us.
************

the best we can do is vote out democrats of congress in '10, have republicans not fund any of these new vast bureaucracies, and then vote out obama in '12 so republicans have the veto pen and they can sign into law a repeal of these destructive and reality-denying health bill.

the next 3 years need to be about wiping out any trace of obama-pelosi's disastrous policies in our federal law.

Posted by: dummypants | March 2, 2010 11:53 PM | Report abuse

and what the hell is social justice? any president who believes in that irrational crap needs to go be a state legislator in chicago.

Posted by: dummypants | March 2, 2010 11:55 PM | Report abuse

The single largest problem with our health care system is that it is driven by private insurance companies. Insurance is a percentage business. Increasing profits is most easily done by increasing the size of the pie rather than increasing one's share of that pie. Hence insurance companies drive costs up. Sure tactically they'll try and screw their customers for every dime. But strategically they benefit from higher health care costs, which create higher premiums in the long run. Our current health care system is the result of many decades of this.

The current health care proposals do nothing to prevent this. In fact they simply increase the size of the pie even more, while blithely assuming that future politicians will do what past (and of course current) politicians have been unable or unwilling to do, which is to force cuts in health care costs. The current proposal will cost money while draining the energy needed to truly reform the system. No wonder Big Pharma, the insurance companies and the medical professional lobbies and AARP are for it.

Posted by: robert17 | March 3, 2010 12:13 AM | Report abuse

"Does it correspond to the facts?" asks Mr. Lane and then proceeds to present no facts, rather "estimates,""maybe's," "may well,""clearly," etc., etc. WHERE are the FACTS?

Republicans moan about our industries "failure to compete" because of health care costs. You would think that fact alone would be reason enough for them to want universal health care, but rather then provide an answer to reduce the costs and take that cost out of the picture in competition, they simply decide that people should go without health care. This is the party that claims to have a monopoly on being "Christian," waving their flags for "God and country," and because of their pride, hatred and bigotry will do anything, including harming their own citizens to get rid of someone or cause them to fail. It is beyond the pale. And when it comes to illegal's, there was someone else not too long ago in history that blamed a group of people for all of their problems - you know that guy who had the final solution??!! If it weren't for the greedy already wealthy people in this country who give illegal aliens jobs (and go forever unpunished for this crime) they would not come here to make their lives better (just as OUR ANCESTORS did).

The reality is that contrary to what Republicans say, we do NOT have the best health care in the world. We rank 38th in quality of care. What is beyond my comprehension is how anyone that can get up and lie the way these people do, telling out and out bald face lies, can still look at themselves in the mirror every morning.

"To feel sorry for the needy is not the mark of a Christian - to help them is." (Fred Clark)
"In as much as you have done it (or not) to the least of these my brethren, you have (or not) done it unto me." (The Christian New Testament)

Posted by: Nana38 | March 3, 2010 12:15 AM | Report abuse

When any of the 20 million human beings you just eliminated from your analysis get sick Where do they go? - The Emergency Room! and who pays? WE DO the Insured! Adding on average $1000 per year to our annual bill. Takes my breath away how someone tosses aside 20 million people

Posted by: dlb086 | March 3, 2010 12:17 AM | Report abuse

Your arithmetic is wrong, and I find your dismissal of millions of lives offensive. You also fail to acknowledge rising costs as well as the million or so individuals that are added to the uninsured each year. These individuals either join the ranks of Medicaid as you suggest or they rely on the emergency room for care. Either way, we're paying a lot more for this random and inefficient system of health care for the uninsured than we would in the system that the president and democrats have proposed. Furthermore, if in fact you are correct and there are fewer uninsured individuals than the President suggests that just means they will spend LESS money than is projected. In your rush to feed the anti-obama monster, you didn't follow your own thought to conclusion and realize you're undercutting your own point.

Posted by: onifadee | March 3, 2010 12:42 AM | Report abuse

Somebody please tell who all these f'ers are who are getting FREE medical care in the E.R. If they are American citizens...they walk out with a paid bill, an insurance claim, OR they have given the hospital everything - including their SSNs - and will now PAY or get judgments. They won't be able to sell their house or automobiles until the liens are paid off.

So who the h.ll is NOT paying? ILLEGAL ALIENS...THAT's who. And they are NOT paying legally. That's right...we have special MEDICAID PROGRAMS and funding set up for them...and they have been coming across our borders and accessing our medical services for frickin decades.

ENOUGH ALREADY. WE NEED OUR GOVERNMENT TO RESPOND TO THIS CRISES...WHICH HAS HELPED BRING US TO A CRISIS POINT.

Posted by: easttxisfreaky | March 3, 2010 12:44 AM | Report abuse

The attitude of commenters (and perhaps Mr. Lane) is awful.

You'd be crying bloody murder if your lettuce, celery and carrots cost $5/lb, and the only reason they don't cost that much is because migrant workers harvest them. (Well, perhaps you don't eat your vegetables, who knows?)

So you want your vegetables cheap, *and* you want to be *assured* that the person who harvested them *can not* get medical attention if he's stricken while plucking your veggies under the hot sun for whatever wage he makes.

You people are sick.

Posted by: douglaslbarber | March 3, 2010 2:03 AM | Report abuse

The number of USA citizens who are totally uninsured is 30-40 million (by all respectable sources).
The number of people who are "under-insured" (who would go bankrupt if they get seriously ill) is even more colossal: more than 80% of USA adults by our estimate.
There are also several million of household that are broke because they PAID for health insurance: without that unbearable cost they would be able to pay mortgage and all.
The author of this article belongs to the aristocratic elite that now rules the USA republic: they are the tiny minority that does not need health insurance. In fact, they have de facto created an absolutist monarchy precisely by blowing health costs out of proportion for their subjects.

Posted by: pier0 | March 3, 2010 2:16 AM | Report abuse

Thank you for allowing me to analyze this college freshman level essay.
Can one of your editors elicit higher quality columns from Lane.

Posted by: josephakocon | March 3, 2010 2:24 AM | Report abuse

Good article.
Fundamentally the main issue for Health Care is to focus on the high cost of insurance. It needs to include how to fix MediCare.

MediCare has been a problem for 30yrs and is long long overdue. Coverage for Medicare s/b at 100%, not the current 80% level. The need to have additional insurance for the 20% portion is mainly why most seniors have Medicare Advantage. Getting stuck with 20% of the medical bill will bankrupt most seniors. Not only do seniors pay MediCare premiums, they also pay additional premiums for the Advantage program.

Yet, Medicare Advantage policies are rising just as fast as regular individual policies. Here in Central Oregon, they've skyrocketed 48% this year alone. The sad fact is many Doctor's will not take seniors on Medicare only. You need the Advantage insurance, as many Doctor's would go broke on what MediCare reimburses. Yet this is the vary program that the Dummycrats want to eliminate to fund a massive health care entitlement for 30 million uninsured.

Yes, I'm for helping the uninsured that truly need help, and this article indicates that may be only 10 million. The sad fact is the current health care bill is full of half truths. Yes, there's allot we need from this bill, but it's loaded with a lot of costly unnecessary crap.

Finally, not including Tort reform and equalizing Medicare reimbursements across all states is a big big mistake.

Posted by: tdpss1 | March 3, 2010 2:38 AM | Report abuse

Of course this information went right over the head of the community organizer. Sure was alot easier to vote "PRESENT", eh Obama?

Posted by: cschotta1 | March 3, 2010 2:55 AM | Report abuse

GIve Hennessey a bit more time and he'll find a way to factor out all the uninsured and then there'll be no more problem! 43 wasn't so stupid after all—he hired Hennessey!

Posted by: rarignac | March 3, 2010 4:10 AM | Report abuse

I am one of the lucky ones. My government agency contributes approximately 67% towards the total cost of my health insurance premiums. Anually, I contrubute $5000, with the government contrubuting $10,200. I have an autistic child, which adds out of pocket expenses for co-pays, prescriptions, and paying for what insurance does not cover, of $5200 per year.

Again, I am one of the lucky ones. How can a family with a 40k per year income, and no employer supplements, afford those costs?

Those of you who have employer supplemented health insurance, and don't believe in reforming the health care system; if you lose your job, you will be begging the government for an affordable insurance option.

Posted by: ginabw | March 3, 2010 4:27 AM | Report abuse

What Lane has done is matter of factly lay out the numbers on how we a society began to describe the "uninsured" problem. What many on the left appear to object to is the impression the number is low, as Lane and many others have noted. What this, and the rabid remarks of Barry, Harry and Nancy have lead me to believe is that they are pursuing this socialistic cause to solidify a heavily Democratic leaning bureaucracy. They are doing this whole "healthcare" thing for political, and non-fact based, reasons. And they wonder why 60% of America thinks they are wrong?

Posted by: JohnnyGee | March 3, 2010 5:54 AM | Report abuse

How about removing the antitrust exemption for insurance companies. After all if there is all this competition they lie about why would they need antitrust exemptions? Where are the people with the 39% rate increases supposed to go?

Posted by: orange3 | March 3, 2010 5:56 AM | Report abuse

I think they are going to remove the anti-trust exemptions. That's one of the things that there seems to be agreement on last I heard. Then too I don't know who's been bought off since I heard about that, so there's no telling now.

Make no mistake, this is a seriously corrupt profit driven industry that is not going to let anything interfere with generating shareholder value.

Bush at least had the sense enough to not even try. It's what the industry wanted, and it kept them quiet & their paid-for shills weren't rabble rousing.

Posted by: Nymous | March 3, 2010 6:15 AM | Report abuse

Mr. Lane, the Constitution mandates that the government provide for the 'General Welfare'. General welfare means health care. Universal not for profit health care is what the framers were talking about, and that's what we need to institute.

Posted by: jkarlinsky | March 3, 2010 6:20 AM | Report abuse

I think there are a lot of issues in this issue and when Pelosi suggested the illegal aliens were not critical in the thinking, I became almost positive they were critical to me. And I don't believe there are 11.5 million illegal aliens in this country: I believe there are something a lot closer to 26-30 million and that a very great many of them are permanent residents at this point.

