Yesterday I included findings from the first of two recent Kaiser Permanente studies on health benefits. Today I report on the second.
The second report is John Holahan & Allison Cook, Kaiser Commission on Medicaid and the Uninsured – Why Did the Number of Uninsured Continue to Increase in 2005?
The study report states:
On August 29, 2006, the Census Bureau reported that the number of nonelderly uninsured Americans had increased in 2005 by another 1.3 million people—for a total of 46.1 million uninsured—continuing an upward trend that began in the year 2000.1 The changes in the rate of employer-sponsored insurance (ESI) as well as in the uninsured rate in 2005, as in 2004, were substantially smaller than were seen from 2000-2003.2 The changes in 2005 differed from the changes in 2004 in that while there was a comparable decline in the rate of ESI in both years, there was virtually no increase in Medicaid and SCHIP in 2005 and thus the uninsured rate increased. In 2004, there was an increase in Medicaid/SCHIP coverage that offset the ESI decline and there was no significant change in the uninsurance rate. The result was a greater increase in the number of nonelderly uninsured in 2005, 1.3 million, versus 850,000 in 2004.
As in previous years, most of the increase in the uninsured was among adults. Of the 1.3 million increase in the number of uninsured in 2005, 1.0 million was among adults. Between 2000 and 2004, all of the increase was among adults and the number of uninsured children declined. In contrast, in 2005 the number of uninsured children increased. The small increase in the number of uninsured children (300,000) in 2005 reversed the small coverage gains among children (400,000 fewer uninsured) that had been made between 2000 and 2004.
. . .
The data provided in this paper have shown that over the first five years of this decade the rate of employer-sponsored insurance has declined and the uninsurance rate increased. By 2005, the number of uninsured children began to increase as Medicaid/SCHIP coverage no longer fully compensated for the decline in ESI as it had in earlier years. In the first three years of the decade, the economy was declining based on a number of measures, and this exacerbated the decline in employer- sponsored insurance and the growth in the number of uninsured. But as the economy strengthened, the ESI rate continued to decline and the uninsured rate grew, albeit at slower rates.
The primary reason for the continued decline in employer-sponsored insurance is the faster growth in premiums than in wages and incomes, but there are other shifts in demographic factors and employment patterns that suggest that the pattern of declining employer-sponsored insurance and growing rates of uninsurance are not likely to change. These include the shift towards work in small firms and selfemployment and increased work in industries such as services and construction that are less likely to offer employer-sponsored insurance.
This report makes clear that we cannot rely on employers to solve the crisis in health care. Either we allow millions to have no or subpar healthcare, or we decide that we must do the responsible and just thing and provide healthcare for all. It is not a question of socialism, as some would put it. Rather it is a question that was answered millennia ago: What you do to the least of these, you do to me.