The Uninsured Class

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The New York Times analysis of census data had a quick blip about health insurance: the number of uninsured increased by 1.3 million from 2004 to 2005. People on the lowest economic rung had already been going naked that is, living without health insurance. The new 1.3 million represents a continuing expansion of middle class people who can’t afford health insurance.

Newsweek reporter Karen Springen and I had blunt conversation about the economics of health care for the middle class. Perhaps I should have suggested we give up on the term middle class, and divide America into the Insured Class and the Uninsured Class.

The difference between the IC’s (insured class) and the UC’s (uninsured class) would not be whether they were vulnerable to an economic collapse as a result of a medical problem. The difference would be how much vulnerability each group faces. The current health care finance system assures that everyone is vulnerable, and insurance makes the difference only between those who can be felled by one trip to the emergency room and those who are brought down financially only by the co-pays, uncovered expenses, and caps that eat them up when a more serious illness strikes.

The bottom line in the Newsweek interview? Our current health care system puts nearly every family at risk. (Read Matthew’s story, if you think otherwise.) But insurance makes a huge difference in how much risk the family takes.

In 2005, another 1.3 million people moved closer to the financial precipice.

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