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January 5, 1994

Dynamics of People Without Health InsuranceDon't Let the Numbers Fool You

Author Affiliations

From the Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass.

JAMA. 1994;271(1):64-66. doi:10.1001/jama.1994.03510250080040

IS THE "problem" of people without health insurance really a problem? Opponents of major health care reform argue no. The Wall Street Journal says, "[T]he alleged 37 million uninsured also wilts under analysis.... Studies show that 70 percent of them are uninsured for less than nine months."1 The Council for Affordable Health Insurance says if everyone were offered a medical savings account, "the numbers [sic] of uninsured could be reduced by as much as 25 million" (from 37 million) because "most (70%) of the uninsured remain without coverage for less than one year."2 Statistics that describe dynamics—people moving in and out of a particular condition—can mislead even with the best of intentions. When intentions are not the best, the statistics can totally confuse. I write as one of the researchers who estimated the distribution of uninsured spell lengths that yields the findings that the median spell length is

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