Uninsured problem grows

Washington Post: Much to nobody's surprise, this year's census shows that the number of Americans who lack any form of health insurance grew in 2002, to 43.6 million -- more than 15 percent of the population. In part, these figures reflect the economic slowdown, which has left fewer workers employed, and the double-digit rise in health care costs, which has left fewer employers and workers able to afford health care. They may also reflect some deeper changes. Health care analyst Gail Wilensky suggests, for example, that the growing number of uninsured may be connected to the long-term shrinking of the manufacturing sector, which traditionally provides full benefits, and the growth of the service and small-business sectors, which traditionally do not. If so, economic recovery may bring less improvement than in past years.
All talk, little action
But while explanations are multiple, solutions are few and far between. Few doubt that high social and economic costs are imposed on the uninsured and their families, as well as on hospitals and other institutions that wind up caring for them. As a result, the plight of the uninsured provokes a good deal of rhetoric during election years and probably will again in the run-up to the presidential election next fall. Yet, while candidates talk a good game on the stump, practically nothing happens afterward.
Off Capitol Hill, however, a genuine debate is beginning to take place about the uninsured, and it has been reflected in two smaller measures enacted in recent years that might well come to serve as precedents. The first was the creation of the State Child Health Insurance Program, a part of the Balanced Budget Act of 1997, which essentially expanded Medicaid to include more low-income children. The second was the Trade Act of 2002, which included health care benefits for workers "displaced" by trade. Both brought coverage to parts of the uninsured population, albeit in different ways.
If expanded further, either method could, theoretically, be used to cover far more of the uninsured.