I do not want the Catholic Church and the Mexican Government thugging us on this issue, and I do not want the fingerprints of the Church and La Raza all over the processes. I want to see Congress insure Americans, but Congress clearly seems to want to insure Americans and illegal aliens.

Finally, Congress has taken over the personal direction of the Census Bureau. It is the political arm of Congress now, and one of the more ugly things that happened in this the mess related to the illegal aliens. In Bush's term, someone objected to the Statistical Averaging method of the Census (I don't believe it was wrong at all.. merely inconvenient) and altered the Statistical Averaging to exclude the count of the illegals. In 2001 the count was eleven million but due to inherent difficulties in the count, probably 13 million. When Congress made the Census a political arm, that report was initially restricted to only a few viewers, and then removed from the reports. The report, by the way, was a UPI effort in the Los Angles Times and in 2001, it was hot property as the immigration service jiggered the numbers.

If the Congress trys to insure the illegal aliens, I will fight Obama's re-election every way I can. I want a straight deal... I am not getting it. If Obama is a crook, let him be a crook in Illinois.

Posted by: joelwisch | March 3, 2010 6:58 AM | Report abuse

Mr. Lane, you lead a very sheltered and privileged life. It doesn't matter if there are 1 million or 50 million people without insurance. In a nation with as much wealth as the US, that's an outrage. Then there are those that can only afford catastrophic health insurance; they can't afford routine preventative care. The young invincibles can't afford private insurance any more than the older unemployed can. So when they get a bad cold, they debate whether or not it's turned into pneumonia and how much it will cost for a doctor's visit and a dose of antibiotics.

Posted by: MNUSA | March 3, 2010 7:19 AM | Report abuse

Interesting straw man. Obama says 30 million uncovered. You say "It's NOT 45 million."

Posted by: EvilOverlord | March 3, 2010 7:26 AM | Report abuse

"To feel sorry for the needy is not the mark of a Christian - to help them is." (Fred Clark)
"In as much as you have done it (or not) to the least of these my brethren, you have (or not) done it unto me." (The Christian New Testament)

Posted by: Nana38

----------------

Another liberal trying to make this about what Christ would do. Forcing someone else to pay higher taxes to help others isn't going to get YOU into Heaven. Christ's challenge isn't to the government, it is to us, as individuals. For years, polls have shown that conservatives give the most money to charity. Libs give the least, with independents in the middle (per usual). I'd love to see you standing in front of St. Peter pleading your case: " But I was for the rich snob racists paying higher taxes to help the poor while I hoarded by big screen TV and dropped an occasional quarter in the red bucket every year during the holidays (what, I've never heard of this Christmas thing as I didn't want any Christians to be able to talk openly in public)." Yeah, good luck with that.

Posted by: dishonest_abe | March 3, 2010 7:32 AM | Report abuse

Now, Mr. Lane...we can't let facts get in the way of ramming a bill through.

Posted by: silencedogoodreturns | March 3, 2010 7:37 AM | Report abuse

tortured drivel. let's vote, now, and move on.

Posted by: auntywbush | March 3, 2010 7:43 AM | Report abuse

Weissler says " ... every state has clinics that charge what you can afford, if you have no coverage. Hill-Burton and state programs mean that no one really HAS to go without care for routine health issues. These clinics are located primarily in lower-income areas, so transportation should not even be an issue. And of course, emergency rooms have to take everyone in case of an emergency. But getting people to go to clinics instead of emergency room INSTEAD is really a better answer,..."

Has Weissler ever checked out the waiting lists for those clinics? And how many have closed in recent months, especially in California, for lack of state funding? I agree, emergency room care is not good health care. ER care only deals with traumatic matters, not chronic care or preventive care. But when someone is faced with a 3 - 8 week or longer waiting list for a clinic, what else is there?

As for the young and healthy uninsured not wanting to pay for insurance, yes, if one of them becomes ill or is injured, s/he will be treated, at least in the ER. And if we get a health care (insurance) bill that bans denying coverage for pre-existing conditions, that uninsured person will, if s/he has any money, be able to buy insurance at or after the time of need. But the whole principle of insurance is to spread the risk before the risk happens, not at or after the time of the risk.

I fully agree with those who point out that our current plan of health care insurance is a significant factor in business costs. If you need an example, look at GM's health insurance costs.

Universal health care, paid for by taxes and, if the individual wishes, additional private insurance, works very well in every other industrialized democracy - look at France, Germany, and Switzerland, for example, if you don't want to look at Canada. Why won't the U.S. learn from the experience of others?

And yes, Lane double counts immigrants, either legal or illegal.

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Posted by: yetuwtrhtuwtuitrirt | March 3, 2010 7:57 AM | Report abuse

Umm... Yet another story about how income should determine your eligibility for coverage at all? I think that is what Mr. Lane is trying to say. Age and income are factors in determining a person's risk. Those factors should not be the determining details of the person's ability to get health care if he/she needs it. In the end, that's what the President's argument states.

Posted by: paquers | March 3, 2010 7:57 AM | Report abuse

Almost everone commenting has made some fine points but missed the original point,"Can average people afford Health Savings Account/Catastrophic coverage?". I make about $65k with wife and 2 kids and recently lost company healthcare. I could afford the approx $350/mo Catastrophic but needed to build $5k HSA savings to cover gap and emergencies. That's near $500/mo. and we were tapped out. Thus Obama's point:Maybe for you, Barrasso but out of reach for most needing it.

Posted by: dbond1 | March 3, 2010 7:59 AM | Report abuse

I was one of those "young invincibles" to which the author refers, but I did not choose to go without health insurance. I worked in low-paid jobs that did not provide health insurance, and I could not afford to purchase an individual plan in Massachusetts, where I live at the time (before health care reform was passed there). My parents ultimately helped me to purchase a plan that cost $289/mo and had a $5,000 deductible. I never used it because I couldn't afford to pay for a doctor's visit out of pocket. I then moved to DC, where I found a plan for $80/mo with a $5000 deductible. I still couldn't afford to visit a doctor, let alone a dentist. I had a painful cyst, a rash, and recurring pain in my jaw that I never had checked out because I couldn't afford to. Even worse, this company decided I had a pre-existing blood condition because I had been tested ONCE in college for mono. I called and protested that I had tested negative for mono and thus had never had a blood condition. The company replied it was their policy that anyone who had even been tested--no matter the results of that test--counted as having a pre-existing blood condition. I was terrified of getting sick, because I knew they could drop my coverage based on this. Just because someone is young doesn't mean they don't need help getting quality health insurance.

Posted by: MeganDC | March 3, 2010 7:59 AM | Report abuse

Another piece by Lane full of shoddy research, from highly partisan sources, constructed to fit facts around his theory. He either selectively quotes studies out of context (such as the one by the Kaiser Foundation), or he derives his numbers from the biased "Numbers USA For Lower Immigration Level" (just the name tells you something about the bias of the group).

Lane is one of the most intellectually dishonest "writer" at WaPo.

Posted by: Gatsby10 | March 3, 2010 8:03 AM | Report abuse

I really don't understand the rationale of quibbling about the count of the uninsured. First and primarily is an issue of trust, trust in the numbers and trust in the source. It seems that this tack is another attempt by republicans to tear the argument for the need of health care reform by attacking one of the "facts" used to support it. Well, this whole point is nonsense. The cost of Health Insurance is astronomical. I for one only want a fairly priced, affordable form of care that I have no fear of losing because I begin to cause the insurance company to lose money. What's going on is nonsense. Why buy insurance at all if I can't depend on it when I need it and if I have a good chance of going bankrupt anyway.
This opinion piece is evidence that the WAPO is abother right wing RAG, similar to Rupert Murdoch's publications. I've got news for you, there aren't enough of those people to support two propoganda rags.

Posted by: whenwillthisnightmareend | March 3, 2010 8:04 AM | Report abuse

Lane has completely missed the import of his own point.

IF LANE IS RIGHT, THE COST OF THIS HEALTH CARE BILL WILL BE MANY TIMES SMALLER THAN THE CBO THINKS!!!

If Lane is right that most Young-Invincibles will pay a fine rather than buy insurance, that's a boon for the government. If Lane is right that only 10 million, and not 30 million need coverage, then this bill will cost one third of the estimated price.

The headline of this post, therefore, should be: HEALTH CARE REFORM WILL BE MUCH CHEAPER THAN EXPECTED.

Of course, I trust the CBO more than Mr. Lane.

Posted by: bpetruska | March 3, 2010 8:05 AM | Report abuse

Mr. Lane is a moron.

Posted by: tojo45 | March 3, 2010 8:15 AM | Report abuse

Mr. Hyatt,

What you fail to mention are the millions of self-employed or under employed people who either don't earn enough for insurance but earn too much for medicaid or who pay what amounts to a mortgage payment to insure their family. I know a number of families who pay between 900 to 1300 dollars a month for insurance with a huge $1000 + deductable. This might seem reasonable for an editor at the WaPo, but for us middle Americans in the Midwest, it's crushing.

Posted by: rlritt | March 3, 2010 8:28 AM | Report abuse

I guess it doesn't matter whether we cover One or One hundred million with this forced sausage.

I wish the democrats would hurry and pass this bill. No matter what comes off the POTUS's desk, will wind up in the federal courts and get thrown out.

To my knowledge,several clauses are Unconstitutional and will be going to the Supreme court.

(1) The government CANNOT mandate any citizen to purchase anything,

(2)Congress cannot write any legislation prohibiting further congresses from amending any legislation.

