Posted on September 29, 2000

Despite Economic Boom, Number of Uninsured Drops Only 4 Percent


42.6 Million Americans Lack Health Coverage, Including 10 Million Children

Despite the longest economic boom in history, the number of Americans without health insurance dipped just 4 percent last year, from 44.3 to 42.6 million, according to data released today by the Census Bureau. While minorities make up 48 percent of the uninsured, 90 percent of the drop was in non-hispanic whites, according to an analysis by Physicians for a National Health Program.

"This discouraging data proves once again that we cannot grow our way out of the health care crisis," said Dr. Steffie Woolhandler, Associate Professor of Medicine at Harvard. "The market is still leaving 42.6 million Americans (nearly one in every six persons) behind, up 5.2 million since 1992."

The 42.6 million uninsured include over 20 million women and 10 million children -- the same number of children uninsured when the Children's Health Insurance Program was enacted.

"The strategies of the last decade to address the problem of the uninsured have failed," said Dr. Quentin Young, National Coordinator of Physicians for a National Health Program. "Meanwhile, we're already spending more than twice as much per capita on healthcare as any nation that guarantees universal coverage."

"When I think of the uninsured, I think of my patients who have died because they couldn't get care," said Dr. Deb Richter, a family practitioner in Montpelier, Vermont and President of Physicians for a National Health Program. "A four percent fall in the number of uninsured is a drop in the bucket -- people are still dying and will continue to die until we make health care a right" (1).

In sixteen states, the percentage of uninsured Americans increased in the last year: Alaska, Colorado, Florida, Hawaii, Idaho, Kansas, Kentucky, Louisiana, Nebraska, New Mexico, North Carolina, Ohio, Oregon, South Carolina, Utah, and Washington. In six states, more than one out of every five persons is uninsured: New Mexico (25.8%), Texas (23.3%), Louisiana (22.5%), Arizona (21.2%), Nevada (20.7%), and California (20.3%)(2). The number of states with less than 10% of the population uninsured has dwindled from eleven in 1992 to just six in 1999.

"Hispanic Americans have the highest rates of uninsurance" noted Dr. Olveen Carrasquillo of Columbia University. "Hispanics are working but employers don't provide coverage -- that hasn't changed."

"Moreover, it's a myth that the majority of Americans have insurance paid for by private employers," continued Dr. Carassquillo. "Excluding workers with insurance paid for by the government or by the employees themselves, fewer than half of Americans (43%) have insurance paid by a private employer.

Private employers pay for an even smaller share of total health spending, just over one-fifth (21.2%)" (3).

"These may be the best of times for the economy, but they are among the worst of times for health care," noted Dr. David Himmelstein of Harvard.

"Double digit premium increases are back, medical bills cause half of all bankruptcies, and nobody expects a substantial reduction in the number of uninsured anytime soon. In fact, between premium increases and/or a cooling of the economy, we're likely to see more than 50 million uninsured in the next few years. It's time to reopen debate over comprehensive national health insurance."



(1) Mortality rates are 20 percent higher in the uninsured. "Health Insurance and Mortality: Evidence from a National Cohort" Franks, Clancy, and Gold, JAMA, August 11, 1993.

(2) If you use the three year moving average, Texas still ranks last in the percentage of its population that lacks coverage (Census Bureau Release).

(3) "Private Employers Role in Providing Health Insurance: A Reappraisal" Carrasquillo et al, New England Journal of Medicine, January 13, 1999.