Eight out of ten uninsured individuals either hold full-time jobs or are the dependents of people who do. The reasons they have no health insurance are clear. In many cases, employers simply do not to offer health insurance as a benefit of employment. This is particularly true of small businesses, which compose the fastest-growing employment sector of the American economy. Even large employers, as a group, are cutting back on their contributions to health insurance, forcing many low-wage workers to forego insurance in favor of food and shelter for their families.
Welfare reform is yet another reason.
Moving off of the welfare roles into a low paying job frequently means losing state or federal health care benefits. The cost of having a job, in other words, is the loss of health insurance. A resident at Johns Hopkins recently told me the story of a neighbor of his who approached him at home because he needed medical advice. The man was a tree trimmer, and a 600-pound trunk had fallen on his hand earlier in the day. The resulting hematoma was so large that the resident couldn't tell whether the hand was broken or not, but the injury was clearly severe.