ObamaCare Is Working As Advertised to Increase the Number of Insured

Even before the individual mandate kicks in, the ACA has added hundreds of thousands of people to health insurance rolls.

Rick Ungar notes that the Affordable Care Act is working precisely as advertised to increase the number of people with health insurance into the United States. In particular, it’s increasing the number of young adults with health insurance — precisely the people we want insured to bring down premium costs.

The provision of the law that permits young adults under 26, long the largest uninsured demographic in the country, to remain on their parents’ health insurance program resulted in at least 600,000 newly insured Americans during the first quarter of 2011.

[…]

Because the under 26 crowd tends not to get sick, adding them to the insurance pools helps bring the very balance that was intended by the new law. The more healthy people available to pay for those in the pool who are ill (translation- the older people), the better the system works and the lower our premium charges should go.

One cannot help but notice that the health insurance companies turned in record profits for the first quarter of 2011 due, according the insurance companies, to fewer people seeking medical treatment.

When you add into their customer base a large number of people who are paying premiums but are less likely to get sick (the young adult demographic), this would be the expected result.

Moreover, Ungar reports that the tax incentives for small businesses have resulted in a 46% increase in small businesses offering health benefits as compared to last year.

I think that these are definitely positive results, but more needs to be done in the area of health reform. For one thing, we desperately need more doctors. Per capita, we have about 1/3 fewer doctors than most other OECD nations, and basic economics dictates that less supply plus more demand equals higher prices. Now, some of that is going to be partially taken care of by more preventative care, which is cheaper.

But the major amelioration is going to come by giving nurses and pharmacists more legal ability to perform basic medical services and some kind of incentive for more bright students to go to medical school. I also think it would be a benefit if the Federal government took over medical regulation from the states completely — there ought to be one, federal medical license. Not 50 state ones. By making a license more mobile throughout the country will help encourage doctors to move from places with lots of doctors to places where there aren’t as many.

FILED UNDER: Economics and Business, Health, Health Care, US Politics
Alex Knapp
About Alex Knapp
Alex Knapp is Associate Editor at Forbes for science and games. He was a longtime blogger elsewhere before joining the OTB team in June 2005 and contributed some 700 posts through January 2013. Follow him on Twitter @TheAlexKnapp.

Comments

  1. James Joyner says:

    What’s not clear from the explanation at Healthcare.gov is whether the grown-up kids on the parent’s policies actually paying for said policies? Or still being covered as if they were kids? If the latter, it’s increasing the number of insured and increasing the number of healthy people in the pool–but not actually adding to the money in the pool to pay for sick people.

  2. hey norm says:

    can’t wait to hear the naysayers chime in on this!!!
    It’s good to see these things working. It will be even better when experimental programs get running and we can see how they work.
    No one ever said this would be perfect as originally legislated – but it’s good for the country that it is off to a good start.

  3. michael reynolds says:

    Parents still pay for kids on their policies. They’re cheap, but then so are 26 year-olds. In fact I wonder if the average 10 year old doesn’t use more health care than the average 20-something.

  4. anjin-san says:

    You mean more people can see the doctor if they are sick? Clearly, the Republic is lost…

  5. James Joyner says:

    @Michael: But don’t most policies simply bifurcate to single and family? Most people don’t pay extra for a marginal child–or, at least, I’ve never been under a plan where that was the case.

  6. Tsar Nicholas says:

    This might be the dumbest post in the history of the Internet blogosphere, which is saying something.

    Even assuming those numbers are accurate and and they’re net of losses to the insurance rolls because of Obamacare (i.e., that they’re not offset in full or in part by larger companies scaling back their insurance benefits or smaller companies dropping workers to stay under the 50-employee threshold), then even further assuming that annualizing these putative net gains makes sense (i.e., that newly-insured youngsters are not all front loaded to the program), that would mean you’re adding 2.4 million people to the insurance rolls per year. That’s not even 1% of the population, Captain.

    Obamacare will cost 2 trillion dollars over the next decade. That’s trillion with a “t”. Do you really believe a multi-trillion dollar, taxpayer-funded program is worth it when the marginal “gains” are so small? If so, then you shouldn’t be allowed to operate heavy machinery or even to cross a street without supervision.

    Also, riddle yourself this question: How many of those 600,000 newly-insured kids have jobs or even job prospects? Not too many, Chief. And here’s a newsflash for you: It’s pretty tough to pay the rent, much less to invest for the future, with an insurance card from mommy and daddy.

  7. @ Michael Reynolds —

    The average 26 year old uses significantly more healthcare services and healthcare dollars than the average 10 year old. There are three drivers:

    1) A significant portion of the 26 year old risk pool has a decent probability of getting pregnant and not so for the 10 year old risk pool.

