The American health care system is certainly better than most people elsewhere admit. The often-quoted drawback of the dynamic free market based American health system, which leads in most global health issues, is the high number of uninsured people: on average 16% or some forty-six million Americans. However a brilliant analysis published in the New York-based Commentary (subscription only) takes a closer look.

But the stark figure fails to convey the shifting face and varied make-up of the uninsured. On average, a family that loses its coverage (most likely through change of job, FH) will become insured again in about five months, and only one-sixth of the uninsured lack coverage for two years or more. In addition, about a fifth of the uninsured are not American citizens, and therefore could not benefit from most proposed reforms. Roughly a third of the uninsured are eligible for public-assistance (especially Medicaid) but have not signed up, while another fifth (many of them young adults, under thirty–five) earn more than $50,000 a year but choose not to buy coverage.

The article makes clear that being uninsured is by no means the same as being unable to access healthcare, because American hospitals are obliged to deliver all kind of acute care to uninsured people amounting to a $100 billion tab each year paid for by the public purse. And the article warns against the Democrats’ obsession with a European-style single payer healthcare system with universal coverage.

Instead it makes the case for George W Bush’s reform agenda, with health savings accounts and attractive tax incentives for everybody replacing the authoritarian WWII employer-based system of health insurance that still covers 180 million American families. By shifting the tax benefits for health insurance from employers to employees, the President seeks to address the main worries of the middle class: that the whole family looses health coverage with any job change. Portability of insurance must surely be at the core of a 21st Century American health system.

From Adam Smith Institute

Tags: Libertarian, Politics, Liberty, Freedom