
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, April 19, 1990                   TAG: 9004190590
SECTION: EDITORIAL                    PAGE: A14   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

FOR MILLIONS, HEALTH INSURANCE FLEETING

A LOT OF figures have been tossed around in the debate about health care; as statistics and estimates will, those have fluctuated. The figure come to be generally accepted for the number of Americans lacking health insurance is 37 million. That is a lot of people, but now there is evidence that the number may be nearly twice as high.

A word about the 37 million figure - which at various times was reported as 23 million and other numbers in between: It was obtained by government survey of the work force at a certain fixed period, the "snapshot" method.

Compare this method to a photograph taken of a horse on a race track. A snapshot can tell where the horse was at a given moment in time. But alone, the snapshot gives no history. On the other hand, a series of such pictures can follow the horse's progress, tell something of his racing style, and show whether he stays the course to the end. As contrasted with the snapshot method, in statistical terms this is called a longitudinal method of measuring.

The Census Bureau used the longitudinal method to track a representative sample of Americans over a recent 28-month period. The bureau found that for many low-income workers and their dependents, health insurance is a sometime thing. While employed, they might have some coverage; while unemployed, they probably didn't. And not all low-wage jobs carried this important but costly fringe benefit, which many employers say they can no longer afford.

Put another way, great numbers of Americans lack continuous, adequate health-insurance protection against the unpredictable times when illness strikes. How many? Extrapolating from the findings in its 28-month survey, the Census Bureau calculates that during this period, 63 million Americans went uninsured for one or more months. Some had no health insurance of any kind during the whole time.

Such data lend a different dimension to the U.S. health-care picture. They show a yawning gap between haves and have-nots: 72 percent of Americans enjoying uninterrupted private or government coverage during an entire 28 months, the remaining 28 percent going without much or all of the period.

It must be said that having health insurance does not automatically translate into good health. To a great extent that is determined by one's personal choices, especially involving diet, tobacco and alcohol.

But the very people who lack steady health insurance are also those whose low incomes and irregular work put them, and their families, in most peril of health problems over which they have little control. When you lack money and insurance, you don't seek treatment for small disorders that can become big ones. An expectant mother doesn't get a physician's advice regularly, and once born, her infant doesn't get needed checkups. Society pays for that in other ways.

In recent years, America has drawn its patchwork health-insurance quilt over the people who can afford good health care, and left uncovered those who can't. Increasingly, private insurers compete financially by not providing coverage to those most likely to get sick. This situation results from the unending spiral in health-care costs, and there's no obvious solution. Throwing more money at the problem may well make it worse. But in justice and enlightened self-interest, the nation cannot let 28 percent of its people go without ready access to the kind of care they need.

by CNB