Policy-ish

Are The Uninsured Worse Off? Politically, It's Debatable

This may not come as a complete shocker, but Republicans and Democrats not only disagree on what health overhaul should look like, they also hold dramatically different views on the effect of being uninsured.

Man holds head in emergency room. i i

hide captionHow much of a headache is it to be uninsured?

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Man holds head in emergency room.

How much of a headache is it to be uninsured?

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That fundamental difference in viewpoint says a lot about what the two parties think is the right remedy for those without health coverage. "If you think that everyone can already get good care, regardless of insurance status, you might not think that comprehensive reform is really necessary," says Tara Sussman Oakman, the lead author of a study published Thursday in Health Affairs.

She and her colleagues note that previous studies have documented that people who are uninsured receive poorer quality of care and have more unmet medical needs than those who have insurance. Nonetheless, only one-quarter of Republicans believe that being uninsured would bar a person from getting necessary health care, in comparison to more than 40 percent of Democrats who believe so, the research finds.

Republicans say there are many ways for the uninsured to get care, including federally funded charity care at hospitals, and free or low-cost health clinics.

Harvard health policy professor Robert Blendon, a co-author of the study, told Shots, "It gives a picture of another reason why when they have a [health care] summit, one group is talking about covering 31 million people, and the other is talking about covering 3 million."

Maybe the more surprising finding in the paper is that the same type of division exists between seniors and younger people. Just 19 percent of seniors think that the uninsured can't get the medical care they need, versus 42 percent of people under 30. The study authors say maybe the difference in perception has to do with personal experience with the uninsured, something seniors don't have to worry about when they're safely nestled under the blanket of Medicare.

The result in the study that could spell trouble for health overhaul advocates down the road, though, is that even when Republicans and Democrats who were surveyed did agree on the problem of the uninsured, they still didn't agree on reform. This may be due to a Republican "ideological opposition to national health insurance," says Sussman Oakman.

The researchers suggest that the political divide could complicate the future of any program passed by Congress this year. "If one party really thinks the issue is less serious, and there's a big shift back to Republicans in the government, we shouldn't be surprised if they decide not to put as much government money toward that problem," said Blendon.

Mertens is a reporter for Kaiser Health News, a nonprofit news service.

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