Unlike you, Robert Samuelson is hard-headed enough to know that the uninsured aren't worth worrying about and the only issue that actually afflicts our health care system is cost. Which is half true. This is one of those "Tough Choices" columns which exist to show that the author, unlike the electorate, recognizes the tough choices facing the country, but refuses to actually outline them or their complications.The meat of the piece is an effort to wave away the problems of the uninsured that, as far as I can tell, relies on some very tendentious readings of health outcomes data. Samuelson touts the equality in health spending on the poor and the rich, but that data is severely skewed by the fact that a substantial portion of the least wealthy Americans are the elderly, and they're covered by Medicare. The relevant comparison for his column would be yearly spending of the insured and the uninsured. And that's just a Google away: "A person who is uninsured all year will average $1,686 in medical costs, while someone who is privately insured will average $3,915." Weird that Samuelson decides not to mention it.He goes on to talk up the health outcomes of the uninsured. "One study compared the insured and uninsured after the onset of a chronic illness -- say, heart disease or diabetes. Outcomes differed little. After about six months, 20.4 percent of the insured and 20.9 percent of the uninsured judged themselves 'better'; 32.2 percent of the insured and 35.2 percent of the uninsured rated themselves 'worse.' The rest saw no change." Choosing a chronic condition for this comparison is extremely weird. Chronic conditions are long-term ailments. They exist for years. Six months of watchful waiting after the initial diagnosis is almost neither here nor there when tracking the disease's ultimate trajectory. But since we're using self-reported outcomes data, we can get a better picture. The Kaiser Family Foundation -- a source Samuelson uses often in his column -- took a look at this issue. The uninsured deal with care costs by postponing care. Here's what happens:
