One thing Congress and the president can count on if universal health care legislation is not passed: the health care problem in the U.S. won't go away.

The percentage of Americans covered by private health insurance has fallen to a 50-year low, according to preliminary data compiled by the U.S. Centers for Disease Control and Prevention and reported by the AP. And 65 percent of non-elderly Americans had private health insurance in 2008, down from 67 percent in 2007 and almost 80 percent in the 1970s and early 1980 according to the CDC.

Further, the CDC estimated that 44 million Americans had no health insurance in 2008 - a total that mirrors estimates by other health and public policy organizations. The U.S. Census Bureau, considered one of the most comprehensive surveys of Americans, is expected to release its closely-followed annual estimate of health insurance coverage for 2008, in August.

'Blue Dogs' seek health spending cuts

On Wednesday night, President Obama is expected to underscore his requirements for health care reform during a press conference. Earlier Wednesday, according to Bloomberg News, House Speaker Nancy Pelosi, D-Calif., said she has the votes to pass health care reform legislation in the House, even as leaders seek ways to bolster the bill's coalition.

"I have no question we have the votes on the floor of the House to pass this legislation," Pelosi told Bloomberg News.

Pelosi has sought to wring additional inefficiencies out of current federal medical spending, including Medicare and Medicaid, in order to meet pleas by selected conservative 'Blue Dog' House Democrats, who argued the health care reform bill does not reduce spending enough and relies too much on revenue, NPR reported Wednesday. Further, the House bill would have to be reconciled with the Senate's bill, which, if passed, is expected to contain many substantive differences, including a lower tax increase on higher-income Americans, increased protection/assistance for small business owners and probably a longer phase-in period for citizens currently without health insurance.

Fiscal/Economic Analysis

Given the likely rise in the U.S. unemployment rate, and the link between unemployment and loss of private health insurance, the percentage of Americans without private health insurance is likely to continue to rise in 2010, at least until job growth resumes. Invariably, that means hundreds of thousands of additional Americans who can not pay for coverage will show up at hospital emergency rooms for treatment at $1,000 per visit and up, paid for by the U.S. taxpayer. That health care inefficiency alone should be enough to propel health care reform, from economic and taxpayer standpoints. Without the health care reform bill's structural changes to Medicare and Medicaid, each program is unsustainable under the current revenue/expense framework.


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