Always August, pt 2: 47 million uninsured

"47 million uninsured:" this is really the jumping off point for progressive health care reform, the ur-talking point. No matter what else is happening in the world, the 47 million (a curiously static number) are always lurking. It is the statistic that built a movement, and like all statistics, it is true and at the same time a lie. And people know it's a lie, especially those who chant it as an incantation on the nation's cable TV outlets. See through the lie, and you will see through the case for progressive health care reform.

The purpose of the lie is this: when you hear of 47 million uninsured, you are supposed to imagine US citizens "just like you" who are either so poor as to have been priced out of the health care market or have lost their insurance through some manner of injustice. And you are supposed to be scared, or at least disquieted, enough to support universal care for all, so it doesn't happen to you. But the majority of the 47 million uninsured do not fit this easily imagined category.

Now it may be true that there are approximately 47 million uninsured people in the US as of August 8, 2009. But it is not true that every man jack among them is so deserving of our help that we must reform health care in the manner put forth by the Democrats. In fact, the majority of the 47 million uninsured are either not truly uninsured, or belong to groups who would not be seen as particularly deserving of all of this bother. I linked to this Keith Hennessey post several months ago, and I would urge you to read it. He lays out in good detail the numbers behind the 47 million:

1. 6.5 million are people who are on Medicare/Medicaid, but mistakenly report themselves as "uninsured." THEY DON'T COUNT AS "UNINSURED".

2. 4.3 million are people who qualify for subsidized care (Medicare/S-Chip/etc), but haven't signed up. They are covered but don't realize it. THEY DON'T COUNT AS "UNINSURED."

3. 9.3 million are non-citizens. Hennessey doesn't break down how many are legal/illegal, but does it matter? No one - not even the golden throated Pres. Obama - could go to the American people and say, "We must provide public health insurance to non-citizens who are here illegally." Politically, it would never work, so they just try to lump these folks in with all the rest. Go ahead and blame "hate" or "racism" if it makes you feel better. But, if there is anything in law or morality that justifies turning the US health care system upside down for the sake of someone who has no legal right to be here, I would like to hear it. Without looking, I think I can assume that even progressive Canada does not extend its health care subsidies to illegals. THESE FOLKS MIGHT BE UNINSURED, BUT THEY DON'T COUNT.

4. 10.1 million are people with incomes that are 3X the poverty level (and thus don't qualify for existing subsidies). For a single person, that's $36,000. For a family of four, that's $62,000. There are 10.1 million stories in the naked city, and 10.1 million reasons why these folks are going without insurance. But as of the over-heated summer of 2009, these are the people whom public policy has determined are capable of purchasing their own insurance. WHETHER RATIONALLY OR IRRATIONALLY, THESE FOLKS HAVE DECIDED NOT TO BUY INSURANCE, BUT THEY CAN AFFORD IT IN THE EYES OF CURRENT LAW.

5. 5 million are adults between the ages of 18-34 who don't have kids, and have not traditionally not been high-end consumers of either health care or health insurance. As with the folks in #4, they have made a deliberate choice to not buy insurance, although their mothers nag them about it on occasion. THEY ARE NOT UNINSURED AGAINST THEIR WILL AND COULD BUY INSURANCE TOMORROW IF THEY CARED TO.

As Hennessey sums up, the remaining 10 million are US citizens, who are not covered by existing subsidies, who earn less than 3X the poverty level, and who are not childless adults between the ages of 18-34. These are the people you are actually imagining when you hear the droning repetition of the "47 million uninsured."

10.6 million does not equal 47 million. In case you didn't know. But no one would support the present 1000 page health reform, if it was meant to help these "deserving" uninsured. That too much trouble for too few people. Thus, we hear of 47 million uninsured, even though 36.4 million belong to groups who are, politically and practically speaking, undeserving of assistance.

Like I say, it's a lie. Dems no doubt tell themselves it's a Noble Lie. Some of them may not even realize these numbers are out there, but many do, and they want universal health care to pass, so they lie. That's to be expected. What's outrageous is how so many of the media people who hear the repetition of the 47 million never question the number. Some watchdogs! If someone asked, say Sec. Sibelius why she counts 9.3 million non-citizens among the uninsured (and she does so by omission every time she uses the 47 million formulation), she would have no good answer and, I suspect, the effect would be similar to that of Hillary's "driver's license" gaffe.

There are many reasons to be against progressive health care reform. There are a lot of things that are motivating people to go to town halls to yell at their members of Congress. No one really knows the numbers set out above. They exist in the public record, but are not part of the public discussion. But, I will bet that there are a lot of people out there who don't believe in the 47 million, even though they don't have the numbers at their fingertips.