America?s Uninsured Dilemma (Commentary)

The number of uninsured Americans continues to rise. Last year, according to the latest Census Bureau data, some 47 million Americans had no health insurance, an increase of 2.2 million from the previous year.

And it’s no longer a problem merely for low-wage workers, if it ever was. The Census report found that 1.4 million of the people who became uninsured in the most recent period had household incomes of $75,000 or more.

In the Census Bureau report, fewer than 60 percent of workers now are covered by employer-provided insurance.

Those Americans who still have insurance, and the employers who help them buy it, are paying dearly. Last week, the Kaiser Family Foundation, a health care research organization that annually tracks the cost of health insurance, said health insurance premiums paid by workers and their employers rose an average of 6.1 percent in 2007, again far ahead of inflation and pay increases, although smaller than the 7.7 percent increase of 2006.

Since 2001, the cost of premiums has risen 78 percent, far outpacing a 19 percent increase in wages and a 17 percent jump in the Consumer Price Index. Premiums for employer-sponsored health insurance for a family reached an average of $12,106. That’s a quarter of the median household income in the United States last year ($48,200) and nearly a third of Arkansas’ median household income ($37,240).

The Kaiser folks warn us to expect another rise in premiums next year. Now, was anyone actually expecting a decrease?

The nexus between employment and health insurance – always an artificial connection – means the escalating cost of health care in this country is as much a business issue as a consumer issue. Businesses are put in a bind. Should the additional costs come out of the bottom line or be passed along to customers or employees? Especially burdened are companies that have to compete with foreign competitors whose employees are covered by national health insurance plans.

The Bush administration touted health savings account plans as a way to ease the cost burden of insurance, and we were enthusiastic about the idea and still think it has merit. But employers and workers haven’t bought into the high-deductible plans under which workers can put money into tax-sheltered accounts to cover higher out-of-pocket costs.

Other countries have found ways to contain health costs better than the United States. Some of those ways are not acceptable, but neither is the status quo.