I could go on and on, but you get the point. This will be held up in court with a restraining order until it can be straightened out. Which by the way will happen Nov.2, 2010

Posted by: frankn1 | March 3, 2010 8:35 AM | Report abuse

It should not surprise anyone that the president would mislead in order to pass his legislation. Remember when he said that doctors amputate diabetics feet so because they get paid $50k to do so? the procedure only pays up to $5k and no doctor removes body parts for money. Anyone who is shocked when our sleazy politicians lie to achieve their goals needs to wake up

Posted by: jbb34 | March 3, 2010 8:43 AM | Report abuse

As a "childless adult between 18 and 34" (in my 20's) with a medical condition, there are plenty of childless young adults who desperately need health coverage and cannot get it. I am lucky to be insured through my employer, because I desperately need health coverage. If I were not insured through my employer, under the current system no one would sell me coverage (and certainly not at a price I could afford, even though I make a good salary). So please don't count out the entire "childless 20's and 30's" group. Some of us need help just as desperately as people with families or people in their 40's and such. It IS possible for the young, childless adult set to have medical conditions. We are not all "invincible".

Posted by: Eleiana | March 3, 2010 8:51 AM | Report abuse

Through my employer we have health insurance and a medical reimbursement account I self-fund (medical savings account) to help offset our enormous deductibles, co-pays, and out-of-network costs. My spouse lost his health and then his small business. Now our choice becomes get the necessary medical care and stop paying all the big-bank owned credit cards and loans we took out to pay medical bills since they are charging us 29.999% and we have literally paid them several times over for what we charged for groceries, gas, oil, and medical bills because we did not have enough disposable income to pay for our living expenses. Our savings were wiped out early on and I have borrowed everything in my piddly retirement account that I myself (not my employer) funded. We've always paid our taxes, our loans, and all our creditors on time. Now due to health issues, we are up a creek without the proverbial paddle. Bankruptcy is our next step. I hope the executives of Citibank won't suffer too much when we have to take this step. We tried to help them with our taxpayers' bailout of their company and our generous interest (which years ago would have been considered loansharking). After working for nearly 40 years, somehow I thought we wouldn't be sliding from middle class to poverty because my spouse became ill. But as some of our politicians, replete with great insurance and lobbyists would say, "big deal, who cares?" They apparently believe that the execs of big banks and big insurance need that money more than we do to survive. Why should we be able to hang on to our home with the leaky roof, ancient duct-taped furnace, and pipes that freeze in the winter when the big corp execs need more, more, more. Bitter, angry, disillussioned and suspicious of any political good intentions in DC? You betcha!

Posted by: purposeful | March 3, 2010 8:57 AM | Report abuse

dy19spider5 said

Another person that does not know the facts. If you invest in a 401K, the take home pay is about the same as if you did not invest. With the taxes that the govt takes out of the paycheck, it almost equals the amount that you put into a saving program. The taxes are not collected until you retire and start drawing out. Check it out and then write your comment. Get the facts before you show your intellect or lack there of

------------

You are the one that has the facts wrong. If you have a marginal tax rate of 30 percent for each $100 you put in the 401K you will see your take home pay fall by $70.

Posted by: pessimist46 | March 3, 2010 8:58 AM | Report abuse

The whole thing of counting people without insurance is ridiculous.
First of all lots of people are embarresed at not having it and would never admit to it. I know many people like me, we are self employed and cannot afford it. I am 59 and raised six kids and have never had insurance. I really do not trust insurance companies because so many of my clients have horror stories that are true.

I am still for the public option or universal health care, so the proposal as it stands now I would not vote for.

Our society has gotton so selfish.... What happens to all those Christians everyday cept Sunday. God forbid we should help one another

Also no one ever asked me if I wanted my tax dollars to go to war which I am completely against, but the same people do not want to pay for abortions.... I guess its OK to just kill the people later.

Posted by: honeybee1 | March 3, 2010 9:09 AM | Report abuse

In response to the post by Weissler, I am reminded of the words of Dicken's Scrooge when he responds to those collecting on behalf of the poor..."Are there no prisons or workhouses?". The next time you're sick, go to a "free" clinic for your care. While they do what they can, it is not a health care solution.

Posted by: tigvatim1 | March 3, 2010 9:27 AM | Report abuse

The Insurance hoers are ta it again, the problem is a way bigger than just the number of uninsured(legal or illegal), the problem is the insurance industry just chose not to pay anymore for services anymore, they just want to pocket the money, I had insurance for the past 19 years, I never seeing, their action like latest years, from no deductible to adding deductible to doubling deductible, so I you believe those scums, do not complain when you have to deal with the Insurance.

Posted by: tqmek1 | March 3, 2010 9:32 AM | Report abuse

I like the fun tricks with math here. Every number is assumed to be as large as possible if it cuts against Obama's claim. So that instead of 30 million we get only 25 million, but based on numbers that are estimates to a degree that do not justify such a distinction.

But then when Lane is trying to indicate Obama is wrong, suddenly the number of uninsured jumps back up to 30 million.

What one gets from this is that it is likely that if one does not assume every number is as rosy as possible and averages where there is doubt one gets something like Obama's claims. If one treats math as a tool for twisting data we get the analysis above. That does not mean it is impossible that Lane is right. Every number could happen to be in the direction of the most extreme case against Obama's claims. But from a statistical perspective it does not seem to be the way to bet.

But after arguing that there are 25 million uninsured who count, the shift back to 30 million when it helps his case gives a sense of how seriously to take Lane's use of numbers.

Posted by: beckerl | March 3, 2010 9:32 AM | Report abuse

I think the writer is missing the point here. Instead talking about the statistics of the uninsured, he should be spending his time analyzing what is causing people loosing their insurance and their faith in the capacity of the private world to manage the health care system.

Mr. Writer: WE NEED MORE GOVERNMENT IN OUR HEALTH CARE SYSTEM! THE FACT THAT WE DO NOT HAVE A GOVERNMENT TO STEP UP AND BE TOUGH TO THE INSURANCE COMPANIES IS CAUSING US TO LOOSE CONTROL OVER OUR INDIVIDUAL FINANCES.

How am I going to plan anything in my life if my health care plan just keeps going up more than 20% every year? I do not want give my money for free so CEOs of big corporations, so they can make 10 million dollars a year for themselves. IT IS UNFAIR TO ME AND MY FAMILY MR. WRITER!!!!

I rather pay more taxes and have a government run coverage than pay more in premiums to enrich few people.

I AM TIRED OF THE SCARY TACTICS USED BY INSURANCE COMPANIES AND SPECIAL INTERESTS GROUP IN REGARDS TO GOVERNMENT RUN INSURANCE. IT SHOULD BE ILLEGAL BECAUSE IT DOES NOT REPRESENT THE TRUTH.

Inappropriate article, I would say. Mr. writer, let's talk about the good business of health care companies and let's talk about statistics of how many Americans need to file bankruptcy because their medical bills. Have some talk with Ms. Elizabeth Warren.

Posted by: lucavalcanti | March 3, 2010 9:34 AM | Report abuse

This is a much better analysis of the problem than the hot air blather that we get from our President. I believe his pursuit of this issue is almost entirely narcissistic

Posted by: bruce18 | March 3, 2010 9:34 AM | Report abuse

As someone who has been among the "left-out" when my unemployment and COBRA ran out, I cannot begin to fathom what the author is trying to say.

Maybe it's "rational" to be uninsured in your twenties, but when you need that appendectomy and wait three days to go to the hospital because you don't have the money for emergency room fees, it's better to have a government program.

It's better to have that safety net than have to be declared "indigent" in order to get a mammogram or chest X-ray.

It's so easy for those who've never had employers keep them under the minimum number of hours of work so they don't have to pay for health insurance to say that a comprehensive program isn't needed.

It is. Both sides should stop futzing around and pass a bill that provides a wide range of options -- health co-ops, insurance vouchers, etc. -- so that people don't end up having tons of expensive emergency care because they can't afford the cheaper preventive care.

Posted by: Fabrisse | March 3, 2010 9:36 AM | Report abuse

Considerthe following plan:
Reduce premium costs by opening up insurer competition through the removal of the anti-trust exemption.
Instruct the Justice Department's anti-trust division to ensure compliance through strict enforcement of exisiting anti-trust laws.
Create insurance exchanges to broaden consumer selections and price ranges.
Eliminate consumer abuse by insurers through the enactment of consumer protection stipulations ensuring fair and enforceable insurance policies.
Eliminate the pre-exisiting condition dilemma by offering Medicaid coverage to those consumers insurers refuse to cover.
Since the focus of this plan would be on utilizing exisiting resources, the additional costs to taxpayers would be minimal, and most provisions could be implemented immediately. And it could probably be done with a fifty-page bill.
Once insurance reform has been attained, the next policy piece would focus on actual healthcare cost reductions, including going after fraud, excesses, and tort reform.
It would be simple to do, if only someone in Washington would stand up to the industry thugs.

Posted by: mtpeaks | March 3, 2010 9:50 AM | Report abuse

Another health care red herring article written by an another journalist with nothing better to do than obfuscate the BASIC facts with stupid detail that is in itself an obfuscation. Why? He had to write something and dealing with real facts that are about people, rather than scoring points in the political battle isn't sexy enough.

Bottom line is that health care is destroying the national economy. Remember that in the face of all this health care brouhaha, the insurance industry is busy rasing its prices for coverage now by outrageous amounts and at a time when they are fabulously profitable and the nation as a whole is experiencing economic dislocation on a grand scale brought to us by those who oppose national health care and you know who they are. Those are actual facts.

The insurance companies can terminate your coverage whenever they feel like it, which will be when you need it. That's a fact. Yes they can and they do.

The uninsured are paid for at this time by you and I. They go to the emergency room and cannot pay, so the entire health care industry factors that into premium prices that you and I pay. I would like the uninsured to pay for themselves, so universal coverage, the mandate, is absolutely necessary. Those who say that the federal government is not allowed to mandate, forget about the draft in time of war, so the government can mandate whatever they want and you all know it and if you don't you should. Were not running a libertarian shop here and we never were, right from 1789, NO MATTER WHAT RON PAUL says.

