Health Care's Big Secret

Saturday, Jun 27,2009, 1:21:00 PM Click:

There's no reason to nationalize health care because most Americans are happy with the coverage they receive - including most of those who don't have health insurance.

Eighty-nine percent of Americans are satisfied with their own personal medical care, according to an article in Regulation magazine this week. Of those with insurance who had suffered a serious illness during the last year, 93 percent were satisfied; 95 percent of those who suffered chronic illness were satisfied with their health care.

Those are some impressive numbers. Yet only 44 percent were satisfied with the overall quality of the American medical system. The reason is that most Americans seem to believe that lack of insurance for others means that those others receive no access to health care. The same survey showed that 88 percent of those surveyed thought the problem of the uninsured was either "critical" or "serious but not critical."

"If the insured come to believe that the uninsured are not that dissatisfied with their health care, it is extremely important," Jack Calfee, a scholar at the American Enterprise Institute, told Fox News on Wednesday. "It could throw a real wild card into the whole health care debate."

The Regulation magazine article closely examines a survey released in October 2006 by the Kaiser Family Foundation, ABC News and USA Today. The survey is unique in that the publicly released data allowed analysis regarding how happy the uninsured are with their health care. While 93 percent of the insured say that they are "satisfied" or "very satisfied" with their own health care, fully 70 percent of the uninsured who indicated their level of satisfaction said the same thing.

If you take the Kaiser/ABC News/USA Today survey's estimate of 13.4 percent of Americans being uninsured and that 17.5 percent of the uninsured are "very dissatisfied" with the care that they are receiving, just 2.3 percent of Americans are both uninsured and "very dissatisfied" with the care they receive. That amounts to 5 million people. Including all uninsured raises the total to 8.4 million. This is a far cry from the 46 million number that is frequently bandied about by politicians and media to count the uninsured.

The explanation for Americans' overwhelming level of satisfaction with health coverage - even among the uninsured - is that the term "uninsured" is misleading. Having no insurance doesn't mean someone goes without health care. The government Medicaid program effectively covers at least some of the uninsured who are dissatisfied. Since Medicaid does not exclude people based on pre-existing conditions, many of those effectively covered by Medicaid do not register until they become ill - they are effectively insured at all times even though they haven't joined the program. Many of the others who are uninsured are illegal aliens.

It's a mistake to try to fundamentally alter a system when so many people are so happy with the status quo. Instead of nationalized health care, a more targeted and much cheaper reform could take care of just those who are dissatisfied. The danger is that the majority of Americans who currently are satisfied will become dissatisfied. The rush to pass something quickly in one giant reform is destined to failure.