    2) The 26 year old male portion of the risk pool still has a decent portion of its membership in the YOUNG AND INVINCIBLE stage of development while having access to power tools, automobiles, and lots of cheap booze. Not so for the 10 year olds.

    3) A bit more wear and tear on the body.

    I would bet that the median 10 year has more healthcare provider interactions in a single year than the median 26 year old, but an office visit for strep throat or a setting of a broken wrist is fairly cheap.

  8. michael reynolds says:

    James:

    Okay, now you’re beyond my capacity to look at the fine print in my policy which is, um, around here somewhere.

    Dave:

    I had not thought of pregnancy. Yep, that’s pricey. On the other hand there are fewer mandated school-driven visits, fewer ear infections, and no overprotective parents freaking out because the kid has a temperature.

  9. steve says:

    “that would mean you’re adding 2.4 million people to the insurance rolls per year.”

    The subsidies dont start until 2014. These initial gains are a bit surprising. I did not expect to see significant increases until 2014.

    “How many of those 600,000 newly-insured kids have jobs or even job prospects?”

    The ACA was health care reform.

    Steve

  10. Kylopod says:

    I wonder how many people will have their insurance ripped from them when and if the Supremes strike down the law.

  11. Tylerh says:

    “some kind of incentive for more bright students to go to medical school.”

    That incentive is quite strong. The problem is that the AMA is traditional guild that uses state-by-state licensing requirements to restrict the number of doctors.

  12. religious Jews dont vote for Obama says:

    Orthodox my a$$

  13. Trumwill says:

    Most of my policies are either single-spouse-kids or they go a step further and say one kid or two-or-more. I don’t think any have been only single-family.

    FWIW, there are aspects of PPACA that I am skeptical of, but raising the age limit is something I do support.

  14. JKB says:

    Actually, the whole under-26 on the parents policy was promoted as a no cost/low cost trick under Obamacare, i.e., little added risk to the insurance pool so little added cost to the family policy. A scheme that left out military families as Tri-Care has no insurance pool so DOD had to price adding adult children at projected cost to the program. I don’t know if Congress has fixed that glitch as of yet.

    So more people covered but either a slight or large increase in premiums. With premiums across the board to increase as experience is gained if the under-26 turn out to be the high risks some state here. If the companies can’t increase family plan premiums to cover the costs, they’ll have to increase premiums across the pool to hide the costs.

    I can’t help but wonder if the continued loss of jobs to 45-64 yr olds isn’t impacted by mandatory insurance since they are the age group with the most medical risk. 65+ are gaining jobs as they don’t add to the employer insurance pool costs.

    And if you care to listen to the doctors, you’ll discover that many are leaving practice as they can’t sustain a practice at the below-cost reimbursement by the government programs, not to mention cost of trying to get reimbursement. I have a doctor friend who told me it is generally cheaper to eat the cost than seek reimbursement from the state MEDICAID program. I assume the cost is written off. As it stand now, those who are the least administrative cost to the clinic are charged more, i.e., those with money to pay for their healthcare directly, while government program reimburse below costs but only after a lot of administrative expense to file and collect. Private insurance falls somewhere in the middle with negotiated reimbursements. That’s some incentive to go into medicine.

    But for those who are drawn to medicine but don’t want to have government under-reimbursement to bankrupt them, I suggest the Public Health Service. There you will draw a salary, manage a shoestring budget that won’t cover costs to provide quality healthcare to your patients and you’ll get to work all over the country in underserved areas such as Indian Health Clinics, prisons, USCG stations.

  15. ej says:

    was an argument that this bill wouldn’t increase insurance coverage ever a critique of this?

    The arguments against where generally:

    -It costs a lot
    -It will increase the deficit
    -It will likely cause reduction in healthCARE access due to price controls and shortages
    -it puts more power into hands of beaurocrats
    -It will further drive premiums up
    -the mandate is unconstitutional

    Wait a few years and lets see what happens in these areas. Because in MA, premiums have gone up, waiting times have gone up, the budget is worse off, and beaurocrats are having an increasingly large amount of control over access decisions.

  16. ej says:

    *bureaucrats

  17. michael reynolds says:

    cj:

    I don’t think the question is whether premiums in MA have gone up but whether they are rising faster than in other areas. They’re going up everywhere.

  18. JKB says:

    Well, the government’s own propaganda site says the increase in premiums could be as little as 0.7% for a family but the allowable premium increase is whatever it would cost to insure a child under the earlier cutoff age. So I guess it depends on how the family plan was structured but this does cut into the promoted increased premiums from minimum-risk 26 yr olds helping to reduce premiums for all. To bad the supposed professional a Forbes doesn’t know how to scan the government website that explains the regs.

    Q: Will young adults have to pay more for coverage or accept a different benefit package?

