Medical Outcasts: Does Anyone Care?
It is quite a trick for something to grow larger and at the same time become more invisible. But that is what's happening to the health care problem in the United States. The greater the number of people without medical insurance, the less the politicians want to talk about it -- let alone deal with it.</br></br>In 1992, when the plight of the uninsured became a major issue in the presidential campaign, there were 38 million non-covered Americans below Medicare age. Five years later, according to a report released last week, the number had grown by 5 million. And the rate of increase is accelerating, from an average of half a million annually in the first two years to an average of 1.2 million annually in the three most recent years.</br></br>But last week, when the National Coalition on Health Care, a bipartisan group headed by former presidents Bush, Carter and Ford, put out its latest report on "The Erosion of Health Insurance Coverage in the United States," it barely made a ripple. Monica Lewinsky's appearance on "Saturday Night Live" drew more coverage than the fact that in the most recent year cited by the report, 1.7 million Americans were added to the ranks of the uninsured.</br></br>Why is this happening? The report's authors, Steven Findlay and Joel Miller -- who had the assistance of Tulane University's Kenneth Thorpe, probably the country's leading authority on this question -- say the legions of the uninsured are rising because of fundamental economic and demographic forces, which, by themselves, are certain to make the problem worse. The authors say that "even if the rosy economic conditions prevalent since 1992 prevail for another decade, a projected 52 million to 54 million non-elderly Americans -- one in five -- will be uninsured in 2009." If a recession occurs, that number likely will jump to 61 million -- one in four.</br></br>Most of the uninsured have jobs, but increasingly, they work in small businesses or in service sectors that either do not cover employees or require them to pay so much for health insurance that they cannot afford it. The growing numbers of self-employed, part- timers and contract workers swell the totals.