0 Trumps 700,000

I'm reading T. R. Reid's book The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care. He writes about the world's major health systems, and notes that every major developed country, except the United States, ensures that all of its citizens have access to medical services. They do it in a variety of effective ways, but they all do it. America is exceptional for its failure to do so.

And, because other developed countries do ensure everyone has access to healthcare, they do it for far less cost per capita, than the United States. This is true, even though many of these countries, have far larger percentages of their population in the 65 and older and 80 and older age groups, than does the United States. Older people use much more medical care than do those under age 65.

Country	% 2000 Population 65+	% 2000 Population 80+
France	15.9%	3.8%
Germany	16.4%	3.6%
Japan	17.1%	3.7%
United Kingdom (Britain)	16.0%	4.2%
United States	12.5%	3.3%

In his travels around the world to learn about the major health systems, he asked the health ministry of each country how many citizens had declared bankruptcy in the past year because of medical bills. "Generally," he writes, "the officials responded to this question with a look of astonishment, as if I had asked how many flying saucers from Mars landed in the ministry's parking lot last week.

"How many people go bankrupt because of medical bills? In Britain, zero. In France, zero. In Japan, Germany, the Netherlands, Canada, and Switzerland: zero. In the United States, according to a joint study by Harvard Law School and Harvard Medical School, the annual figure is around 700,000," even though we've modified bankruptcy law to make filing more difficult. We've reformed bankruptcy law to provide additional protection for creditors. It's now time to reform healthcare to provide protection for all Americans.

The U. S. population totals about 307 million people. The population of Britain, France, Japan, Germany, the Netherlands, Canada and Switzerland totals more than 392 million.

The purpose of health insurance is to protect us from the financial catastrophe resulting from illness or injury. The rest of the industrial world has developed far more effective answers than we have in the United States. The score is World - 0, United States - 700,000. And with a score like that, it's the United States that is losing.

The Surge of the Underinsured

Much of the tragedy of our unreformed health care financing system is hidden. We don't find out how poorly we are covered by our health policy until we have a serious illness. An interesting report from the Commonwealth Fund shows the fastest growing population segment is those who are underinsured, not those who are uninsured.

The uninsured population has grown about 54 percent between 1993 and 2008, rising from about 30 million to 46.3 million in 2008. Since the full impact of the Great Recession was felt in 2009, and since those who can afford to keep employer-based health insurance as a result of COBRA for up to 18 months would only now be losing coverage, even at this point in 2010, the number of uninsured is probably less than 55 million, and this would represent an increase of 83 percent over 15 years.

The following charts show that the number of underinsured has grown by 62 percent in only the four years from 2003 to 2007. Conversely, those who are adequately insured in the population under age 65 (Medicare provides universal coverage for those 65 and older), dropped from 65 percent to 58 percent in the four year period. The cause? An 8.8 percent increase in the uninsured, and a 62 percent increase in the underinsured.