It has been called the "biggest moral shortcoming" in health care today: the reality that 43-million American adults and children lack health insurance. Despite the robust economy and changes in welfare laws intended to shore up working families, more Americans are without health insurance today than in 1994, when the ambitious health care initiative spearheaded by Hillary Rodham Clinton crashed.

Though the number of uninsured nationally dipped slightly last year for the first time in decades -- and it took eight years of economic expansion for even that minor improvement to register -- in many states, including Florida, the numbers have continued to grow.

With the defeat of the Clinton plan still reverberating and a more closely divided Congress facing gridlock, it would be easy to conclude that little can be done to address this uninsurance epidemic. But a recent pairing of former ideological rivals suggests that the diagnosis for change may not be that bleak.

The Health Insurance Association of America -- the trade group that doomed Clinton's plan with its infamous "Harry and Louise" ads -- and the consumer-friendly Families USA have offered a joint proposal that, while not perfect, provides a constructive starting point for addressing the problem.

The proposal, also supported by the American Hospital Association, would attack the problem where the need remains the greatest: among low-income workers and their families. It would expand Medicaid and the Children's Health Insurance Program, opening both to low-income parents and childless adults as well as children, and offer a tax credit to employers who bear a greater share of health premiums for their low-income workers.

With its focus on low-wage workers, the proposal can help debunk the longstanding myth that most uninsured Americans have created their own problems by refusing to get a job. To the contrary, more than 80 percent of the uninsured are in working families.

Most labor in low-wage, service-oriented jobs in which health benefits are either not offered or not affordable. Twenty percent of uninsured Americans are workers who declined their employer-offered insurance because they could not afford their share of the costs.

Bringing relief even to that minority of workers will not be easy -- or inexpensive. The authors readily admit that their modest proposal would require a significant public investment. But federal lawmakers shouldn't be allowed to hide behind the myth that doing nothing is cheaper.

The uninsurance epidemic costs us millions of dollars every year in work and school absenteeism, avoidable hospitalizations and premature disability and death. If that incalculable human toll is not enough to drive Congress to act, perhaps the continuing drain on the public coffers will provide sufficient impetus.

Back to Opinion

Contact the Times | Privacy Policy
Standard of Accuracy | Terms, Conditions & Copyright

From the Times
Opinion page