    A: Any qualified individual must be offered all of the benefit packages available to children who did not lose coverage because of loss of dependent status. The qualified young adult cannot be required to pay more for coverage than similarly situated individuals who did not lose coverage due to the loss of dependent status.

    Now best of all is the definition what “child” is eligible

    Your adult children can join or remain on your plan whether or not they are:

    married;

    living with you;

    in school;

    financially dependent on you;

    eligible to enroll in their employer’s plan, with one temporary exception: Until 2014, “grandfathered” group plans do not have to offer dependent coverage up to age 26 if a young adult is eligible for group coverage outside their parents’ plan.

  19. ej says:

    michael,

    But the MA plan was sold as a means that prices where going to fall. They have not. And the plan is costing far more than the original projection. I expect a similar dynamic to occur nationally. You can’t promise more free healthCARE to people and insulate them more from the costs of the transaction and expact the healthINSURANCE price to fall.

    The only way this ends up causing premiums to slow down is because price controls restrict what actual healthCARE you can get, essentially what we are seeing in Medicaid right now where doctors are not taking new patients – so you are covered but you have no access.

    This bill like the MA bill was a converage bill and its backers had a buy now pay later mentality. That recklesness is going to make any potential budget fix even more difficult and painful then it already was, never mind any means to actually get healthcare costs under control.

  20. MarkedMan says:

    FWIW, conventional wisdom in the part of the health care industry I interact with is that the real shortage of doctors in the US is the shortage of internists and primary care physicians. There are a lot of things driving down their numbers, but another piece of conventional wisdom (from people in a fortune 500 company who are paid to analyze this – not politicians) is that while a surgeon may do as many as 25 surgeries a week and therefore might have to deal with 25 different health care plans it doesn’t compare to the hundreds of patients a PCP sees in a week. The amount of health care BS they have to deal with is actually exponentially greater, because in addition to the order of magnitude increase in patients, they don’t know what is wrong with the patient until they see them, they can’t verify their insurance before they come in, and they can’t pre-approve their treatment with the insurance company, all of which surgeons and other specialists can do.

    If you ask most independent PCP’s and internists what the most frustrating part of their job is, I’d bet nickels to dollars they would say it is the byzantine, arbitrary and cruel private health care insurance system we have today. Compare this to, say, The Netherlands, where you walk in with a card, they scan the card or write down your number, and then actually do medicine.

  21. Joe R. says:

    I think that these are definitely positive results

    That’s right, forcing people to buy something they neither want nor need is a positive result.

  22. michael reynolds says:

    cj:

    I don’t disagree with that, and I don’t know how Romney went about pitching this to voters — I assume with a mix of half-truths, exaggerations and rosy assumptions, the way we always do these things.

    The cost-cutting measures of ACA aren’t really in place yet. Not that I expect them to accomplish much. And of course the projections will be wrong. No projection ever — from the guy who redid my kitchen a few years back, to every Pentagon weapons system — has ever overestimated the eventual cost.

    I supported the ACA because we have to set as a starting point that American citizens will get reasonable health care. That marker has now been laid down. I think eventually we’ll end up with a more purely government run system, but first we have to waste a lot of time and money getting Americans to understand that a more European approach makes sense. Had Obama pushed that right out of the gate he’d have lost. So in typical Obama style he got what he could get. This is not the end state, this is a transition.

  23. michael reynolds says:

    That’s right, forcing people to buy something they neither want nor need is a positive result.

    Like when the state forces you to buy car insurance. So setting aside your sarcasm, yeah, it’s a good thing.

  24. Hey Norm says:

    Joe R.
    You have it exactly wrong. PPACA prevents people from passing their health care costs onto me, by showing up in emergency rooms and clinics with no insurance and no means of payment. Deciding to not carry insurance is taking an action of irresponsibility. The cost of that irresponsibility is borne by the interstate health care system and passed on to responsible people. One of the prime roles of government is to protect the responsible from the irresponsible.

  25. Rock says:

    Why have more than 1300 O’bamaCare waivers or exemptions been approved? A lot of waivers have been approved for Unions and health care providers. I think AARP even got a waiver. Who’da thunkit?

  26. David M says:

    Rock, why don’t you explain what the waivers were for and why you disagree with them, and I’m sure a couple people would be happy clear things up. Just saying “waivers!111!!!” only means you’ve heard some right wing talking point somewhere, not that you are actually understand the issues surrounding health care reform.

  27. sam says:

    @ej

    “But the MA plan was sold as a means that prices where going to fall. They have not. And the plan is costing far more than the original projection.”