Today if you lose your employer sponsored health care, any condition you have is suddenly pre-existing. If you have to get new insurance on your own you will not be covered for what already ails you that you were previously taking care of with the employer sponsored health care. This means you have no coverage and you will not be able to get it. On that basis, the prevailing point of view where you are concerned, for the medical community, the insurance industry and the larger national population that has health care, is that you should die and solve all their problems. They are not concerned with yours. Disgusting but there they are, more facts.

You can talk about cost, NUMBERS of people, (statistics), doughnut holes and whatever else but what is being left out of all of this is actual flesh and blood people. Over and over again, I talk to good Americans, who have coverage and they say, I've got mine, I don't care about anyone else, why should I? This is how we feel about our fellow citizens, we could give a hoot abut whether they live or die, or whether they are in pain. We just don't care. We would rather play politics like its a spectator sport and let those other unseen Americans die. Go for it America you deserve what is happening to you.

Posted by: robertmerry | March 3, 2010 10:03 AM | Report abuse

I think what is missing here is a basic understanding of the nature of insurance- the whole concept is based on the spreading risk over as broad and diverse a pool as possible, so universal coverage is most efficient. As soon as you start letting people out of the pool, the system is in jeopardy. If insurance costs more, more healthy people will decide to go without it, costs will increase for those remaining in the pool and the cycle continues. Universal coverage is really the only way to ensure a stable and low cost insurance market in the long term. And if you think that its not fair to the young and healthy individuals for whom its rational not to buy insurance, who exactly is picking up the bill when they have a severe accident or are diagnosed with an expensive illness? Given that hospitals are likely to continue covering individuals with emergent need, chances are they'd get the treatment they need without buying insurance first- with the rest of our insurance premiums picking up the tab. One of our best solutions to long-term cost-control is prevention. If younger people aren't seeing health providers at all and aren't able to be targeted by incentive programs promoting and rewarding healthy choices, then we may lose our on our best opportunities to nip expensive illnesses, like obesity, in the bud.

Posted by: NatinFallsChurch | March 3, 2010 10:10 AM | Report abuse

For me, this was an informative article, Mr. Lane. You identified some factions of the uninsured, and new perspectives at determining who is amongst them that I personally was unaware of. Informative article. Thanks.

Posted by: bbwk80a1 | March 3, 2010 10:15 AM | Report abuse

All the screaming against Government control of Healt care is pure hipocrisy. More than 180 million people already get taxpayer-subsidized Health coverage. The only way to reduce the burden of paying for this for the insured minority is a Public Plan. But no one in this privileged group wishes to join us in a call for the Public Plan, much less share what we pay for them with us.
Its "I got mine Jack-to each his own."
Some people like to call this "the rugged individualism of America" We are great going out overseas to help others in crisis, but we don't give a damm about our suffering neighbors. Haiti got more help than Katrina. And so it goes.

Posted by: lionelroger | March 3, 2010 10:17 AM | Report abuse

From my perspective, Lane is living in never never land. I am 53, was forced out of a good job because I had the misfortune of having my wife get sick and use our medical. This made senior management at our company unhappy.

At 53 I am unemployable, not because I lack skills, I have a Ph.D. in a hard science and am skilled in at least 6 fields, but because my medical will be expensive. We had health insurance through COBRA for 18 month until it ran out.

My wife is sick, and needs pain medicine. This makes her uninsurable in many locations, for example Missouri. She has pre-existing conditions which results in insurance rejection from many more companies.

We have had the misfortune to deal with Doctors. I used to work at several pharmaceutical companies, and am well versed in the medical field, and we were not able to find acceptable medical care. My wife has a undiagnosed arthritis or slow cancer. We spent well over $1,000,000 on trying to find a diagnosis with no success. Our conclusion is that America is a terrible place to be if you do not fit into one of the little boxes our physicians are familiar with. We spend thousands going to poorly run, crappy clinics (Cleveland, Mayo, etc).

The real problem we have today is that Doctors are not held accountable for their work, and our legel and insurance system has isolated the doctors from the patients. When I was a kid, we had a doctor that cared. Today, if you ask questions you take up to much time in our medical assembly lines and are a difficult patient. It is no wonder America has some of the worse medical outcomes in the civilized world.

It makes me sick to read this type of article. It is far better for our country to have healthy citizens, and we need to fix the medical systems, we need national health care with the option to purchase more. Of course the crooks at the AMA are fighting this tooth and nail as most physicians are on the insurance gravy train.

Posted by: Harlow1 | March 3, 2010 10:21 AM | Report abuse

So how does Obama accurately judge the cost of this program is we have no accurate figures of the numbers? 5, 10, 20, 30, 50 million??? This is the classic carelessness associated with government that ends up with totally bogus cost numbers and then overruns to deliver the service. The government has to do a better job of costing.

And while I am at it, it is totally inappropriate to call the CBO into the White House. Too intimidating you think? With Rahm Emanuel staring you down???

Posted by: hz9604 | March 3, 2010 10:22 AM | Report abuse

Obama is lying about the "left out." Gee what else is new?

Obama needs a bigger number in order to justify wanting to run health care.

If he says we're spending a trillion dollars to treat 20 million people America would say simply say NO.

ObamaCare is not about health care at all - we all know that.

ObamaCare is about positioning the federal government with more power and influence and this will enable Democrats to trade on political capital to become even more powerful.

Posted by: ravioliman6666 | March 3, 2010 10:28 AM | Report abuse

The article is misleading in a number of ways. The current deductables as well as high out of pocket expenses for things like hospital stays make health insurance unaffordable even for families making good salaries. You can say there aren't as many uninsured as is asserted, but it's irrelevent when premiums plus deductables are in the $20,000 range. More if I have to go out of network. Sure I have insurance, but if I really have to use it, I will spend every penny I saved for my kids' college.

Posted by: ssernaker | March 3, 2010 10:43 AM | Report abuse

I think the writer's point is, at least, two-fold. One, the health care "problem" is being overstated to win broader support.

And two, the young and healthy may be forced to buy insurance that they don't want and more insurance than they need. The latter is interesting because pro-health care reformers have pointed to this as a problem: "people are buying more health care than they need" has been cited as one reason for rising costs. It seems hypocritical make certain people buy more health insurance than they need to solve of "crisis" that has been "caused," in part, by people buying "more health care than they need."

The nut of all of this is that supply and demand, largely, is what is driving up the cost of health care, and the gubment doesn't like paying the market price. So the gubment thinks that by tinkering with the market it will solve the problem. I think that is doubtful, and I think most Americans recognize the not-so-hidden problems that will arise if the reform on the table passes.

Posted by: Fletch_F_Fletch | March 3, 2010 10:48 AM | Report abuse

Oh, gee - do you have to stop there - by the time you're through, most Americans will be found to be overinsured! The fact is that the "facts" here are bogus. He doesn't trust the Census, so he makes up his own "corrections" to see them to us as "fact." The facts are - as have been well-documented - that there are between 30 and 45 million uninsured. Certainly not all of them will be covered, but let's at least make some headway, instead of spewing garbage.

Posted by: garoth | March 3, 2010 10:51 AM | Report abuse

I would like every American citizen to never have to worry about money ever again. It is a problem ravaging over 300 million Americans on a daily basis, and it needs to be addressed now.

When it comes to things like healthcare there are no rights, only luxuries that society either can or cannot afford. The situation in government provided healthcare is already on track to bankrupt the nation. This bill blithely ignores that fact and only makes the problem that much worse by massively expanding our governments healthcare outlays without implementing any healthcare reform. Anybody that calls this a healthcare reform bill is misspeaking(the only question is whether they are dishonest or incompetent). It leaves unmolested and in fact reinforces all the perverse incentives that prevent a rational price ceiling for medical services from forming. This is a huge step in the wrong direction.

The central problem is that rising costs have been disguised by the tax advantage for employer provided health insurance and lost wage increases as employers move more and more of their employee's raises from wages to premiums. All the while deductibles and copays have been lowered to almost negligible amounts. What all this has meant is that drug makers, medical equipment manufacturers, hospitals, and doctors have not needed to worry about what they charge for decades. The sky's been the limit. The only thing holding them back has been negotiated fees with health insurance companies.

When people are actually spending their own money they tend to make much more cost conscious decisions. This would force medical providers to offer services at a price that people are willing to pay. Costs would come down, and that is what Obama and his allies have not been able to wrap their head around. If you don't believe me look at other medical services that are not subject to this huge distortion. Elective cosmetic surgery prices have plummeted over the past couple of decades (while medically necessary cosmetic surgeries cost more and more). The same is true for lasik eye surgery. With tooth implants people are still generally responsible for at least half of the bill even with good insurance. Again prices have dropped dramatically. In rational markets there are good reasons why things cost what they do, why a gas station cannot get away with charging $6 per gallon. This has not been true in the healthcare world.

But the Dems refuse to address this singular threat to our nations fiscal solvency. They want to expand entitlement spending and claim a healthcare reform victory. They are putting the cart before the horse in a tremendously reckless way. Universal coverage is a laudable goal and one that needs to be pursued but under the right circumstances. We are just digging our hole that much deeper with this bill.

Posted by: jmcdavisum | March 3, 2010 10:52 AM | Report abuse

Catherine Rampel in the NYT recently showed statistics that support the idea that young people who don't get insurance don't get it because they are low income and can't afford it. This supports the idea that young people without health insurance do want health insurance.

Posted by: ideallydc | March 3, 2010 10:54 AM | Report abuse

I am missing Mr. Lane's point. He has given us a list of statistics concerning who would or would not potentially have insurance under a reformed health care system. Nobody can verify these statistics since they each depend on a potential scenario. I suspect Mr. Lane already has good insurance coverage. The company I retired from does not provide health insurance past retirement. That is a sin and a shame.

Posted by: ThelmaMcCoy | March 3, 2010 10:58 AM | Report abuse

dy19spider57
Where, exactly, did you get your math degree? Lets say I want to put $4K into my 401k. Assuming that my marginal tax rate is the max, 35%, my take home pay is approximately ($4K x 0.65) or about $2600 dollars less. Of course your number may vary depending on how much income you make and how much is actually subjected to the maximum marginal rate.

