"Dear Larry: You're right. How dare I go and have a heart attack when I don't have any health-care insurance. You're a cold, cold man."
Letters like this one explain why I call my new book "The Ten Things You Can't Say In America" (St. Martin's Press). Specifically, the writer objected to my chapter: "There is No Health-Care Crisis."
The Clinton administration informs us that nearly 50 million Americans go without health-care insurance. Yes, some Americans have no health-care insurance and others face expensive medical bills. But let's blame the right party -- government.
Let's examine these "uninsured." A few years ago, the government placed the number without insurance at 37 million. Martin Anderson, formerly with President Reagan's Economic Policy Advisory Board, disputed the seriousness of this figure. In an article called "Who Are the 37 Million Uninsured?" Anderson broke down the figure. His conclusion? The problem is far less severe than popularly believed.
About 51 percent of the so-called uninsured go without insurance for only a few months, while between jobs. Martin found that 72 percent remain uninsured for less than one year. Another 10 percent of the uninsured enjoy high-paying jobs, but decide that it makes more sense to pocket the premium money while running the rather minor risk of getting sick. This category consists of 3.8 million with average family incomes that exceed $50,000. On top of this, there are over six million more without health-care insurance, but who have family income in the $30,000 to $50,000 range.
Many of the uninsured include young, well-educated, healthy people, who are unlikely to get sick. Their car insurance, they reason, will handle any medical-related vehicle injuries. These young people simply perform a cost-benefit analysis and conclude that it makes more sense to pocket the money than to send it to an insurance company. Is that a problem?
For a modest amount, many working mothers and fathers can add their children to their employer-provided insurance. Why don't they? Many say they cannot afford it, but a shifting in family priorities -- yes, this is possible even among the "working poor" -- could pay for it. According to the 1992 Census Bureau, 92.2 percent of the poor own color televisions; 60 percent own microwaves; 7.4 percent have personal computers; and 41 percent own their own homes outright.
Bottom line, according to Anderson, this leaves about 10 million Americans without insurance -- who simply cannot afford it. And, among these, the government provides Medicaid, and most hospitals must admit patients on an emergency basis. Included among this 10 million are 2.5 million people defined as "other." Other? This includes prostitutes, criminals and illegal aliens. But, why quibble? Let's give them insurance coverage, too.
"To even suggest," says Anderson, "that the American taxpayers submit to higher taxes, lose the right to choose their doctor or be forced to carry around a national identity card in order to cover 10 million health insurance deadbeats is obscene."
But what to do about the truly needy? Answer: Dismantle the government-provided welfare/health-care system. But doesn't Medicare and Medicaid help the truly needy? In the 20 years preceding the Medicare Act of 1965, the cost of a one-day stay in a hospital increased three-fold. In the 20 years following the Medicare Act, the typical stay increased eight-fold. Today, taxpayers pay nearly 50 percent of the nation's health-care bill. This type of socialism drives up the cost of goods and services. Rules restrict the supply of doctors, and prevent nurses and other health-care practitioners from performing tasks that they are competent to do.
This country did the heavy lifting during the Cold War, sent troops to Somalia, Haiti, Bosnia, and Kosovo for humanitarian reasons, spent nearly five trillion dollars domestically over the last several decades to alleviate poverty, and gives more money for foreign aid than any other country.
But the "It Takes a Village" crowd, against all historical evidence, argues this: that Americans only give because the government extracts their money in the form of taxes. Take that away, we become Ebenezer Scrooge. Let 'em eat cake! Never mind that nearly 70 cents on the public welfare dollar never gets down to the intended beneficiary because of salaries, costs, and the inherent inefficiencies of government. Never mind that organizations like the Salvation Army and United Way -- heavily dependent on volunteers -- deliver over 80 cents of the donated dollar to the intended beneficiaries.
More Americans, 75 percent, report some kind of charitable contribution. Contrast this with 44 percent of Germans, and 43 percent of the French. Nearly half of Americans volunteered within the last 12 months, as compared with 13 percent of the Germans and 19 percent of the French.
Moral to the story: Any country with people as generous as Americans will maybe, just maybe, care about their fellow Americans. But, as Al Gore might call it, this sounds like a risky faith-in-fellow-Americans' scheme.