    Dave Schuler has argued for a long time (as have others) that one of the main causes of the cost spiral in health care–if not the main cause–is the fee-for-service model. Massachusetts will attempt to address this (if proposed legislation passes) by

    [requiring] all health care providers – doctors, hospitals, specialists, therapists and the like – to align themselves into networks called Accountable Care Organizations, or ACOs, that will get paid a fixed amount each year for a patient’s care. [Massachusetts struggles to rein in health care costs]

    If the fee-for-service model is the culprit, then we’ll have to move away from that model. But as the story cited points out, it wouldn’t be easy. But it would represent a sea change in how we deliver and pay for health care.

  28. Hey Norm says:

    I’m also not sure anyone said prices would fall. What prices in this world ever fall? Technology maybe. What else? Prices should rise more slowly.

  29. mantis says:

    Why have more than 1300 O’bamaCare waivers or exemptions been approved?

    Those are stopgap measures to insure continued coverage until other parts of the PPACA kick in. They are not permanent and they are not political in nature. What’s your problem with the waivers?

  30. Wiley Stoner says:

    Reynolds, the state does not force you to buy car insurance if you do not own a car. Good straw man though. I guess if you live in Pelosi’s district you don’t have to buy health care either. Exemptions, exemptions. What will you bet, Mikey, the SCOTUS strikes down Obama Care based upon the mandate?

  31. ej says:

    “PPACA prevents people from passing their health care costs onto me, by showing up in emergency rooms and clinics with no insurance and no means of payment.”

    This is a bunch of bs. Uncompensated care is about 1% of total expendatures. If stopping this free rider problem was suppsoedly a goal, then why was the “solution” to creat a much bigger free rider problem via forcing young healthy people to buy insurance to subsidize old people and take money from tax payers to give subsidies to those same people who used to create that 1% cost shifting? Those who where free riding are now free riding even more.

    This would be like saying we are thowing away 5 billion a year in waste. Lets spend 50 billion a year to stop it!

    This bill was about expanding insurance coverage via socializing healthcare costs – nothing else.

  32. Wiley Stoner says:

    David, why don’t you explain what the waivers are for??? Labeling the truth as “right wing” keeps you stuck in believeing the lies this administartion has put out. I guess you suffer from the mental illness knows as liberalism.

  33. ej says:

    you are still paying for these people via higher premiums and higher taxes.

  34. Wiley Stoner says:

    Right On EJ. The whole idea is to bring down the health care insurance industry so it can be replaced with the idea (failing in Europe) of a single payer system. A great move away from capitalism toward socialism. One of the final steps is elimination of the intelligencia. Almost none of the commenters here would need to worry about that. They would all have jobs replacing farm animals ahead of energy efficient plows, pulling.

  35. Ben Wolf says:

    Wile E. Coyote,

    You’d be better off getting back to your rape/do-not-rape lists, and leaving discussion of health care to people not likely to join Future Felons of America. Furthermore, as you yourself are a socialist pig suckling at the the government welfare trough, don’t expect anyone to take you seriously.

  36. David M says:

    You say this like you think it’s a bad thing. Are you unclear how insurance works?

    This bill was about expanding insurance coverage via socializing healthcare costs

    Wiley, feel free to ignore this like you ignore most other facts, but the temporary waivers are for one year only and are meant to reduce disruptions to existing health insurance plans before all the health care reform laws take effect. San Francisco already had a health insurance requirements for employers, so it’s not surprising those businesses are being given time to modify their existing plans to meet the higher requirements.

    Anyone minimizing the free rider problem based on current numbers is clearly ignoring how things will change when insurers are no longer allowed to discriminate based on pre-existing conditions.

  37. MarkedMan says:

    Oh, and by the way, any discussion that doesn’t include the fact that the US private insurance system engenders a 40% cost of overhead is ignoring the elephant. Medicare? 3%. European countries that have universal health care? 2-7%.

  38. george says:

    Reynolds, the state does not force you to buy car insurance if you do not own a car.

    Are they forcing you to buy health insurance if you don’t have a body?

  39. Southern Hoosier says:

    The Daily Caller reported that among HHS’s most recent round of 204 Obamacare waivers, “38 are for fancy eateries, hip nightclubs and decadent hotels in House Minority Leader Nancy Pelosi’s Northern California district.” That’s right: Nearly 20 percent of exemptions from Pelosi’s crowning health care achievement were doled out in her backyard.

    On Monday, the Las Vegas Sun reported that Nevada—Senate Majority Leader Harry Reid’s home state—received a partial statewide Obamacare waiver, too.

    http://goo.gl/yw3oT

    Nice how the Democrats exempt their supporters from unpleasant things in order to ensure their reelection.

  40. sam says:

    “This bill was about expanding insurance coverage via socializing healthcare costs – nothing else.”

    But aren’t healthcare costs already “socialized” (= government expenditures) to a large extent (somewhere between 40-50%)? See, Is the Administration Cooking the Books on Govt’s Share of Health Spending?

