STYRING: Obamacare rests on numbers concoction

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Bill StyringEverybody’s talking about Obamacare. Website crashes. People booted off their health insurance. Sticker shock. No doubt we’ll be talking about it through the 2014 election. And the 2016 election. And most likely well beyond that.

So this might be a good time to step back and look at just what “uninsured problem” Obamacare purports to solve. Just who are those “uninsured” Obamacare is so worried about?

We hear there are 45 million (or 44 million or 48 million … no one knows the exact number) “uninsured” or “without health care” (not the same thing). Sounds like an epidemic worthy of massive intervention to fix, right?

Not so. When you peek behind the curtain, any “uninsured” problem is quite modest and could be solved, if one is so inclined, with measures way short of Obamacare’s taking nuclear weapons to the whole health care sector.

Say the number really is 45 million. Illegal aliens are about 12 million of that. Is it a national tragedy that these souls don’t have health insurance? If they were back in El Salvador or Mexico, they wouldn’t have insurance, either. And the mere fact that they are here reveals a preference for being uninsured here rather than uninsured back there.

Another 10 million or so qualify for Medicaid but don’t, for whatever reason, bother to apply. This number is surprisingly large. About a third of those who could be on Medicaid aren’t.

Turning down this freebie isn’t necessarily irrational. Serious studies—including a particularly huge one in Oregon—conclude there is little difference in health outcomes between having Medicaid and having nothing. Medicaid ain’t the Mayo Clinic.

How many tears should we shed over those turning down a welfare program? They rate applause rather than pity.

Then there are the “young invincibles” who could afford to purchase insurance but choose to spend their money elsewhere. (These are the folks Obamacare wants to commit mass irrationality by buying health insurance they don’t need.)

This number is spongy but is in the multi-multimillions. If a 23-year old wants to blow the budget in singles bars rather than subsidize my arthritis, it isn’t a national disaster.

Don’t forget the temporarily uninsured. When numbers like “45 million uninsured” are thrown around, the implication is that a vast pool of people are always uninsured—sort of a permanent insurance underclass.

In fact, most people who get private health insurance get it through their place of employment. (How we got to this unnatural state of affairs is a topic for a separate column. Hint: The federal government screwed this one up, too, by imposing wage controls during World War II.)

Being unemployed from a job with a health plan causes millions—my own research says roughly 6 million to 7 million in the current economy—to be uninsured. For them, the solution isn’t Obamacare. It’s a job.

So let’s see. Forty-five minus 12 minus 10 minus multi-millions minus seven is … my goodness. We’re down to the fewer than 10 million who have, through no fault of their own, an uninsurable existing precondition. Maybe 2 percent of the population.

These people don’t need Obamacare. They need some kind of subsidized high-risk pool. Indiana has one, and the coverage offered is decent.

Obamacare rests on a phony uninsured “crisis.” But then you can’t have a power grab on one-sixth of the economy without concocting one.•


Styring is an economist, a former Indiana Chamber of Commerce lobbyist, and a former senior fellow at the Hudson Institute. Send comments on this column to ibjedit@ibj.com.


  • I'd like to get in touch with Bill
    Back in the 1980s, I was the Senior Research Associate of the Indiana Fiscal Policy Institute. Bill was a VP at the State Chamber. Could you please pass along my contact info to Bill? My phone number is 317-670-8060. Thanks so much!
  • ACA
    A look at the cost structure of the ACA, for those who are interested. Good luck. https://www.youtube.com/watch?v=j7Y-5rjsaJY
  • Let's Go Back
    I liked it better the old way ... when only healthy or rich people could get health insurance in the individual market. I don't want all these sick people in MY insurance pool!

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