THE UNINSURED: Interest Wanes as Problem Grows

      "Many Americans appear to be unaware of just how many workers still lack insurance coverage," reveals a new report published in the November/December issue of Health Affairs. In recent surveys, only half of respondents knew that the ranks of uninsured have grown over the past five years, and only 28% knew that more than 40 million people lack coverage. Half of respondents also thought that most uninsured individuals are from families in which no one is employed. In reality, however, most of those who are uninsured are from families in which someone works.

Lower Priority
      Also, the study suggests that a growing number of people "may be unaware of the barriers to health care faced by the uninsured." Fifty-seven percent of those polled believed that the uninsured have access to health care when they need it -- compared to 43% in 1993. Despite murkiness about actual statistics of the uninsured, an overwhelming majority of Americans -- 79% -- support government legislation to fix the problem. However, the report noted that while 55% of the public ranked health care as the second most important issue for the government to address in 1994, only 9% ranked it as highly in 1999 showing that "the problem of the uninsured also has become a somewhat lower priority" for Americans (Blendon/Young/DesRoches, Health Affairs, Nov./Dec. 1999). Robert Blendon, co-author of the study and professor of health policy and political analysis at Harvard's School of Public Health, said at a Monday press briefing that while the uninsured would be one of the "top issues" for the upcoming presidential election, it "will not rank as high as in 1993 and 1994." He said the issue will share the health care slot for this election with the Patients' Bill of Rights and Medicare issues. He also noted that while a majority of Americans agreed that some action must be taken, researchers "could not find any public consensus about what to about the uninsured."

Limited Reform vs. Sweeping Change
      The public is divided between those willing to pay more taxes for a major change and those advocating limited reform in an effort to avoid raising taxes and government interference. Blendon added that "there is an incredible status quo bias for people who have work place insurance to want to keep it." Noting that workers with job-based coverage are "very risk-averse," he added, "[There is] no sign in a poll that those who have work place insurance are willing to surrender it for a broader good." Blendon pointed to the current economic boom and waning press coverage of the issue as reasons behind the public's misperceptions. "People are riding the economy and feeling better ... It takes the [news]papers to tell them that people aren't getting care," he said. For now, Blendon concluded, "the mood is for some incremental change to help the uninsured, but if it gets too broad and threatening," reform will not happen. "I don't see the underlying stomach for" sweeping change, he said (Heather Weaver, AHL, 11/9).