  41. michael reynolds says:

    What is a “decadent hotel?” Can I filter my Expedia results to find them?

  42. mantis says:

    Nice how the Democrats exempt their supporters from unpleasant things in order to ensure their reelection.

    Hoosier, explain what the waivers are. Can you?

  43. Hey Norm says:

    Ej….
    In Washington State the cost of uncollectable debts and charity care by hospitals and other providers adds over $900 to the medical bills of the insured. This number is climbing as the number of uninsured climbs.
    I’m sure you don’t care…but I could think of several ways I would rather spend $900 than giving it to my insurance provider.

  44. sam says:

    About those San Francisco waivers:

    [T]hese waivers are so heavily concentrated in San Francisco not because of any political maneuvering or malfeasance by the Liberal Powers That Be, but because of Healthy San Francisco.

    Under Healthy San Francisco, all San Francisco businesses with over 20 employees must provide health care coverage or access to health care for its employees. Many employers opt to open a Health Reimbursement Account or HRA for its employees; those accounts are then used to reimburse employers for some health care costs.

    The waivers that are granted for one-year periods are intended to protect employees from suffering any reduction in coverage because of suddenly increased premiums, and to limit how much employers need to pay in a given year for coverage. The federal Department of Health and Human Services has approved 1,372 waivers so far — almost 90 percent of the waiver requests it has received.

    “We have mandatory health care expenditures. We are the only place I know of in the country that has that,” said Rob Black, executive director of the Golden Gate Restaurant Association. “Because we have a 100 percent expenditure rate, we are going to have a much higher take-up rate (of waivers) than the country as a whole. That is what is driving that.” [Source]

  45. michael reynolds says:

    Stoner:

    Not Pelosi’s district, but I am moving to Lynn Woolsey’s district, Marin County. It’s hyper-liberal and just the kind of howling wasteland of horror you’d expect. In Tiburon people are reduced to cannibalism. Gay cannibalism in fact. Godless gay cannibalism. But always with a nice arugala and edible flower salad.

  46. Hey Norm says:

    Really? The Daily Caller? Really? That’s the source of information you base your opinions on? Really?

  47. steve says:

    “And if you care to listen to the doctors, you’ll discover that many are leaving practice as they can’t sustain a practice at the below-cost reimbursement by the government programs,”

    I ama doctor. They are not leaving.

    “Because in MA, premiums have gone up, waiting times have gone up”

    If you look at historical waiting times in Massachusetts, they have always been long. The recent increase puts them back to where they were a few years ago. on costs, MA has always been high. They were expected to rise initially with the expenses of starting a new program. IIRC, costs have not increased at a faster rate. The long term effects remain to be seen.

    Waivers were a way to avoid disruptions in programs until the full ACA takes effect in 2014. While this was a good policy from an administrative POV, it has made for great demagoguery from the right. They probably should have waited until 2014 when the subsidies start to begin these programs. It would have avoided these endless, and stupid, posts about waivers.

    Steve

  48. Southern Hoosier says:

    What it comes down to is, all the liberals blogs support Obamacare and the conservative ones oppose it.

  49. Rock says:

    They are not permanent and they are not political in nature. What’s your problem with the waivers?

    Uh-huh.

    If the State of Texas asked for a waiver would it get it? I think several states have now. Nevada did and got it. What’s that Senator’s name from Nevada? Oh yes, I remember, it’s Harry Reid!

  50. Southern Hoosier says:

    michael reynolds says: Monday, May 23, 2011 at 17:13

    Stoner:

    Not Pelosi’s district, but I am moving to Lynn Woolsey’s district, Marin County

    The racial makeup of the county was 84.03% White, 2.89% Black or African American, 0.43% Native American, 4.53% Asian, 0.16% Pacific Islander, 4.50% from other races, and 3.47% from two or more races. 11.06% of the population were Hispanic or Latino of any race.

    I can see why you would want to move there. Another example of white flight.

  51. Joe R. says:

    You have it exactly wrong. PPACA prevents people from passing their health care costs onto me, by showing up in emergency rooms and clinics with no insurance and no means of payment.

    No, a thousand times no. You are the one advocating that people pay for something they aren’t using. Not me. I would be perfectly happy with a system where people pay their own health care costs and don’t pass them onto you.

    That said, I am anxiously waiting for you to show me the hospital bills that taxpayers have covered for uninsured twentysomething males.

  52. Southern Hoosier says:

    Hey Norm says:
    Monday, May 23, 2011 at 17:14

    Really? The Daily Caller? Really? That’s the source of information you base your opinions on? Really?

    Heritage Foundation

  53. JKB says:

    @steve -I ama doctor. They are not leaving.

    Failure of logic. Your being a doctor does not offer any evidence for your statement that “they” are not leaving. Perhaps you are not leaving. Perhaps you don’t know any doctors who are leaving but that doesn’t imply that doctors are not leaving.

