Census' take on health, wealth

In a move sure to enliven the debate on health care, the U.S. Census Bureau released new data yesterday showing that the number of people without health insurance is continuing to rise.

Forty-seven million people - 15.8 percent of the population - are now uninsured, up from 44.8 million, or 15.3 percent, in 2005.

For one of the richest countries in the world "to have 15.8 percent of our residents without health-care coverage is horrible," said Ann Torregrossa, director of policy for Gov. Rendell's office of health-care reform. "Something has to be done."

Health-care advocates were especially concerned about an increase in the number of uninsured children. One in nine children - 11.7 percent - lacks insurance. In 2005, 8.0 million, or 10.9 percent, had no health-care coverage.

Congress and President Bush are wrangling over funding for the State Children's Health Insurance Program (SCHIP), which is aimed at children whose families are not quite poor enough to qualify for Medicaid.

Health-care coverage has become a hot political issue. Some states are tackling changes on their own, while presidential candidates are promising overhauls.

The number of uninsured has been trending upward since the Census Bureau began studying the issue in 1987. Then, 12.9 percent of Americans lacked insurance.

This region has followed the national trend. Ten percent of Pennsylvanians were uninsured in 2006, up from 9.7 percent in 2005. In New Jersey, the percentage rose from 14.5 in 2005 to 15.5 in 2006.

It could be worse. Nearly a quarter of Texans are uninsured, the highest percentage in the nation.

Experts say people without insurance are more likely to delay care until their health problems become emergencies. The government, health providers and the insured then subsidize the cost of their treatment.

New Jersey hospitals expect to give $1.6 billion in charity care this fiscal year. Uncompensated care provided by Pennsylvania hospitals rose from $543 million in 2005 to $600 million in 2006.

"The impact can be devastating on the ability of the hospital to continue to operate," said Kenneth Braithwaite, who leads the Delaware Valley Healthcare Council.

A census official and other health experts blamed the growing numbers of uninsured on the continuing decline in employer-based health insurance. In many cases, experts said, workers turn down employee health insurance because of the cost.

According to Families USA, a Washington nonprofit group that advocates on health issues, employers pay an average of $11,278 for family health coverage. A typical employee must contribute $3,000 of that. An individual buying insurance on his own would probably pay more, if he could find a company that would sell him a policy, said Kathleen Stoll, the group's health-policy director.

Brothers Miguel Burgos and Joe Lugo, who started a business, Outsmart Pest Control Services, four years ago, are going without health insurance. "We just can't afford it," Lugo, 24, of Philadelphia, said yesterday. If he gets sick and has to go to the doctor, "I pay out of my pocket," he said. Dental care is a luxury that is out of the question, the brothers said.

Pennsylvania's relatively low uninsured rate may be due to several factors, said Amy Kelchner, a spokeswoman for the state's health-care reform office: an expansive SCHIP program, a relatively high number of residents who qualify for Medicare, and a long history of unions that demanded health benefits.

This fall, she said, Rendell plans to resume campaigning for his controversial proposal that businesses provide insurance or pay a "fair-share assessment" of 3 percent of payroll.

Ron Czajkowski, a spokesman for the New Jersey Hospital Association, said New Jersey's 15.5 percent uninsured rate might stem from its high cost of living combined with little competition among health insurers. A study done for the association last year found that "New Jersey has some of the highest medical insurance premiums in the country."

David Knowlton, president and chief executive officer of the New Jersey Health Care Quality Institute, said that about 300,000 of New Jersey's 1.3 million uninsured people are eligible for Medicaid but have not enrolled and that 400,000 are undocumented immigrants. Many do not enroll in Medicaid until they get sick, he said, and hospitals may not push it because they sometimes get better reimbursement from the state's charity-care program.

His nonprofit organization is working with state political leaders on a plan that would require everyone to have health insurance and that would make it affordable. The estimated cost: $1.1 billion.

"The health-care system in the United States is broken," said Knowlton. "It's interesting that I think every citizen knows that. We've got to get the decisionmakers to see that."

Read highlights of the new national census data on health insurance, income and poverty at http://go.philly.com/poverty. Has a link to the full report.

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