Another Reason Government-Sponsored Health Care Is Destined to Fail

posted at 3:38 pm on September 2, 2009 by Howard Portnoy
[ Healthcare ]   

Depending evidently on the day of the week and similarly arbitrary factors, Barack Obama and other Democrats eager to pass health care reform will tell you there are anywhere between 45 million and 47 million Americans without health insurance. Even though those numbers are almost certainly an exaggeration, taken at face value they represent approximately 15 and 16 percent of the population respectively. That’s a lot of Americans who can’t afford routine visits to the doctor, let alone — God forbid — hospitalization and/or treatment for a serious illness. Health care, moreover, the administration and Democrat leaders in Congress will tell you is a right, not a privilege. That, too, is a debatable point.

Let me for the moment play devil’s advocate. Let’s take Obama and company at their word and assume that 40-odd million Americans lack health insurance and that all of them want to be insured. In fact, let’s say all are desperate to be insured. Let’s imagine, finally, that H.R. 3200 were currently the law of the land, public option and all. It stands to reason that every uninsured American would be beating a path to the government’s door to claim their prize, right?

Maybe not. Not if we extrapolate findings from a report published by the Urban Institute titled “Medicaid-Eligible Adults Who Are Not Enrolled: Who Are They and Do They Get the Care They Need?” In the interest of full disclosure, let me note at the outset that the report was published October 1, 2001. Most of the data, moreover, were gleaned from the 1997 National Health Interview Survey (NHIS), a large, nationally representative sample of the U.S. noninstitutionalized civilian population. That means the findings are at least 12 years old.

Nevertheless, the report contains comprehensive statistics on the number of Medicaid-eligible adults who are enrolled in the program and those who are not. And the findings are surprising, to say the least. Of more than 3.2 million Americans surveyed, 51.4 percent who were eligible for Medicaid coverage not enrolled in the program.

The details broken out by age, ethnicity, poverty level, and other demographic factors are captured in the table below.

This report is limited to adults, but children fare no better. A second study, completed more recently, in September, 2007, indicates that better than 6 out of 10 uninsured children qualify for Medicaid or the State Children’s Health Insurance Program (SCHIP) but are not enrolled.

Neither report addresses the question of why individuals who qualify for government-assisted health care fail to avail themselves of it. One possible answer may be adduced from the education data contained in the above table. Notice that as education level increases, so does the percentage of Medicaid-eligible individuals who take advantage of the program.

But then this poses a whole new problem for an administration bent on providing nationalized health care to a population many times larger. To understand the dilemma they face, consider the amount of bureaucratic red tape that was part and parcel of the Cash for Clunkers program that has some cars dealers wondering if the government will ever reimburse them for sales they made. For that matter, when has the federal government ever been successful at simplifying even the most trivial of its dealings with the American people?

Nationalized health care may pass. I’m keeping my fingers crossed that it won’t. But it does, expect the resulting boondoggle to be of a magnitude that dwarfs the Big Dig in Boston.

Cross-posted at Zombie Contentions

Blowback