Last week's article on why 45 million Americans go without health care insurance touched a nerve and generated many questions and assertions:

"You and your pesky statistics! Forty-five million Americans without health care is huge. And you wrote that 89 percent of the 85 percent of people with health insurance are satisfied. That means 25 percent of all Americans are unsatisfied!"

Elder: Those "pesky" statistics become especially pesky when misstated. I wrote that 45 million Americans have no health insurance, leaving 85 percent with health insurance -- but not without health care. ERs must treat the uninsured, including illegal residents. Meanwhile, 89 percent of Americans -- with or without insurance -- are satisfied with the quality of their own health care.

An 89 percent satisfaction rate sounds pretty darn high. Are people, for example, 89 percent satisfied with their jobs? Their marriages? Their financial situations? Their experiences at concerts or ballgames or restaurants or hotels or with airline travel? An 89 percent satisfaction rate is pretty impressive for most things we pay for.

And as for the remaining 11 percent -- to what degree and for what reason are they "dissatisfied"? Had bad experiences? Don't like having copays? Would prefer a complete choice of doctors but are restricted by their plans? Had to wait for appointments or sit too long in waiting rooms? (Canadians are used to eight-month-or-more waits and long lines. Americans, I assure you, are not.) A lot of people simply complain -- about most everything.

For example, 10 years ago I had laser eye surgery. I filled out a questionnaire designed to determine how fastidious I am. Why? The doctor told me the surgery would not get me 20/20 vision. Was I OK, the doctor asked, with a less than 20/20 result? I was. He said some prospective patients, however, are dissatisfied with such a result. Given their -- in his view -- unrealistic expectations, the doctor wouldn't treat them.

"Doesn't universal coverage work in Canada?"

Elder: Not exactly. Large numbers of Canadians came (and still come) to America to avoid waiting for MRIs or to get time-sensitive treatment that couldn't wait. Canada is moving toward more privatization -- which was previously illegal in Canada but is now permitted as a result of a successful lawsuit. Imagine having to sue to spend your own money in a voluntary transaction between two parties! According to a 2007 survey by the Canadian Fraser Institute, the median wait time in Canada between visiting a general practitioner and receiving treatment was more than 18 weeks -- and up to 38 weeks for procedures such as orthopedic surgery. Continued...