Census data for 2007 health coverage in America was released just over a week ago, and by now, a pretty clear picture of the meaning behind the numbers is beginning to emerge. The reigning consensus is that public health care really works.

First, the raw numbers:

After climbing steadily for six years, the number of Americans without health insurance dropped by more than a million in 2007, to 45.7 million, the Census Bureau reported Tuesday.

Of course, depending on how you slice the numbers, various trends appear among different groups. For example, women across different demographics are still losing out:

Women who work part-time:  For women who work part-time (i.e. less than 35 hours per week for all jobs), uninsurance rates continue to increase.  Twenty percent of women who work part-time were uninsured in 2007, compared to just 13 percent of women working full-time.

Young Women:  For the last five years, uninsurance has increased among young women ages 18-24.  Overall, about 18 percent of women are uninsured, but the proportion of uninsured women in this age group is significantly higher, at over 26 percent.

Poor Women:  In spite of the increase in public coverage, the proportion of uninsured women living below the federal poverty level (those whose income was $10,200 or less in 2007) continued its steady increase from 2006 to 2007.  Over forty percent of women at this income level were uninsured last year, more than twice the rate for women overall.

Asian, Native Hawaiian, or Pacific Islander Women:  For these women, rates of uninsurance increased from 17.2 to 18.5 percent from 2006 to 2007.

The most striking slice of data, however, is the percentage of people with private insurance vs. the percentage of people with public insurance:

According to the new census data, in 2007 the percentage of people with private coverage dropped from 67.9% to 67.5%, while the number of Americans with government-provided health coverage increased from 27.0% to 27.8%. The number of children with private insurance also fell by 0.4%, and 1.2% more children received coverage through public programs.

In other words, even as the number of people covered with private health insurance continued to drop (at about the same rate we’ve been seeing for the last few years), with primarily state insurance programs picking up the slack, more people overall were insured.

This data neatly punctures some pretty widespread conservative arguments against public health care. On the one hand, as Ezra Klein notes, we’ve seen the proliferation of low-cost private health options meant to spur “free market competition” like health savings accounts. Yet, even with these new scams products on the market, the private health care system continues to let more and more people drop through the cracks. On the other hand, as various forms of public health insurance pick up the slack and then some, more and more people are realizing public health care isn’t the nightmare conservatives make it out to be. It indeed can be well run and provide adequate coverage, a far cry from the bureaucratic hell conservatives make it out to be.

Of course, the health care crisis isn’t necessarily on its way towards solving itself. One of the main problems with America’s health care system still remains: Cost. Health care costs are still projected to rise dramatically, and without a change in our system - which allows private health care to insure profitable patients and drop them onto public plans when they become liabilities - those costs will continue to rise.

Still, these numbers and the problems we still face point towards a way out. Major social change occurs in crisis, when problems are so bad and so self-evident that people become receptive to major shifts in policy. Social change is also helped along by people’s individual life experiences - people are more likely to push for change, or at the very least not work against it, when they are somewhat familiar with coming changes.

With health care in America, we have both. The crisis is still very real. Millions are uninsured, even more are under-insured, and individuals and businesses (especially small business) are feeling the pinch of skyrocketing costs in uncertain economic times. People are bombarded with stories every day of private insurance putting profits before people, of folks curtailing needed medical care because they can’t afford it (or sometimes can’t even afford to drive to the doctor). And more and more people are being dropped by their private insurance. Yet, we also have familiarity, as more and more join public insurance plans and get comfortable with a new system.

The fact that people in America both understand the crisis (82% want a “major overhaul” of the health care system) and are flocking to public plans in greater numbers makes me very optimistic we will see real health care reform in 2009. All signs point to the fact that people are ready for change, and that conservative fear-based arguments against public health care will be less effective than ever.

(also posted at MyDD and the NOW! blog)

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