Carpe Diem

31% of Americans without health insurance live in households making $50k or more, and 38% are between 18-34 years old

The Census Bureau recently released its annual study on “Income, Poverty, and Health Insurance Coverage in the United States: 2011,” and reported that in 2011 there were 48.6 million Americans living in 20.5 million U.S. households without health insurance, which was a slight decrease from the 49.9 million uninsured Americans in 2010.

The chart above shows the distribution of those 20.5 million uninsured households by household income level in 2011.  There were 3.1 million U.S. households making $75,000 per year or more who were not covered by health insurance in 2011, and this group represented 15% of the total number of uninsured households last year.  There were 3.3 million American households without health insurance with household income between $50,000 and $75,000 in 2011, representing 16% of the uninsured.  For those two groups combined, 31% of Americans without health insurance last year were living in the 6.4 million uninsured U.S. households with annual income of $50,000 or more.

Q: With $50,000 or more in household income, wouldn’t many or most of those 6.4 million American households be without health insurance voluntarily?  That is, couldn’t many of those households afford some type of low-cost basic health insurance?  As one example, you can purchase high-deductible basic health insurance coverage through BlueCross BlueShield of Texas for as low as$80 per month for a 30-year old male and for $102 per month for a 30-year old female, which is about the same as the monthly cost of a cell phone or cable TV plan.

Alternatively, with those income levels (especially the 3.1 million households with income above $75,000), couldn’t many of those households choose to forgo health insurance in favor of being “self-insured,” at least for routine health procedures? Given the widespread availability of more than 1,300 convenient and affordable retail health clinics around the country at Wal-Marts, Targets, Meijers, CVSs and Walgreens, these households could easily operate on the “pay-as-you-go” model of self-insurance for health care, at least for routine medical services.  And even for more expensive medical procedures, there are market-based medical providers like MediBid and the Surgery Center of Oklahoma that provide low-cost, cash-only medical services like surgery and MRIs at huge savings for self-pay patients.

It’s also the case that about 4 out of 10 uninsured Americans (38.1%) in 2011 were between the ages of 19 and 34 years, and more than half of the uninsured were between ages 19 and 44.  It’s possible that many of the younger people in those age groups are voluntarily uninsured and instead decide to be “self-insured” because they are young and healthy and elect not to purchase health insurance.

As Thomas Sowell wrote three years ago when Obamacare was being rushed through Congress before the August recess:

As for those uninsured Americans who are supposedly the reason for all this sound and fury [Obamacare], there is remarkably little interest in why they are uninsured, despite the incessant repetition of the fact that they are.  The endless repetition serves a political purpose but digging into the underlying facts might undermine that purpose. Many find it sufficient to say that the uninsured cannot “afford” medical insurance. But what you can afford depends not only on how much money you have but also on what your priorities are.

Many people who are uninsured have incomes from which medical insurance premiums could readily be paid without any undue strain (see chart above). Many young people, especially, don’t buy medical insurance and elderly people already have Medicare.  The poor have Medicaid available, even though many do not bother to sign up for it, until they are already in the hospital– which they can do then.

Throwing numbers around about how many people are uninsured may create the impression that the uninsured cannot get medical treatment, when it fact they can get medical treatment at any hospital emergency room.

MP: We’ve now got Obamacare coming soon, and everybody will be forced to buy a federally approved insurance policy whether they want one or not, even those who can currently afford insurance but choose not to, and the young 18-34 year-olds who also currently elect not to buy insurance.  We might have another very expensive government solution to what might have been very much of a non-problem.

10 thoughts on “31% of Americans without health insurance live in households making $50k or more, and 38% are between 18-34 years old

  1. You find the same thing in every government “poverty program”. They are sold to the gullible public as helping those who are destitute, but a big portion of the beneficiaries are not. There are not 40 million people in the US who cannot afford to buy food. There are 40 million people who are glad to have someone pay for their food (and cell phone). The average household income of people earning minimum wage is over $50,000, but they’re quite happy to have someone pay them more in the name of helping the destitute. The typical person receiving a subsidized educational loan comes from a middle class income family. Families earning over $80,000 can be eligible for SCHIP insurance. The purpose of these programs is not primarily to help the destitute; it is to buy votes by taking money from one set of people and giving it a another.

  2. I think the question is what should happen to these people if they require expensive healthcare because they either get severely injured or sick, requiring expensive medical treatment they can’t afford? Is it acceptable for them to die since they choose not to buy insurance? At the very least, perhaps we should allow them to obtain doctor assisted suicide so they can end their lives without suffering since they can’t afford medical care that would otherwise save thier lives?

  3. why is this such a revelation? This is human nature – around the globe.

    The same people would not buy auto insurance unless “forced”, nor would they pay FICA taxes unless “forced”, they would not pay property taxes for schools and law enforcement, EMS service unless forced.

    These folks would spend their whole life not paying for it until they then need it – and cannot get it and then rely on the govt (other taxpayers) to pay for their medical care, retirement expenses.

    That’s the core issue – not just in this country but every industrialized country around the world – more than 100 countries and a billion people – there is a certain number that will not pay for things they will use or ultimately will need.

    A certain number of people simply will not set aside money for their future needs even if they can afford it – and then later when they inevitably encounter costs – they will expect the govt / others to pay. They’ll show up at the ER expecting to get care and when they get the bill, they’ll say they can’t pay it because they have a lifetime of not paying for things they don’t have to.

    The compulsory payroll taxes protects other taxpayers from these people.

    These are the same people that we put traffic signals up for and laws to regulate their behavior -to protect others from them.

    Now there are countries where these kind of people are left alone and are “free”. They are called 3rd world countries and in those countries, they WILL let you die on the steps of the ER.

    But in every single industrialized country on the surface of the earth – they won’t let you die on the ER steps but they also won’t let you shrink your responsibility to pay.

    These folks have choices. They can convince enough others to have a govt that does not force them to pay (good luck on that) or they can go find a country that better suits their needs.

    The really funny thing is that the is the Conservative GOP that originally favored the “individual mandate” in 1993.

    In fact, in 1798, many of the signers of the Constitution supported “forced” payment of taxes for health care.

    Now you would have thought that if the framers of the Constitution did not envision the govt taxing people for health care – that they would have strongly opposed such legislation,but in fact, they favored it.

    • Larry, Auto liability insurance is an indemnification for personal injury or bodily injury to a third party. The potential loss to the third party would be a result of your action. By definition you would have to make them whole even if you did not have insurance. You cannot make the same argument for health insurance. Your actions do not cause another’s illness nor does your failure to purchase health insurance transfer their health risks onto yourself.

      Your other examples of taxes being involuntary is also wrong. Most taxes are by definition consensual i.e., duly passed laws by freely elected representatives. Most taxes are ethical even those that fund the grant of positive rights like general revenues being allocated for a negative income tax better known as the EITC.

      The question for policy is not just what is ethical, e.g., do we have your consent to infringe on your negative rights, but also what is an effective policy; does it achieve its goals? Obamacare fails the ethics test and it perhaps fails the effectiveness test.

    • So you would force people to do something in order to prevent them from being forced to do something?

      As always, the are several major logical problems with your comment. If you wish, I’ll point them out to you. Just ask.

  4. How many of the folks in the 25 to 50k category are families, where the medical insurance premium for the family is over 10k a year (a typical premium). 20% of income or up to 40% in that range is a lot to spend, although any family under 42k would be able to put their children on SCHIP in many states.
    If a family of 4 50k makes one at 225% of poverty or there about.

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