8. Kaiser Family Foundation, "Employer Health
lesson from national health care systems
Benefits 2007 Annual Survey," Kaiser Family
around the world, it is not to follow the road to
Foundation, September 11, 2007.
government-run national health care, but to
9. 2007 Annual Report of the Board of Trustees of the
increase consumer incentives and control. The
Federal Hospital Insurance and Federal Supplemental
United States can increase coverage and access
Medical Insurance Trust Funds (Washington: Gov-
to care, improve quality, and control costs
ernment Printing Office, 2007).
without importing the problems of national
10. Jagadeesh Gokhale, "Medicaid's Soaring Costs:
health care. In doing so, we should learn from
Time to Step on the Brakes," Cato Institute Policy
the successes--and the failures--of systems in
Analysis no. 597, July 19, 2007.
other countries.
11. Carmen DeNavas-Walt et al., "Income, Poverty
and Health Insurance in the United States: 2005,"
Notes
Current Population Reports (Washington: U.S. Census
Bureau, 2006). This number should be approached
The author wishes to thank Pierre Bessard of the
with a great deal of caution, however. A study for the
Institut Constant de Rebecque; Valentin Petkant-
Department of Health and Human Services suggests
chin of the Institut Economique Molinari; Alberto
that the Current Population Survey "appears to over-
Mingardi of the Instituto Bruno Leoni; and Regina
state the uninsured substantially compared to other
Herzlinger of Harvard University for their assis-
surveys." Cathy Callahan and James Mays, "Working
tance. The author would also like to offer special
Paper: Estimating the Number of Individuals in the
thanks to Jonathan Cohn of the New Republic and
United States without Health Insurance," Actuarial
author of Sick: The Untold Story of America's Health
Research Service, prepared for the Department of
Care Crisis--and the People Who Pay the Price, for his
Health and Human Services (Washington: U.S.
willingness to review and comment on this paper
Department of Health and Human Services, 2005),
despite disagreeing with my conclusions.
p. 22. Other studies put the actual number of unin-
sured at 2131 million. Congressional Budget Office,
1. SiCKO, Dog Eat Dog Films, 2007.
"How Many People Lack Health Insurance and for
How Long?" (Washington: Congressional Budget
2. Paul Krugman, "The Waiting Game," New York
Office, 2003). Moreover, all those estimates include
Times, July 16, 2007.
people who could obtain coverage. For example, as
many as one-third of Americans without health
3. Physicians for a National Health Program, "Insur-
insurance are eligible for existing government pro-
ance CEOs Fattened on the Suffering of Many,"
grams such as Medicaid or the State Children's
http://www.pnhp.org/news/2006/april/the_health
Health Insurance Program but have failed to sign up
care_tipp.php.
for the program. BlueCross BlueShield Association,
"The Uninsured in America," January 2005, www.
4. Paul Krugman and Robin Wells, "The Health
coverageforall.org/pdf/BC-BS_Uninsured-America.
Care Crisis and What to Do about It," New York
pdf. Roughly another third live in households with
Review of Books, March 23, 2006.
annual incomes above $50,000, suggesting that
many could reasonably afford to purchase insurance
5. Organisation for Economic Co-operation and
if they chose to do so. Devon Herrick, "Crisis of the
Development, "OECD Health Data 2007: Statis-
Uninsured: 2007," National Center for Policy Anal-
tics and Indicators for 30 Countries" (Paris:
ysis Brief Analysis no. 595, September 28, 2007.
OECD, 2007).
12. "Overview of the Uninsured in the United
6. Christine Borger et al., "Health Spending Projec-
States: An Analysis of the 2005 Current Population
tions through 2015: Changes on the Horizon,"
Survey" (Washington: U.S. Department of Health
Health Affairs 25, no. 2 (2006): w61w73, http://
and Human Services, 2005).
content.healthaffairs.org/cgi/content/abstract/
hlthaff.25.w61.
13. This is not to say that universal coverage
should be the goal of health care reform, and cer-
7. Uwe Reinhardt of Princeton University, for ex-
tainly not the primary goal. Universal insurance
ample, estimates that nearly half of the difference in
coverage does not necessarily translate into access
spending between the United States and other
to care. And, while some evidence indicates that
industrial nations is due to America's higher GDP.
uninsured Americans have somewhat worse
Uwe Reinhardt, Peter Hussey, and Gerard Anderson,
health outcomes than insured Americans, the evi-
"U.S. Health Care Spending in an International
dence of a direct link between health insurance
Context," Health Affairs 23, no. 3 (2004): 1112.
and health is weak. Nor is expanding insurance
36