Friday, January 2, 2015

Grubermania! Strikes Uninsured

In a post last January THC asked Where Are All The Uninsured?, pointing out that the
widely used figure of 40-50 million Americans unable to get health insurance was a gross overestimate.  He wrote of the Affordable Care Act:
Has this entire fiasco been triggered by bad estimates abetted by the misuse of those estimates to create a crisis atmosphere to justify passing a law under which the Department of Health & Human Services estimates that up to 93 million Americans may lose their existing insurance, and, in many cases, end up spending substantially more out of pocket for their new coverage and possibly losing their existing doctors?  
THC recently came across further confirmation of his post in a 2009 paper by, of all people, Jonathan Gruber of Grubermania! fame.  In that paper, Universal Health: Progress & Issues, Gruber observes:
You cannot get to universal coverage without an individual mandate. It’s simply impossible. I know that because today one-third to one-half of the uninsured are already offered free or heavily subsidized insurance but don’t take it. Four-fifths of uninsured kids right now could walk into a Medicaid office and get free public health insurance but don’t do it. One-third of the uninsured are offered heavily subsidized health insurance by their employer, but they don’t take it because they think they’re invincible and they don’t need it. So there’s no way to get to universal coverage unless you have a mandate. 
The professor's estimate of 1/3 to 1/2 of the uninsured actually having access to free or heavily subsidized insurance prior to the passage of Obamacare exceeds THC's estimate of 1/4 of the uninsured being in that category.  There is no footnote or discussion for the source of Gruber's data so comparison with THC's estimate may be difficult.  Nonetheless, his assertion is further support for the proposition that supposed number of the uninsured and more importantly, the reason for the lack of insurance, was used in a misleading way to induce a sense of urgency with the public and Congress.

And by the way, in the same paper Gruber states that Obamacare is designed to provide coverage to the uninsured but has no (as in zero, nada, zilch) cost control measures in it so yes the President was making "incorrect promises" (in the nomenclature preferred by the New York Times) when he promised everyone that their premiums would decrease by $2500.

No comments:

Post a Comment