[Homestead] Poverty and Health

Tvoivozhd tvoivozd at infionline.net
Wed Sep 1 00:46:20 EDT 2004

Nibbling around the edges does nothing to reduce the former or help the 


  Poverty and Health

Tuesday, August 31, 2004; Page A20

THE CENSUS BUREAU reported last week that the poverty rate rose in 2003 
for the third consecutive year and that the percentage of people without 
health insurance climbed for a third straight year as well. But what's 
really revealing about the trends in poverty and health coverage is not 
the similarity, which reflects the downturn in the business cycle, but 
rather the contrast. Put simply, the long-term trend in health coverage 
is negative: The percentage of Americans without insurance is up from 
about 13 percent in the late 1980s to nearly 16 percent today. But the 
long-term trend in poverty is positive: The rate ranged between 13 
percent and 15 percent in the 1980s, but it has hovered at about 12 
percent in the past half-decade. Moreover, the real decline in poverty 
is bigger than suggested by these numbers.

What policy prescriptions follow? The health insurance figures are a 
call to action: Economic growth over the past 15 years has failed to 
improve coverage, so some kind of policy response is essential. Indeed, 
this conclusion is only reinforced if you dig into the data. The 
percentage of uninsured has gone up despite expanded government 
activism: Since 1987, the first year for which the Census Bureau has 
data, government has gone from covering 23.3 percent of the population 
to covering 26.6 percent, a rise that primarily reflects the extension 
of Medicaid to a wider circle of low-income people. But the trend in 
company-provided health insurance has been negative, except during the 
extraordinary bubble of the late 1990s. The soaring cost of health 
insurance is driving companies to withdraw coverage, and there's little 
reason to expect this trend to reverse itself. More government activism 
-- possibly in the form of incentives to companies to keep offering 
insurance, such as those proposed by Sen. John F. Kerry -- seems 

tvoivozhd---that is a bunch of bullshit too, Bush already tried to 
subsidize employers to keep offering health insurance to 
employees---each year the number of employers who offer employees health 
insurance declines---for the very good reason that employer-provided 
health insurance and pensions for employees is the worst of all possible 
worlds. Any and all Canadian employers will tell you they are for 
tax-paid Universal National Healthcare because it makes them competitive 
in global markets. They cannot compete if they provide pensions and 
healthcare and their domestic or global competitors do not. Tje only way 
to level the playing field is for all principal trading nations to adopt 
a tax paid Universal National Healthcare system---as all leading nations 
but the U.S. already do.

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*^__ *

Interpreting the poverty data is harder. Economic growth has been a 
powerful antidote to poverty, and the long-term reduction in the poverty 
rate is all the more impressive because it defies powerful head winds. 
High immigration in the past two decades might have been expected to 
increase poverty; the same goes for the rise of single-parent families, 
which are four to five times as likely to be poor than two-parent ones. 
Yet economic growth, while powerful, is not a magic bullet. For one 
thing, the surprisingly small increase in the poverty rate during the 
recent economic downturn owes something to the policies of the 1990s, 
which provided financial incentives, training, child care and other 
services to people trying to escape poverty via work. For another, the 
positive news on the number of people in poverty masks an alarming 
trend. The number of people in extreme poverty -- that is, subsisting on 
less than half the income defined as the poverty line -- stands at 15.3 
million, higher than at any time since the Census Bureau began 
collecting data 28 years ago.

This fact deserves more attention than it has received. The policies of 
the 1990s may have successfully pushed former welfare recipients into 
work, but those who have not found work, or who have found it and then 
lost it, appear to be worse off than before. A bit oddly, the 
congressional debate on reauthorizing the welfare law has dwelt minutely 
on the details of the design of work incentives rather than on the 
program's function as a safety net; it is not often noted, for example, 
that fewer than half the families eligible for money and job training 
actually receive any, a shocking contrast with the participation rate of 
80 percent that prevailed in the mid-1990s. A combination of deft 
government incentives and a strong economy may have reduced overall 
poverty. But the people at the very bottom are being forgotten.

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