    In fact, here is a recent article about the Mayo Clinic advising that most of their providers would not participate:

    Just over a month ago, the administration released long-awaited draft regulations for “accountable care organizations,” networks of doctors and hospitals that would collaborate to keep Medicare patients healthier and share in the savings with taxpayers. Obama’s health care overhaul law envisioned quickly setting up hundreds of such networks around the county to lead a bottom-up reform of America’s bloated health care system.

    But in an unusual rebuke, an umbrella group representing premier organizations such as the Mayo Clinic wrote the administration Wednesday saying that more than 90 percent of its members would not participate, because the rules as written are so onerous it would be nearly impossible for them to succeed.

  54. Hey Norm says:

    Heritage Foundation…hahaha…they’re the ones that had to delete the ridiculous lies they told in support of Ryans Tea Party Manifesto. Supported by the Koch Brothers…simply political hacks.

  55. Southern Hoosier says:

    Joe R. says: Monday, May 23, 2011 at 17:54

    That said, I am anxiously waiting for you to show me the hospital bills that taxpayers have covered for uninsured twentysomething males.

    Illegal immigrants represent about 15 percent of the uninsured, but for various reasons (they’re younger, they lack access to government programs) they don’t represent 15 percent of uncompensated care; it’s more like 10 percent, according to a study by the Center for Immigration Studies, a nonprofit research group. Using the Kaiser data, the center calculates that providing uncompensated care to illegal immigrants costs taxpayers $4.3 billion annually.

    http://goo.gl/UEX1R
    Does that answer your question?

  56. Hey Norm says:

    Joe R…
    That’s the point…the status quo has others passing their costs onto me. There is no one who doesn’t use health care.

  57. sam says:

    @Joe R

    “That said, I am anxiously waiting for you to show me the hospital bills that taxpayers have covered for uninsured twentysomething males.”

    Adolescents accounted for 15.4% of the population and 15.8% of emergency department visits in 1994. Late adolescents were overrepresented in emergency department visits relative to their population proportion (6.8% of visits, 5.3% of population), whereas early adolescents were underrepresented (4.6% of visits, 5.9% of population). Lack of health insurance was more common among 11- to 21-year-olds (26.2%) than either children (13.6%) or adults (22.7%). By ages 18 to 21 years, 40.5% of male visits and 27.6% of female visits were uninsured. [my emphasis] Injury-related visits were more common among adolescents (28.6%) than either children (23.1%) or adults (18.2%). Injury was the leading reason for visits among all adolescent age-sex subgroups (36.6% to 42.0% of male visits and 14.1% to 27.2% of female visits) except females aged 18 to 21 years for whom digestive reasons ranked first (18.8%). Injury was the leading diagnosis for all adolescent age-sex subgroups, with peaks at early adolescence of 61.6% for males and 45.8% for females. Across all adolescent age-sex subgroups, 3.1% to 5.3% of visits resulted in hospitalization, and 41.0% to 52.5% of visits were urgent. These rates did not differ from those of children but were lower than those of adults.

    Conclusions. Utilization of emergency departments increases and health insurance decreases during adolescence, suggesting that adolescents with inadequate health insurance may rely heavily on emergency departments for their health care needs. Most adolescent visits to emergency departments are not urgent and might be better treated through nonemergency, primary care sites. [Emergency Department Utilization by Adolescents in the United States]

    Really, you know, the information is out there — if you’d take the time to look.

  58. David M says:

    Joe R: delaying and denying urgent health care treatments as standard practice until proof of insurance / ability to pay is established is a complete non-starter and I’m shocked anyone in a civilized society would advocate for it.

    I’m still waiting for an explanation of what the temporary waivers are for and why they are a problem.

  59. Southern Hoosier says:

    Hey Norm says: Monday, May 23, 2011 at 18:02
    simply political hacks.

    And makes you think you know so much more, other than you read an article on here?

    Ten Myths of Ryan’s House Budget Plan
    Published on May 13, 2011 by Brian Riedl , Robert Moffit, Ph.D. and Romina Boccia

    http://goo.gl/ezBrQ

  60. Southern Hoosier says:

    But the two-day dustup may have obscured a more pressing question for Democrats: Why are businesses in liberal San Francisco and elsewhere clamoring to opt out of the massive healthcare law that was supposed to help them?

    The answer boils down to simple dollars and sense, experts say. Because so-called Obamacare prohibits lifetime dollar limits on health insurance plans, businesses from Pelosi’s — as well as Senate Majority Leader Harry Reid’s — districts are demanding waivers because they already are paying for employees to be covered in plans with limits in the hundreds of thousands of dollars.

    http://goo.gl/3m3Zx

    As Rush always said “Follow the money.”