That is reason the more money you make the more a 401K deduction is worth to you. The same applies to HSA's. The lower your marginal rate the bigger the hit to take home pay since the government subsidy (the tax deferral) is less. 401K's are actually bad for a lot of folks but thats a different discussion.

HSA's are a bit better since they result in an immediate tax deduction, not a deferral. But it also means you may have to carry medical costs to achieve this if you have to pay a cost up front since you can't take out what you haven't yet put in.

Posted by: elkiii_2008 | March 3, 2010 11:01 AM | Report abuse

Why not just look at the Kaiser report, rather than assuming it does not factor in citizenship?

It starts with 37.6 million adult uninsured, and breaks these down by citizenship in Table 12, and shows 29.2 million citizen uninsured (26.6 citizen/native, plus 2.6 citizen/naturalized). So, Obama's 30 million figure is fairly close, and specifically doesn't include non-citizens.

It also shows (Table 15), how many low income citizens are uninsured: 23.8 Million. (22.2 million citizen/native, plus 1.6 million citizen/naturalized). So, 23.8 million of the 29.2 million uninsured citizens low income. This is 81.5%.

This sounds a lot like the "vast majority" of 30 million people, just as Obama said.

http://www.kff.org/uninsured/upload/7451-05_Data_Tables.pdf

Posted by: ken_ridge | March 3, 2010 11:07 AM | Report abuse

Health insurance is not the same as healthcare.
Forcing people to buy health insurance they don't want to buy conflicts with fundamental principles of liberty.
Catastrophic health insurance really makes much more economic sense for most people than covering each doctor visit. Many people go to a doctor once a year or less. Why force people to pay for more than they want to buy? Why spend money processing all the insurance claims for each visit?

The best treatment/prevention for most illnesses is sleep, improved diet and reasonable exercise, none of which is covered by health insurance. That applies to everyone across all socio-economic groups.

We suffer from too much healthcare insurance, not too little. If you take away the tax incentive to have employers pay for health insurance, people would make more reasonable decisions about how to allocate their resources.

The proposed legislation goes in exactly the oposite direction of good heathcare policy.

Posted by: jfv123 | March 3, 2010 11:10 AM | Report abuse

You also have to pay attention to the reduction in premium that comes with switching to a higher deductible plan. Switching from a $500 deductible plan that has low copays and pays 80% of the bill after the deductible to an out of pocket maximum of around $2,000 to a $2,500 deductible plan with preventative benefits but otherwise no copays and then 100% coverage after the deductible is met, saves approximately 30% of the premium dollars. That means that for someone that costs $500 per month or $6,000 per year to insure on the rich PPO plan would cost approximately $4,200 to insure under the HSA plan. That $1,800 in savings can now be put to use according to the individual's discretion and any unused amount will be available next year.

Posted by: jmcdavisum | March 3, 2010 11:14 AM | Report abuse

Mr. Lane, could you possibly be this stupid?

Obama says 30M, real number (assuming 10M gustimate error in Medicre count) is 25.7M. Do you know how ridiculus your statement is? Do you know nothing about estimates and rounding (taught in second grade)?

It's rational for the 5 million citizens 18 to 34 to be uninsured? Are you out of your mind? If it's so rational why don't you pay the $25,000 bill for the 150,000 in this group who will end up in an ER this year.

Dumb Arse!

Posted by: chucky-el | March 3, 2010 11:16 AM | Report abuse

Oops my above post should have been addressed to elkiii_2008

Posted by: jmcdavisum | March 3, 2010 11:16 AM | Report abuse

The truth about the uninsured is that they are living on the edge. All the time. Every day. Doesn't matter if they work hard, if they have good health, if they play according to the rules. One false step and they will find themselves in economic disaster.
You can spout off all the statistics you want, but that is the stark truth: illness or accident = bankruptcy.

Posted by: lxp19 | March 3, 2010 11:20 AM | Report abuse

In a 2003 publication, the Institute of Medicine publication Unequal Treatment used figures of 22.8% and 17.5% in describing the numbers of uninsured African Americans and White Americans respectively. All reports do suggest that the health insurance situation for the under 65 group has not improved since that time. This nit picking column filling verbiage from Mr Lane is typical of those who condone the denial of basic services to people perceived as having little or no power. This is done because those being denied are seen as having no power. There will be a price to be paid for the continued denial of basic healthcare services to all Americans. The denial of early detection and follow up has had a price. Diabetes, Hypertension and obesity are rampant in America in the 21st Century. AIDS is a fact of life and Tuberculosis has been resurgent. Swine flu, though less discussed represents a new cadre of diseases which may have been avoidable within a health system that saw profit in the prevention of illness. Only the most callous and ignorant will support the denial of appropriate healthcare to any segment of this society. There is peril in this approach for us all.

Posted by: Draesop | March 3, 2010 11:26 AM | Report abuse

On the one hand, political and economic necessity may make young invincible policies a good idea. On the other hand, we're diluting the health insurance pool. More at http://www.healthcaretownhall.com/?p=1630

Posted by: JEngdahlJ | March 3, 2010 11:35 AM | Report abuse

I am a childless man between the ages of 18 and 34. Last December I was trampled in a crowd and broke my leg. Total treatment coast have not been finalized but the number already exceeds $25,000 dollars.

I don't deserve to be insured? Without insurance I would have declared bankruptcy before graduating college.

Health insurance isn't just about taking care of those who are sick, it's about making sure that those who aren't sick yet can stay in the work force by preventing major illness.

The ideals expressed in this article are elitist and sicking. No one deserves insurance more than anyone else. Everyone deserves their health.

Posted by: SCL24 | March 3, 2010 11:41 AM | Report abuse

"That leaves 25.7 million people -- not 30 million, as the president said."

Oh thank God. Only 25.7 million people are uninsured. That's a relief.

Posted by: arancia12 | March 3, 2010 11:47 AM | Report abuse

Health care reform is necessary. I speak for many in my family; in this country since 1780, who do not have ANY insurance even though they are employed. This reform is necessary. They are not covered and neither are their children. They make too much for aid programs; so they go without and make do. They are one accident away from bankrupcy. My cousin died, after fighting breast cancer for many years. She was not eligible for any aid until she quit her job as a nurse's aid at a nursing home. She had no insurance; but took care of those who did. She was only 42; and left 3 children behind. Leave politics out of this debate; people are dying and suffering. What exactly is the point of this article? Maybe the author needs to get out more and speak with real people instead of listening to insiders that have their own agenda.

Posted by: djanes | March 3, 2010 11:49 AM | Report abuse

I think the numbers aren't far enough off to make a difference to those that are uninsured. Several years ago, I was laid off from a job. I couldn't afford the COBRA premiums even after taking a temporary position. This lasted for a little over a year and it was a scary period as I'd just had my third child. My kids were covered under a state program, but what might have happened if my wife or I had become ill.

As I noted, numbers are meaningless when you are the uninsured!

Posted by: wourm | March 3, 2010 11:51 AM | Report abuse

MR LANE,

I did not realize that 10 million Unisured people could fit into my little county in Western Pennsylvania.

I think Mr. Lane needs to take a trip out of Washington DC and see how the rest of the country is LIVING !!!

Posted by: BUDDY-IN-PA | March 3, 2010 11:52 AM | Report abuse

MR LANE,

I did not realize that 10 million Unisured people could fit into my little county in Western Pennsylvania.

I think Mr. Lane needs to take a trip out of Washington DC and see how the rest of the country is LIVING !!!

Posted by: BUDDY-IN-PA | March 3, 2010 11:52 AM | Report abuse

Health insurance is not the same as healthcare.
Forcing people to buy health insurance they don't want to buy conflicts with fundamental principles of liberty.
Catastrophic health insurance really makes much more economic sense for most people than covering each doctor visit. Many people go to a doctor once a year or less. Why force people to pay for more than they want to buy? Why spend money processing all the insurance claims for each visit?

The best treatment/prevention for most illnesses is sleep, improved diet and reasonable exercise, none of which is covered by health insurance. That applies to everyone across all socio-economic groups.

We suffer from too much healthcare insurance, not too little. If you take away the tax incentive to have employers pay for health insurance, people would make more reasonable decisions about how to allocate their resources.

Posted by: jfv123

_____________

Talk about elitist and snobby. So a working woman with children can easily get 8 hours of sleep a night? What if she's going to college too? Or caring for a sick father?

A working family of four making $19k a year who have never had training in how to prepare meals or shop can improve their diet?

Sir, you're going to pay somehow. You will either pick up the cost of emergency room visits or you will pick up the cost of educating the uneducated in a healthy lifestyle.

I might also note that your panacea is not the cure all for disease. Once upon a time putting cocaine in a drink was the cure all. Taking an aspirin a day was a cure all. Nothing is a cure all and nothing works for all people.


Posted by: arancia12 | March 3, 2010 11:57 AM | Report abuse

Help me out here...a family member is a 25 yr old musician. He's considered "self-employed". He barely makes enough to eat and pay rent. Of course he doesn't make enough money to have health insurace. As I understand it, if the bill passes, he'll HAVE to buy insurance, (again,HE DOESN'T MAKE ENOUGH MONEY to pay for it), or else he'll be FINED by the government? Does this make sense?

Posted by: scmonty1 | March 2, 2010 6:45 P
??????????????????????????????????????????????????????????????????????????????????????

No, it doesn't make sense but that's because that is NOT the way the program will work. Your family member will be given the opportunity and the help to purchase affordable health care. It would be even better if there were the public option but Republicans and some Democrats would never go for that. That would be to much like being right. However, there are provisions to assist people based on their income to purchase affordable health care. Right now he doesn't have anything and if he gets sick or has to visit the emergency room, he still wouldn't be able to pay for it. Guess who will pay? We the consumer, just as we have always paid with higher medical and insurance cost.

