Uninsured or Unexamined?

In the shadow of President Obama and Speaker Pelosi’s increasingly desperate efforts to get health care reform past a recalcitrant Congress, the Cato Institute recently decided to host a discussion highlighting further weaknesses in the President’s public relations campaign. This Monday, July 20th, Cato hosted a discussion at Rayburn Office Building intended to discuss a new study by former Congressional Budget Office (CBO) Director June O’Neill, now of the Employment Policies Institute, entitled “Who are the Uninsured?”

O’Neill prefaced the discussion of her study by highlighting the administration’s oft-repeated claim that 47 million people are uninsured. “That number grossly misrepresents the size of the problem,” O’Neill said, adding that “the number of uninsured is not synonymous with those who lack health care because they can’t afford it.”

This assertion was borne out by O’Neill’s talk, which included several statistics with negative implications for the President’s plan. While O’Neill conceded the 47 million statistic, she pointed out that only thirteen million were actually living close to the poverty line, 29% of which had private insurance. Furthermore, O’Neill said, 42.9% of the uninsured were “voluntarily uninsured,” or earned an income high enough that health insurance was affordable, but still chose to forego it.

According to O’Neill’s study, 40% of the uninsured lived in Texas, California, Florida and New York. Furthermore, the remaining 60%, O’Neill said, were concentrated in the Southern States, states which have historically voted against Democratic policies despite being “quite poor.”

The question of public insurance did not go ignored. While discussing one metric—life expectancy—that could be used to measure the health of the uninsured, O’Neill showed her audience a graph detailing the likelihood of dying by age 60 among Americans who had already reached 51-61 years of age by 1992. While the involuntarily uninsured were 7.1 percent more likely to die than the average, those with public insurance were 17.4 percent more likely to die than the average, with a death rate of 29.3 percent in 2002 and 39.7 percent in 2006. “Those with public insurance were ten percent more likely to die than those who are involuntarily insured,” O’Neill said.

In her concluding remarks, O’Neill expressed skepticism about how much the current health care reforms would change her figures. “The bills that I have seen…are spending more money. It’s not clear that it is really well focused on the problem,” O’Neill said.

Following O’Neill’s presentation, Michael Tanner of the Cato Institute gave a few brief remarks which focused on the general problems with the case for socialized medicine. “Hard cases make bad policy,” Tanner argued, before proceeding to mock the strategies employed by single payer advocates. “You always get this impression that the uninsured are middle class who work two jobs and have seven kids, all of whom are disabled and they just lost their health care yesterday,” Tanner said. “We tend to equate the idea that health insurance equals health care equals health…but there is no evidence that giving them a piece of paper called health insurance makes them any healthier.”

During the question and answer period, O’Neill was pressed for a guess at what the actual number of “uninsured” was in America. “I would say 12 or 13 million,” O’Neill said, before adding, “but that’s a guess.”

Mytheos Holt is an intern at the American Journalism Center, a training program run by Accuracy in Media and Accuracy in Academia.