Factcheck.org reviewed last night’s Republican debate and found a number of errors. I’m posting the two most significant errors, which repeat claims which are often heard from conservatives, as two separate posts. The first is the claim that reports of 47 million uninsured are greatly inflated by healthy people who choose not to have insurance. These facts also support Barack Obama’s argument that mandates are not necessary because most people who have the opportunity to receive affordable care will do so.
Romney’s Freeloaders
Romney offered a theory for the number of uninsured that is simply false:
Romney: And the reason health care isn’t working like a market right now is you have 47 million people that are saying, “I’m not going to play. I’m just going to get free care paid for by everybody else.” That doesn’t work.
This idea – that most uninsured Americans simply don’t feel like having health insurance – has been heard before from this year’s GOP field. We addressed it here, after Huckabee claimed at a Dec. 10 debate that a third of the uninsured “think they’re healthy and invincible.” Experts say this is simply not the case: Most people who are offered insurance do not turn it down, neither because of perceived invincibility nor from an unwillingness to “play” the insurance game.
The National Academies report that “only 4 percent of all workers ages 18 to 44 (roughly 3 million people) are uninsured because they decline available workplace health insurance, and many do so because they cannot afford the cost.” A 2007 study published in Health Affairs found that 56 percent of the uninsured were neither eligible for public coverage nor able to afford insurance without assistance. This study also found that 20 percent of the uninsured could have afforded coverage, but even leaving aside other factors like being turned down for insurance, that’s hardly 47 million people refusing to “play.”
Romney is also misleading when he implies that the uninsured are simply choosing between toeing the line and freeloading as two roughly equal ways of obtaining health care. While uninsured individuals can get a certain amount of free emergency care, it is by no means comparable to the care given to those with insurance. The Kaiser Family Foundation reports that the uninsured have less access to care, are more likely to be hospitalized, are often financially unable to follow treatment plans, get less preventive care and are in general poorer health than the insured. Poorer health among the uninsured could also affect their ability to purchase private coverage, since insurance companies often reject individuals with preexisting conditions.
This is the traditional argument the Republicans pull out for all manifestations of poverty and inequality in the U.S.: it’s all their fault.