So, do you want your family member to go without assistance and your health insurance premiums to constantly rise so you can pay for him and the countless other who can't afford health care OR Do you want health care reform so ALL Americans have access to affordable health care?

Posted by: catmomtx | March 3, 2010 12:00 PM | Report abuse

Help me out here...a family member is a 25 yr old musician. He's considered "self-employed". He barely makes enough to eat and pay rent. Of course he doesn't make enough money to have health insurace. As I understand it, if the bill passes, he'll HAVE to buy insurance, (again,HE DOESN'T MAKE ENOUGH MONEY to pay for it), or else he'll be FINED by the government? Does this make sense?

Posted by: scmonty1
_____________________

While I prefer single payer, I can still say, yes, this does make sense.

Your family member probably goes to an emergency room for care after he becomes very ill. They treat the symptoms but don't address long term issues. In other words, they stabilize him then send him home.

Who pays for his care? We do. The taxpayers. If he goes to a cut-rate clinic, that cost is absorbed by the taxpayers.

Under a revised system he would be able to get a policy that he can afford. It would cover the essentials and he would pay at least something towards his own health care, unlike now. Pooling his funds with other insurance buyers will allow economies of scale.

As a taxpayer this should make sense to you and as a family member you should feel relieved. On one hand an American will have some buy-in in his own health care, on the other he will be able to find a doctor, establish a relationship, and practice some preventative health care instead of waiting until he is deathly ill to seek emergent care.

Posted by: arancia12 | March 3, 2010 12:06 PM | Report abuse

I disagree with the characterization that all the uninsured are poor, or working poor, or dilitante young people. What about all the people who have had a prior illness (or born with a condition) and are considered uninsurable due to a "pre-existing condition"? Odds are, most of those folks are not poor; they're working middle class folks who don't have a voice in the health care debate. Most of these folks cannot even get catastrophic health insurance, or the last resort insurance offered by the individual states. Sen. Barrasso's solution does nothing for changing the underlying problem with health care delivery - our country has made the mistake of giving all the leverage to the insurance companies. Dr. Barrasso should know better; most doctors want the system to change.

Posted by: lkovathana | March 3, 2010 12:06 PM | Report abuse

"neither the president’s proposal nor the House and Senate bills would make undocumented aliens eligible for subsidized coverage. They couldn’t pass if they did."

Not true. Neither the House nor the Senate bill REQUIRES that a person's immigration status be checked. Therefore, undocumented aliens will still get subsidies. It's like a town posting a 25 mph speed limit but not hiring police to enforce the law.

ALSO -- many illegal aliens live in households with citizens or legal immigrants, and will get coverage through the family.

Posted by: pmendez | March 3, 2010 12:16 PM | Report abuse

What he doesn't address are the millions who can't get coverage because of pre-existing conditions. I am an insurance agent. I own my own business, as does my wife, who is a CPA. Neither of us can get insurance because of pre-existing conditions. We could sell our businesses, and go work for someone else, and get insurance through their group plan, but we can't put our own group together and so are left out in the cold.
I have lived in both Canada and Ireland, and was covered in both countries under their plans.
I'm not looking for hand out.I'm looking for an insurance company to accept the fact I was born club-footed, have had seven foot operations before I was 10 years old, and have not had a problem with my feet since. I also have had hepatitus and high blood pressure controlled by medication. The combination makes me uninsurable for those conditions. Health insurance is over $1000/month, but would not cover my feet, heart and circulatory system, liver or kidneys. I guess if I got the sniffles, I could go see a doctor.
Too many are left in the same situation.
I have clients who own their own businesses paying over $1800/month for them and 2 young children. It was $1000/month in 2000. When will it stop?

Posted by: COLEBRACKETT | March 3, 2010 12:16 PM | Report abuse

Pre-existing condition issue is a serious one, and needs to be addressed. But government does not need to take over 16% of the economy to do so.

How about a multi-year coordination of benefits between new & old insurer? If you did not previously have an insurer, there will be a multi-year waiting time before benefits are payable (i.e. 0% for first year, 20% for 2nd year, etc., )

Surely there are ways to fix the most egregious abuses of insurance companies without full-blown government takeover.

Posted by: pmendez | March 3, 2010 12:31 PM | Report abuse

I guess the author believes that local free clinics are "health care". I guess the author believes that Medicaid, which covers emergencies, is health care. I guess the author believes that insurance companies are health care. Health insurance does not guarantee health care. It guarantees access to health care but not necessarily coverage of all costs. Our health care system is the most expensive in the world and doesn't even reach all citizens. That's not good enough.

Posted by: clairevb | March 3, 2010 12:48 PM | Report abuse

Anyway you look at it, as long as we insist on slicing and dicing the nation's healthcare risk we had better plan on paying approximately twice as much as we need to. There are solutions if you are willing to look outside of the box. Go to http://sites.goole.com/site/healthcarefix for a viable solution.

Posted by: DrS1 | March 3, 2010 12:54 PM | Report abuse

"Truth on the Uninsured" ??????? The truth is a far cry from what is presented here.

Lane begins with a false presumption - that there are 45.7 million uninsured. He gets this from Census Bureau data published in Aug. 08. In April '08 unemployment stood at 5.0%. In January 2010 it is now 9.7%.

Lane goes to guestimate a number of figures "several million" here and several million there that and comes up with a concocted figure of 20 million. Abracadabra. As Lane says "so right there you've got 20 million" !!!!!

Lane quotes Bush admin economist "calculations" for data. The problem there is obvious.

Lane further assumes that the private insurance plans have some value. Most private insurance in this country is worthless because it is immediately lost when the insured becomes sick, or has copays and deductibles that render them ineffective.

Aside from the obvious problems from Lane's piece, the tone is distasteful in the extreme. The tone can be summed up as 'Uninsureds are not hard working middle class. They're poor, they're not citizens, they could get Medicaid if they weren't so dumb and sold every thing they have.'

The Post's continued efforts to dismiss the valid need for real health care reform in this country is even more detrimental than its efforts to promote neocon wars.

Posted by: ophelia3 | March 3, 2010 12:58 PM | Report abuse

This author pooh-poohs the whole notion of there being any health care problem. If it's true that there are basically not enough uninsured or underinsured people to worry about, how come we have so many bankrupcies related to health care costs? He should get his head out of the sand. We need this reform and need it now. Even big companies realize that the increases in health insurance costs for their employees will reach totally unreasonable levels in a few years.

Posted by: catherine3 | March 3, 2010 1:18 PM | Report abuse

Several contributors have expressed confusion as to what the author was trying to say. That's exactly the point - and why many of us question the varacity of claims being made by Obama, Pelosi, Reid, et al. Before this huge bill even got started, the targeted number of potential beneficiaries should have been unequivically ascertained. Minus that, how can accurate estimates of cost be developed? START OVER!!!

Posted by: ddnfla | March 3, 2010 1:42 PM | Report abuse

this column is laughable. lane accuses the president of "sweeping generalizations" then bases his rebuttal on presumptions that are far less convincing than the information the president relied upon. he even acknowledges his information deficit. wow!

has the wapo become the employer of last resort for out of work, third rate republican hacks who fancy that they have a clue?

Posted by: jimfilyaw | March 3, 2010 1:59 PM | Report abuse


Truth? The headline says 'truth'.

What, from this writer? Get real.

Posted by: whistling | March 3, 2010 2:04 PM | Report abuse

I'm sick to death of the grabby Federal Government in my work place and private affairs. I have paid for adequate medical insurance my whole god-d-amn life. I am a net tax contributor, and now all the things I've worked for will be taken away from me and doled back grudgingly to me in my old age by a dimwitted, resentful, overcompensated minority driven bureaucracy. I owe them nothing, but many of them owe their very existence to Democrat Great Society welfare largess that encouraged their mothers to procreate for dollars and benefits. And their current political dominance is a disaster and an injustice.

I'm tired of being a workhorse and serf for the minority underclass.

Posted by: greg3 | March 3, 2010 2:05 PM | Report abuse

Disgusting rationalization for the suffering of your fellow Americans. If the idea of caring for your neighbor causes you such pain maybe you ought to get the F out and set up shop in an authoritarian wonderland.

Look if you want to be a right wing d-bag about having to pay any more (potentially) when you're happy with what you have then just say it. Just come out and say "I got mine Jack and I don't think I'll end up as one of the 14,000 who lose insurance each day so just go off and suffer where I can't see you so you don't ruin my dinner."

The system is broken......it finally looks like it's gotten bad enough that we're going to pass legislation to attempt to slow down this greedy monstrosity that we call health insurance. It's obvious to a lot of folks that you all are lobbing last ditch hail mary passes to stop this.

Posted by: theobserver4 | March 3, 2010 2:24 PM | Report abuse

Pre-existing condition issue is a serious one, and needs to be addressed. But government does not need to take over 16% of the economy to do so.

How about a multi-year coordination of benefits between new & old insurer? If you did not previously have an insurer, there will be a multi-year waiting time before benefits are payable (i.e. 0% for first year, 20% for 2nd year, etc., )

Surely there are ways to fix the most egregious abuses of insurance companies without full-blown government takeover.

Posted by: pmendez

************************************************************

Force insurance companies to coordinate benefits? It might lower health care costs in the long run, but it raises costs for the health insurance company. That's not going to work.

Single Payer would fix that. Just have our insurance companies vying for rights to process claims and network doctors together. That's pretty much Medicare.

