Who are the uninsured?

If you're a fan of competitive cycling, like I am, you may have read Lance Armstrong's compelling memoir "It's Not About the Bike: My Journey Back to Life." A little-known fact is that soon after being diagnosed with a highly aggressive form of testicular cancer, Armstrong, having recently switched cycling teams, found out that his new sponsor's health insurance would not pay for cancer treatments because they considered his illness to be a pre-existing condition. Even though Armstrong was a wealthy world-class athlete, the cost of these treatments would have nonetheless rapidly depleted his considerable savings. Fortunately for him (and us), a personal appeal to his sponsor resulted in a quick reversal of the decision, permitting Lance to undergo arduous treatment, emerge a survivor, and win the Tour de France 7 straight times from 1999 to 2005 and finish 3rd in a comeback this year to raise awareness for his cancer foundation.

Most uninsured or underinsured Americans aren't so lucky. In contrast to public perceptions that the 47 million uninsured are either unemployed and destitute (and therefore actually eligible for Medicaid) or young, healthy people who choose to be uninsured to save money (see this recent Washington Times editorial), 3 independent national health surveys have found that 2/3rds of the uninsured are employed adults, more than half of whom earn less than 200% of the poverty level (less than $37,620 for a family of four in 2003). For example, although Wal-Mart recently came out in support of an employer mandate to provide health insurance, in 2006 they only provided insurance to 46% of their employees.