Why Does Nobody Theorize About the "Causes" of Health Uninsurance?

The Census released health insurance estimates showing that the number of uninsured people came down significantly between 2013 and 2014.

Most of the decline in health uninsurance came among adults between the ages of 18 and 64, with some children also joining the rolls. The fully socialized age range of 65+ saw little change for the obvious reason that virtually all of the elderly are already insured.

Despite gains, considerable health uninsurance remains, which raises a natural question: what is the cause of health uninsurance?

Is it low educational attainment?

This correlation would seem to suggest so.

Is it low household earnings?

Again, it seems so. Just look at that relationship!

If I cared enough, I am sure I could even show that things like single motherhood and a lack of Goodnight Moon time during childhood also correlates with health uninsurance. In fact, throw anything at me that normally passes as a serious theory for the "cause" of poverty, and I bet I could show some kind of relationship to uninsurance.

Yet, no matter what X you come up with as the cause of uninsurance, it's also true that X has absolutely no relationship to uninsurance in some places in the world. This is because in some countries everyone has health insurance guaranteed as a social right. Consequently, all the bars on all the graphs labeled health uninsurance find themselves hopelessly stuck at 0%.

When it comes to health care, liberals seem to be unified in the belief that health uninsurance is the result of a bad health care system. There is a remarkable dearth, even on the Right, of arguments that try to explain health uninsurance in terms of lack of education, family structures, shiftlessness, cultures of health uninsurance, and so on. For whatever reason, everyone seems to discount those kinds of arguments as profoundly silly, in the health insurance context.

When you switch the topic to poverty, however, everything changes. All of a sudden, massive amounts of research and posturing are done to "prove" that X, Y, and Z are the real causes of poverty. Instead of believing that poverty is the result of a bad income distribution system just like health uninsurance is the result of a bad health care system, liberals and conservatives alike furiously scratch their chins as they ponder the deep causes of some people having very little money in a country that has so much of it.

Indeed, in my experience, pushing the discussion to income distribution systems is often met with a kind of eye-rolling, as if you are being obtuse and intentionally derailing the serious poverty discussion. This is a ridiculous reaction, of course, but what's most striking about it is its asymmetry.

In the realm of health care, if you were to blame health uninsurance on single motherhood, people would think you are an actual nut. You'd be laughed out of the room and rightly so: there are single mothers in the UK, Canada, and many European countries, and yet they all manage to have health insurance. But when it comes to the realm of poverty, everything is reversed. If you blame poverty on single motherhood (or education or whatever), people think you are super serious and that your dismissive critics gesturing only at the system are the nuts!

I don't know why this is exactly. But hopefully it turns around some day. A liberal movement hell bent on poverty fixes that don't involve changing the income distribution system is one that will produce a lot of meandering Nicholas Kristof columns, but very little actual poverty reduction.

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