Posted by: theobserver4 | March 3, 2010 2:28 PM | Report abuse

This article misses the point, as do many commenters. And Obama probably elided it: reason this bill is great is as follows -- mandating that people buy insurance or get fined. We have an ENORMOUS FREE-LOADER PROBLEM in this country. Millions of people know they can get emergency room and other care for free, because emergency rooms and hospitals are obligated to provide care, even if they know a person cannot pay. In essence we are pretending to ourselves that insurance is a private commodity, but we are treating it already (partially) as a utility, or even as a right. As a result, the hospitals end up trying to recoup the enormous costs of that care from people who ARE insured. That is what results in $120 pills of Tylenol charged for those people, via their insurance. Not only that, but a big, big insurer, in fact, the biggest already, is....Medicare!!! So the government is ALREADY paying vast sums of money, reflected in excess payments, for people who, for whatever reason, don't carry insurance, but aren't eligible for Medicare. In fact the government already pays for a majority of healthcare in this country. That is why this bill will ultimately save us money. It severely curtains the freeloader problem. It also severely curtails the "insurance death spiral" problem, whereby in bad times, healthy people drop their covereage, whereas unhealthy people hold tight to any coverage for dear life, thereby FORCING insurance companies to raise premiums for the remaining policyholders in order to avoid massive losses.

I am in particular responding to this comment, by scmonty1. "Help me out here...a family member is a 25 yr old musician. He's considered "self-employed". He barely makes enough to eat and pay rent. Of course he doesn't make enough money to have health insurace. As I understand it, if the bill passes, he'll HAVE to buy insurance, (again,HE DOESN'T MAKE ENOUGH MONEY to pay for it), or else he'll be FINED by the government? Does this make sense?."

The reason, Bub, is that if this highly-responsible seeming (ahem) young fellow (or one of the millions like him) needs to go to the emergency room for any reason, I'LL BE PAYING FOR IT, AND SO WILL YOU. In the future, he will have paid for that already.

Posted by: inkerton | March 3, 2010 2:42 PM | Report abuse

It shouldn't shock me that you are using statistics from the Bush administration. I am a SW in the medical field. Ask the one person who is very sick and needs medical care and can't get it unless they go to the ER. Ask the person who has insurance but is billed in excess of what the insurance company will pay. Don't ask the people who have insurance. They don't care. They will care when they lose their job and their coverage. I have seen it all. One or 10 million. This is America. It is a national disgrace that any human being should have to suffer because they don't have the coverage. I don't think anyone is asking for free. We are asking for fair. P.L.

Posted by: EAguard54 | March 3, 2010 2:45 PM | Report abuse

The attitude of commenters (and perhaps Mr. Lane) is awful.

You'd be crying bloody murder if your lettuce, celery and carrots cost $5/lb, and the only reason they don't cost that much is because migrant workers harvest them. (Well, perhaps you don't eat your vegetables, who knows?)

So you want your vegetables cheap, *and* you want to be *assured* that the person who harvested them *can not* get medical attention if he's stricken while plucking your veggies under the hot sun for whatever wage he makes.

You people are sick.
_______________________________


Deport the illegals. Maybe we can put prisoners in the fields. Or find somebody to take minimum wage in the fields, or negotiate.

If we can't enforce Federal immigration law how can we hope to enforce Federal conscription law if it comes to that?

We're doing a great job encouraging people to respect Federal law..... and this country's resolve

China to Obama "like you'll do anything over Taiwan. We'll pull our trillion dollars of T-bills and wreck your economy. Your military is stretched so thin you can see through it-- enlisting 42 year olds. And good luck trying to enforce the draft, you can't even enforce immigration laws."

Posted by: cmarshdtihqcom | March 3, 2010 2:47 PM | Report abuse

You will never hear the administration be this precise because it won't fit on a bumper sticker and it takes longer than 30 sec commercial to explain.

They have had a year to explain the details of their 2,400 page bill and they never got to page 2 of their PowerPoint presentation. You don’t sum up $2.3 trillion dollars with a few quick bullets and some anecdotal tales of personal hardship.

The public knows a con job when they hear it, and we’re not buying it.

Posted by: randkdavis | March 3, 2010 3:18 PM | Report abuse

Huh? You subtracted the young and healthy...

They don't have insurance.
Therefore, they are uninsured. You separate them from the median earners (and separate their numbers in your math), so I assume they are a different set of people, presumably earning near 40k. Most at that age do.

Using your numbers and rightfully including that segment back in, we arrive at 15.6 million.

15.6/25.7= 61%

"Vast majority" may be an overstatement of 61%, but no matter. You seemed to have missed the point of the debate anyway.

Posted by: trident420 | March 3, 2010 3:27 PM | Report abuse

This is a ridiculous attempt to minimize what the vast majority of people agree is a major problem. What about the 16 million people who are 18-34 or make 3 times the poverty line? They are uninsured and will seek "free care" whenever anything happens to them. We all pay for that. The author just sweeps them away like they don't exist. Non-citizen legals are in the same boat, even though they are considered pariahs politically.

Posted by: jake14 | March 3, 2010 3:30 PM | Report abuse

I ashed you to limit your article to 300 words and you are way beyond the limit.

27.5 million vs. 30 million, what is the difference?

If there is only 10 million, that is way too much for an advanced country as ours.

You should have slept in dude instead publishing some nonsense.

Posted by: Maya2 | March 3, 2010 3:31 PM | Report abuse

Obama either has bad information and/or he is lying to the public on Healtcare statistics.
But, what would you expect from someone who has crafted a bill full of bribes and lies.

Posted by: badgerburg | March 3, 2010 3:37 PM | Report abuse

More crap from lane.

Take a hike you loser.

Posted by: rcubedkc | March 3, 2010 3:40 PM | Report abuse

strategiesinter: "I would not worry about the possible 9.3 million illegal aliens. As word of the expanding social programs is getting out, many a getting into "pay for play" sham marriages with US citizens to legalize their presence in the US and become US citizans in the process.

We are soon going to have an explosion in population as a result of the social state that the US is on its way to becoming."

Where ya been the last 9 years. It was a repub president, King george the Drunkard, who invited so many millions of ILLEGAL ALIENS into the country with his "A willing worker for a willing employer" and "jobs that Americans wont do" and absolutely REFUSING to protect our borders.

Go take a dose of reality.

Posted by: rcubedkc | March 3, 2010 3:47 PM | Report abuse

Lane's just trying to polish another turd.
That's his job: turd polisher.

Posted by: misterbumbles | March 3, 2010 4:19 PM | Report abuse

Mr. Lane, if you could have gotten more column space and kept writing you could have gotten to the point that there are only three uninsured people in America to cover. We pay more for healthcare than any industrialized nation in the world and rank about 16th in outcomes. Companies are getting 20 to 30% increases in rates annually. The Republicans are not interested in health care reform of any kind. They controlled all three branches of government for 7 years of Bush's two terms and never brought the subject up, even for those ideas they allegedly like, such as interstate competition. The Republican's core philosophy is Darwinian economics, survival of the fittest - every man, woman and child are on their own. The Republicans are frightened to death some of their tax money is going to help a poor person, particularly a black poor person. And while Bunning blocks extension of unemployment benefits, Senator Kyl says unemployment benefits are a disincentive to find work, and Kyl is trying to cut the estate tax to the tune of $850 billion for estates worth over $7 million. Unbelievable!

Posted by: wrw01011 | March 3, 2010 4:21 PM | Report abuse

Mr. Lane you have missed the entire point. FDR realized there is nothing in the Constitution that allows for Health Care to be run by the government. That is why he wanted a second bill of rights. It failed then and it should fail now. There is no room for debating. The point is moot.

Posted by: pechins | March 3, 2010 4:38 PM | Report abuse

One thing is always true: the Washington Post comments are a sewer for the most uninformed xenophobic commentary around. If you want hatred for the "other," the Kaplan Daily News will provide you with all the hate you want. Stormfront doesn't have near the reach that semi-anonymous comments on WaPo have.

So if you hate people of Hispanic descent and think every one of them must be an undocumented immigrant, please come to WaPo to spew your hate. If you hate "libruls" and think it's an effective debate technique to insult your opponents, come to WaPo and make inane comments about ideology in commentary for sports articles.

Whatever hate you've got, the Washington Post is happy to provide a forum for it. Thousands of dollars of servers dedicated to allowing the most puerile, fact-free and hatred-laced comments on the web.

Posted by: jjhare | March 3, 2010 4:52 PM | Report abuse

Mr. Lane--you are wrong-dead wrong. Every day people are dying in this country because they can't get affordable healthcare because they have no insurance or are underinsured or because they can not afford it or have pre existing conditions. Affordable and decent healthcare is a right under "Life, liberty and the pursuit of happiness".

Posted by: jstewartecu | March 3, 2010 4:53 PM | Report abuse

I think that Mr Lane's article highlights the main problem with public discourse in America right now.

If we are going to have a discussion about Healthcare there is no need to fudge and use fuzzy numbers to "win" the argument. Let the best argument win, not the best lie.

First off there is "First, the number includes 9.3 million non-citizens." So, the line in the sand has moved from illegal aliens to non-citizens. Unfortunately for Mr Lane, non-citizens include people with green cards (the first step to citizenship). So, the article begins by ignoring legal US residents?!? People who work and have families in the US. People who will one day be Citizens?

As one comment suggests, if Mr Lane kept writing he would find a way to whittle the number of uninsured down to 3. Not that he would believe that number, or any number that he comes up with. He simply thinks that that is the way the game is played.

If the right-wing keep playing the game as if all Americans are stupid then they are using a losing strategy, but I guess that it pays the bills for now (kind of like the Bankers with Mortgage backed securities, except the Republican party are not too big to fail).

Posted by: Selims | March 3, 2010 4:55 PM | Report abuse

guess I'm missing the writer's point. Is he saying that the President is overstating the health care problem?

In my opinion, he's understating it. We're leaving out the millions with basically what should be considered "catastophic" health care coverage. The kind that individuals only use for major health problems. With $2,000 and higher deductables, there is no preventive care and little care for serious, yet not life-threatening, illnesses.
=============

And what's wrong with Catastrophic Coverage?

Were you aware that the cost for "Self-Pay" health care - are 1/3 the cost for a full service claims processed procedure? And there’s even a bigger savings on the premiums.

Preventive tests that cost upwards to $750 when processed through an insurance claim costs less than $200 when self paid.

You will ALWAYS pay more when you involve a second or third party to handle your affairs.

The advantage of Catastrophic Care (even with a $2,500 deductible) - you take ownership of your own health rather than relying on strangers who see you only as a number. If you are smacked down with a debilitating disease, once you hit the deductible, you are covered 100% (with most policies) - full coverage without fear of losing the farm.

For those who feel catastrophic insurance is ONLY for people who can't afford anything else - you couldn't be more wrong. It's for people who are independent thinkers, take ownership of their health and able to get as much quality health care as the "full service" policy holder, for 1/3 the cost. PLUS … there are no networks that restrict access to doctors YOU want to work with.

Americans should give it a try - but unfortunately, the majority have bought into the Obama Plantation thinking mode and convinced only the government can do for them because they are incapable of doing for themselves.

The truth is, with this bill the government is doing it TO them and that's why most Americans know this is a bad bill.

Posted by: asmith1 | March 3, 2010 4:58 PM | Report abuse

I urge everyone to READ THE LEGISLATION and understand for THEMSELVES the implications of this horrible bill to their health and well-being. It is not an accident that the vast majority of Citizens see this as an egregious hurt.

Posted by: wcmillionairre | March 3, 2010 5:09 PM | Report abuse

I am in the "young invincibles" age group and although I don't have numbers and facts, I can say from anecdotal experience that all of my friends (juniors and seniors in college) are terrified of losing their parents' health care insurance.
We may be young, but we get sick too. Young people are most at risk for swine flu, take birth control and reproductive health seriously and are subject to random infections, broken bones, etc. that anyone else has to deal with. My friends and I don't want to be in the position of having to decide between rent, food, and health-related expenses if we get in a bind and don't have insurance.
Most of us don't know what its like to be without a safety net, but we definitely don't want to find out.

Posted by: ChemEStudent | March 3, 2010 5:15 PM | Report abuse

if you are young and healthy but have an accident with severe injuries you can start your life in deep deep debt. Or, you may get a terrible infection and receive substandard care because you are uninsured. Most college kids, as many have mentioned in earlier posts, are afraid of losing their coverage through their parents. Mr.Lane should try an experiment: give up his health insurance for a year, just for fun. If he has a family, make sure they also are not covered. See how that feels. Maybe he is a billionaire so it won't matter, but I doubt it. I know people who are without insurance. Free clinics and clinics that charge "what you can afford" a few and the care is spotty at best. Will the currently proposed bill solve all problems? Of course not but it is a beginning towards a better system. If you are poor, young or old and have no insurance or are denied because of pre-existing conditions you can speak with authority about what it is like to be uninsured. Mr. Lane has no credibility on this subject in my opinion.

Posted by: babsygee2 | March 3, 2010 5:42 PM | Report abuse

To douglaslbarber:

Labor is about 3% to 5% of cost of produce. So, you could double the wages paid to those who pick vegetables and the price would go up a couple of cents a pound.

Thanks to immigrant field workers, labor costs on the farm are too low. This discourages farmers from investing in mechanized harvesters.

Cesar Chavez's union men went into the fields and beat the tar out of any illegals they found.

Posted by: pmendez | March 3, 2010 5:46 PM | Report abuse

A few factoids for comparison
- 0.5 to 1.5% - the TOTAL cost of medical malpractice in US.
If we could magically every malpractice lawyer we'd only save 1%, about $25 billion a year

- 2-3% - total cost of treatment for undocumented aliens. Yes, this is mostly borne by public hospitals and ERs.
If we magically shipped every illegal home tomorrow we save 2%, about $50 billion a year.

So, you're still left with 97%.

- 12-17% of total healthcare costs. That's the $250-450 billion a year going to for-profit insurance firms to provide absolutely no value.

That's about $2.5 to $4.5 TRILLION over the next 10 years of our money completely wasted. Not a penny pays for a doctor or pill. That's 4 times greater than the public spending on HR 3692.

o you think insurance firms have a greater influence than tort lawyers and defenders of illegals? Why don't the Republicans complain about the insurance firms? For that matter, why do half the Democrats in the Senate defend the insurance firms? D

Posted by: boscobobb | March 3, 2010 6:40 PM | Report abuse

I loved this column. We need more, much more, of the same. Most of the commentary has been so blindly ideological that the public is short-sheeted, I'd bet intentionally, on the bare basics: who is uninsured? Many wonder about subsidizing, people who are comfortably over the poverty line.

We need reform. Warren Buffett said it best - forget the 2000 pages -- work on reducing costs. But that is not what these bills - and their perfervid supporters, is about.

This is especially inexcusable given the poll numbers against this massive bill.

Other countries enforce strict immigration policies wherein migrants are not permitted to become a burden to society. With our hospitals completely overwhelmed in key areas, ours is a free-for-all - literally. Any and all comers cannot be permitted to use this country, and our taxpaying citizens, as an ATM.

The U.S. is circling the drain. Don't ask what your country can do for you, but what you can do for your country? Forget it.

Posted by: SueR1 | March 3, 2010 7:38 PM | Report abuse

Okay, I think it is funny that the writer failed to state what the poverty level is in this country because saying 300 percent above poverty sounds like a lot of money, right?
Okay, so the poverty level for an individual under the age of 65 in 2009 was 11,000 and some change. So, three times that is $33,000/ year. Take out, say $6000 for tax and that leaves you with $27K. Divide by 12 would give a little over 2K a month to live on.
Now, I lived on 35K a month for five years and I could not afford health insurance premiums of $350/ month for a healthy individual (I was in my 30s) after I paid rent, groceries, car, gas, etc... And forget clothes. I got those for Christmas from family.
For this loser to think that those people can afford insurance proves that he has never lived at 300 percent poverty level. The fact that poverty level is so low in this country is criminal in itself.
So, yes, Obama actually has a soul and should provide coverage for the 25 - 30 million people that CANNOT afford health insurance.

Posted by: phorse | March 3, 2010 7:52 PM | Report abuse

This issue has lost all coherence. The vast majority of the people I know either have no coverage or are people who have recently discovered that what they're paying for does not cover their problem. The first step is to get the insurance industry out of the medical business.

Posted by: mikie44 | March 3, 2010 8:24 PM | Report abuse

Doesn't the Post have an editor who will step in when this kind of nonsense shows up on the desk. Lane is quoting some right wing talk-radio talking points here. I would invite him to sit down for 5 minutes with any ER doc to find out what percentage of patients are uninsured. I have yet to find anyone anywhere who quotes less than 25%. Of course that number includes many repeat visits from the chronically ill who are uninsured, but these carrots and sticks make a tremendous financial impact on the system.

Posted by: dcharles1 | March 3, 2010 9:06 PM | Report abuse

For all the MD who think Obama Health Care is a good idea and save money, there is a even better solution that won't bankrupt the country. Cut your fee by 90% and stop ordering useless tests to cover you own behind. Hello, MDs, you are rich, you can afford it, you don't really need that big house and fancy car. There really isn't any reason why it should cost $150 for a 3 minute visit while I wait for 30 minutes in the waiting room with the other 10 people. No, you don't like that? Than stop telling me to pay for it with higher taxes.

Posted by: AT_MD | March 3, 2010 10:03 PM | Report abuse

Mr. Lane,

What the point of linking an immigration website and saying "clearly a lot of them are" counted among the uninsured.

Really? Prove it. Otherwise, you look like a donkey. Problem is, you can't prove it.

Posted by: delantero | March 3, 2010 10:40 PM | Report abuse

""Hello, MDs, you are rich, you can afford it, you don't really need that big house and fancy car""

Really? What's the average cost of a medical school education PLUS residency? What's the cost of opening up your own medical clinic, to include the overhead, the staff, the malpractice insurance, billing and fighting insurance companies for care, etc? What does Quest or similar lab company charge for those tests that you whine about?

Posted by: delantero | March 3, 2010 10:46 PM | Report abuse

"These clinics are located primarily in lower-income areas, so transportation should not even be an issue

Weissler"

Show me the transportation available in Appalachia, the acres of farmland that dot the Plains, etc where no one can get a doctor that wants to go treat a town of 1,000 . . as they can't make the books work. How about you leave your computer and go try to get to a clinic with "public transportation" outside of your big city.

Posted by: delantero | March 3, 2010 10:50 PM | Report abuse

You have to be kidding...did you say something about some Bush expert or something...puhlease!!

Posted by: dbarts27 | March 3, 2010 11:15 PM | Report abuse

So, there are only 25 million "ewal" uninsured in America. Problem Solved.

Oh, there are only 10 million "real" Americans without insurance or access to it. But the republican plan only covers 3 million.

For younger people not to have insurance is not rational. They may run a lower risk of needing insurance, but this is an economic decision based on percieved risk and their decisions to entertain that risk based on multiple circumstances including economic levels, but it is not thus rational. Let's not pretend this is some sort of proven logical decision or statement.

Lastly, of the 20 million or so the article opines are non-citizens, if they need medical care they still go to US hospitals. And if they are uninsured, or do not otherwise make payment the cost of that care is still passed on through the system nonethelrss. Lets also not pretend that non-citizens never require healthcare services are non-existent in their effect upon the greater system.

Posted by: jmdziuban1 | March 4, 2010 12:23 AM | Report abuse

Basically, teh author by simply stating his number of uninsured as lower than 30 million, that therefore every claim concerning healthcare by the president is disproved. One example apllies to all situations, the author seems to be making a jump from the particular to the general, which is invalid.

Posted by: jmdziuban1 | March 4, 2010 12:27 AM | Report abuse

This is a good idea, Lane. If we just ignore the middle class that doesn't have insurance, stop treating the elderly that don't sign up for Medicaid, keep prices high enough that it remains rational for 30-year-olds to not purchase coverage, and pretend illegal aliens won't get treated by hospitals, then we'll have far fewer uninsured to count! (Though we'll still pay more per person and have more uninsured and underinsured than any other first world nation). But wait... that's what we have right now. Lane, can you come up with an idea to make it worse?

Posted by: ParkShark | March 4, 2010 9:49 AM | Report abuse

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