Underinsured in America

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A new study in Health Affairs takes up an issue often neglected in debates over health care, but quite important: namely, the underinsured. These people have coverage, but it’s usually inadequate, leaving them vulnerable to high out-of-pocket costs and often forcing them to forego essential care. About 12 percent of adults, some 16 million, fell into this category in 2003, which can be tacked onto the estimated 45 million without insurance at all. Most of the underinsured were either minorities, had low incomes, or were sick.

The other big story here is that the vast numbers of underinsured are the result of an increasing trend in America. Employers, wracked with health care costs, are responding by pushing more and more of the financial burden for coverage onto the workers themselves, whether that includes higher deductibles, patient cost sharing, or restricting benefits. As a result, many workers are left without adequate coverage, and end up seeking out less care in the end. (Cost-sharing, almost by definition, hits the poor and the sick the hardest.)

It’s doubtful that this trend can be reversed, and at any rate, it probably shouldn’t be. Employers were never meant to be in the business of providing health care, and that goes double in an age where workers switch jobs frequently and firms need to be competitive in the global economy. Eventually, the government will have to take over the business of managing care. That’s inevitable. The problem is that unless the transition period is well-managed—which is certainly not the case right now—then we’re in for a long period of time where companies are slowly and steadily loading the costs onto the backs of their workers and more and more employees become unable to afford adequate care. Eventually it will all hit a crisis point and voters will demand some sort of national health care system. But who knows when that will be? The interim period, meanwhile, will be devastating.

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Reclaiming power from those who abuse it often starts with telling the truth. And in "This Is How Authoritarians Get Defeated," MoJo's Monika Bauerlein unpacks six truths to remember during the homestretch of an election where democracy, truth, and decency are on the line.

Truth #1: The chaos is the point.

Truth #2: Team Reality is bigger than it seems.

Truth #3: Facebook owns this.

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Truth #5: It's about minority rule.

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Please take a moment to see how all these truths add up, because what happens in the weeks and months ahead will reverberate for at least a generation and we better be prepared.

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SIX TRUTHS

Reclaiming power from those who abuse it often starts with telling the truth. And in "This Is How Authoritarians Get Defeated," MoJo's Monika Bauerlein unpacks six truths to remember during the homestretch of an election where democracy, truth, and decency are on the line.

Truth #1: The chaos is the point.

Truth #2: Team Reality is bigger than it seems.

Truth #3: Facebook owns this.

Truth #4: When we go to work, we're in the fight.

Truth #5: It's about minority rule.

Truth #6: The only thing that can save us is…us.

Please take a moment to see how all these truths add up, because what happens in the weeks and months ahead will reverberate for at least a generation and we better be prepared.

And if you think journalism like Mother Jones'—that calls it like it is, that will never acquiesce to power, that looks where others don't—can help guide us through this historic, high-stakes moment, and you're able to right now, please help us reach our $350,000 goal by October 31 with a donation today. It's all hands on deck for democracy.

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