  61. David M says:

    As Rush always said “Follow the money.”

    What’s your point? Are you just linking to random articles about the waivers? (The SanFran issue has already been posted about several times, it appears you just skipped over or didn’t understand a large part of the thread.)

  62. Hey Norm says:

    Southern Loser,
    The Heritage Foundation claimed unemployment under Ryans budget would drop to 2.8%…anyone who says that has zero credibility. Zero.

  63. Southern Hoosier says:

    David M says: Monday, May 23, 2011 at 18:41

    As Rush always said “Follow the money.”

    What’s your point? Are you just linking to random articles about the waivers? (The SanFran issue has already been posted about several times, it appears you just skipped over or didn’t understand a large part of the thread.)

    The point is saving Pelosi’s and Reid’s voters money so they can get reelected.

    The answer boils down to simple dollars and sense, experts say. Because so-called Obamacare prohibits lifetime dollar limits on health insurance plans, businesses from Pelosi’s — as well as Senate Majority Leader Harry Reid’s — districts are demanding waivers because they already are paying for employees to be covered in plans with limits in the hundreds of thousands of dollars.

    Understand?

  64. Federalism, who needs it, is that it Alex?

    Oh, and Michael Reynolds, bringing up car insurance means you either aren’t really serious or seriously misunderstand insurance. Leaving aside no fault states for the moment, if you are going to drive a car on public roads you are required to have liability insurance from the state issuing the tags (note, not the federal government). You are not required to insure the car, or yourself for that matter.

  65. David M says:

    If I understand Southern Hoosier correctly, the point I’m missing is that health care reform should have been easy enough to implement that it should have only taken a month or two. Also, there weren’t any areas of the country with different health insurance requirements that might conflict with the new ACA rules. If you start with those assumptions, the waivers make less sense.

    Here in the grown up world, people would expect more waivers to be issued in San Francisco due to Healthy San Francisco. You keep pointing out how uneven the existing health insurance laws were, but treating it as a problem with the ACA.

  66. Southern Hoosier says:

    @ David M
    Still don’t get it do you? How many times do I have to post this for you to read?

    The point is saving Pelosi’s and Reid’s voters money so they can get reelected.

    The answer boils down to simple dollars and sense, experts say. Because so-called Obamacare prohibits lifetime dollar limits on health insurance plans, businesses from Pelosi’s — as well as Senate Majority Leader Harry Reid’s — districts are demanding waivers because they already are paying for employees to be covered in plans with limits in the hundreds of thousands of dollars.

  67. Hey Norm says:

    I’m sure it’s all about raising money for Pelosi and Reid…unless it’s really about preventing a significant decrease in access to benefits or a significant increase in premiums for people in general. Just consider where this comes from…Rush Limbaugh and The Daily Caller and The Southern Loosier.

  68. David M says:

    Pelosi worried about re-election? Seriously? That didn’t clue you in that you’re being played for a fool?

  69. Southern Hoosier says:

    David M says:
    Monday, May 23, 2011 at 19:38

    Here in the grown up world, people would expect more waivers to be issued in San Francisco due to Healthy San Francisco. You keep pointing out how uneven the existing health insurance laws were, but treating it as a problem with the ACA.

    I’ve never said a word about uneven existing health insurance laws. Healthy San Francisco has limits on their healthcare. Obamacare does not have limits. Healthy San Francisco. does not want to switch from limited to unlimited, hence the reason for the wavers. Understand?

  70. Southern Hoosier says:

    David M says:
    Monday, May 23, 2011 at 19:50

    Pelosi worried about re-election? Seriously? That didn’t clue you in that you’re being played for a fool?

    Little Nancy is not worried about reelection, now that she has give out all those wavers to her supporters,

  71. Hey Norm says:

    Hoosier…
    Maybe if your arms were a little longer you could make even more of a reach.

  72. anjin-san says:

    That didn’t clue you in that you’re being played for a fool?

    I think SH’s answer is a resounding… “NO”!

  73. anjin-san says:

    As Rush always said “Follow the money.”

    Even when it leads to his drug dealer?

  74. michael reynolds says:

    I can see why you would want to move there. Another example of white flight.

    I live in Irvine, CA now. If I’m “fleeing” it’s from Asians. And if I were fleeing Asians it would mean leaving my daughter behind.

    I make a nice living. I tend to live in upscale places. The relevant demographic isn’t race, it’s income or wealth.

    As usual: you’re a cretin.

  75. Southern Hoosier says:

    anjin-san says:
    Monday, May 23, 2011 at 20:31

    That didn’t clue you in that you’re being played for a fool?

    I think SH’s answer is a resounding… “NO”!

    Since when did you start speaking for me? I didn’t jerk your chain, did I?

  76. Southern Hoosier says:

    michael reynolds says: Monday, May 23, 2011 at 20:54

    The relevant demographic isn’t race, it’s income or wealth.

    I understand. It is just an odd little coincident that most of the nicer neighborhoods are predominantly white.

  77. michael reynolds says:

    Hoosier:

    Mostly I try to avoid living near ignorant rednecks. I had plenty of you people growing up.

  78. Pete says:

    Hey Norm;

    Southern Loser,
    The Heritage Foundation claimed unemployment under Ryans budget would drop to 2.8%…anyone who says that has zero credibility. Zero.

    I wish reporters would pay as much attention to a more important failed prediction: the Obama administration’s assurance that its policies, including the “stimulus,” would foster job creation and prevent unemployment from reaching 8 percent. We have reproduced this graphic before:

    stimulus-vs-unemployment-september-dots-thumb-410×250.gif

    Don’t know how to copy the graphic so the text quote will have to do. So Norm, if your logic is sound, how much credibility does the Obama administration have? Ryan’s numbers are predictions; Obama’s prediction is, unfortunately for him, FACT!

  79. Southern Hoosier says:

    michael reynolds says:
    Monday, May 23, 2011 at 22:31

    Hoosier:

    Mostly I try to avoid living near ignorant rednecks. I had plenty of you people growing up.

    Living around me won’t be a problem for you, as I live in a racial mixed neighborhood. Odd how you call me a racist and your the one living in a lily white world.

  80. Pete says:

    Hoosier, I don’t think Reynolds is a racist, but he sounds like an arrogant snob. Yet, we should understand that, according to him, he made something of himself, has become wealthy and if he chooses to live amongst other “successful, arrogant snobs,” what’s the problem? The rest of us less successful peons cannot afford to insulate ourselves from the economic riff raff; race has little or nothing to do with it. I don’t hold it against him. Hell, none of us are perfect and we peons have our flaws also. Some of my friends are just like what I imagine Reynolds to be. As long as I understand the differences, they will only bother me if I let them.

  81. Pete says:

    Hoosier, one more thing. Reynolds could very well be none of what I imagine. How do we know what people are really like unless we can look them in the eye and have a conversation. Even then it may be difficult, but it provides much more insight than this medium which can bring out the “road rage” mentality in many people. Reynolds has offered some very cogent commentary here, so I think we should give him the benefit of the doubt.

  82. reid says:

    Very gracious post there, Pete.

  83. @ Michael Reynolds — going back a bit in the conversation:

    “On the other hand there are fewer mandated school-driven visits, fewer ear infections, and no overprotective parents freaking out because the kid has a temperature.”

    But all of those things are DIRT CHEAP. For instance, my 2 year old daughter had a nasty ear infection last month. The sick child visit cost $39 ($20 co-pay, $19 from the insurance company) and the penicillin was $4 at a grocery store that is selling generic anti-biotics as a loss-leader. Total social cost of the sick incident was probably $45 to $50 including the cookie my daughter got as we waited for the prescription to be filled.

    Same goes with your typical kids annual physical, <$100 is what an insurance company will pay a par provider. Kids touch the medical system a lot, but they tend to touch it very cheaply each time.

  84. michael reynolds says:

    I don’t think Reynolds is a racist, but he sounds like an arrogant snob.

    A bit of background: My mom was 16 when she had me, my birth father disappeared. Raised in an army family — my dad was an enlisted man before making warrant. Lived in trailer parks (including Niceville, FL where we were threatened by the KKK for having black people in our home) and base housing. Dropped out of high school. Spent about 15 years working as a waiter, store clerk, night manager, house cleaner etc… At one point in my life I was homeless and sleeping under a freeway overpass in Austin, TX. I snuck in the back door of writing by ghosting for other people for little money and no credit. I succeeded the same way I always had: by working everyone else into the ground. I’m author/co-author of 150 books. I bought my first new car when I was 39. I saw my first really big check when I was 45.

    So: dues paid and then some.

  85. Pete says:

    Yes, Michael, I’ve always felt there was some serious character behind your rants. And you seem to have earned the right to say whatever “flips your switch.” Nice life story.

  86. michael reynolds says:

    Pete:

    Thanks. As the Grateful Dead would say, it’s been a long, strange trip.

  87. anjin-san says:

    I didn’t jerk your chain, did I?

    Sorry dude, you could not yank my chain with a tractor. An IQ in triple digits is a minimum requirement, and you are south of the border. I was just pointing out that you are clearly unaware that you are being played.

  88. Eric Florack says:

    Of course what Alex misses as do all proponents of Government healthcare, is that doctors are leaving the system. We’re losing doctors. The way it’s going, insured we may well be… but you won’t be able to get in to see a doctor.

    Gee, I know I feel better about it all