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Who Are The Uninsured?

If reform opens access to 32 million new patients, we should get to know them.

FROM THE EDITORIAL DIRECTOR
Jim Thomas

One of the key features we hear in virtually every sound byte about healthcare reform is that it will provide insurance for 32 million presently uninsured individuals. The logical question to ask is: Who exactly are these people? After all, if they're going to visit your practice sometime soon, shouldn't you know something about them?

I donned my official investigative reporter's uniform — the trenchcoat and the fedora with the "PRESS" ticket prominently displayed on the side — and went to work.

Statistically speaking

Before I get into the numbers, let me provide a disclaimer: I'm citing commonly published data by sources, such as the Census Bureau (2008 statistics) and the Congressional Budget Office (CBO). Their numbers, such as the CBO's 32 million figure, often incite heated debate. I have no political stake in arguing the data. My purpose is to understand the demographics of those soon-to-be-insured patients, many of whom may visit optometric practices for their eye care. So here goes:

► The total number. The Census Bureau estimates that 46.3 million people are not covered by any type of health insurance.
► Location. The Bureau presented this regional breakdown of those 46.3 million: Northeast - 6.2 million, Midwest - 7.5 million, South - 20.1 million and West - 12.3 million. Of the total uninsured, 39.0 million live inside metropolitan areas, leaving 7.3 million residing outside these areas.
► Income. Of those uninsured, 17.7 million have annual household incomes of $50,000 or more, and another 28.5 million without coverage earn less than $50,000 per year.
► Age. The largest group of uninsured people here — 11.3 million — fell between the ages of 45 to 64, followed by the ages of 25 to 34 (10.8 million), 18 to 24 (8.2 million), 35 to 44 (8.0 million) and those younger than age 18 (7.3 million). Of those age 65 and older, 646,000 are uninsured.
► Employment status. In 2008, those uninsured who worked full time numbered 20.9 million. Another 6.9 million worked part time, and 10.6 million did not work.

Opportunity

Will these "new" patients provide an opportunity for optometry? So far, most observers in the government and in the optometric profession answer with an optimistic "yes." And when one considers the value of optometry — including its role as an entry point into the healthcare system — it would be hard to disagree with this answer. OM