On many occasions, I have been accused to trying to turn every important leadership and management decision that is thrust in my direction into a “math problem”. I do believe that data, and the numbers behind the data, on the assumption that it is accurate and relative to the issue at hand, can be used to measure the success or failure of almost any activity.  The real numbers almost never lie.

With this hypothesis in mind, let’s take a look at some important numbers that are having direct and material effects on the lives of everyday Americans.  We will start with the basics:

(All data retrieved from the United States Census Bureau and the U.S. Department of Health and Human Services)

  • 330,000,000  — the approximate population of the United States in 2019
  • 159,000,000  — the number of people with employer-sponsored health insurance plans in 2019
  • 84,000,000    — the number of people with health insurance from non-employer plans in 2019
  • 56,000,000    — citizens over age 65 with health insurance provided by Medicare in 2019
  • 30,000,000     — the number of US citizens who were uninsured in 2019

All of these numbers are focused on the state of health care in America in 2019.  Of particular note is the number of uninsured which was approximately 30 million.  But we have to take a look inside these numbers in order to accurately measure the state of health care in the United States.

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It is relatively straightforward to calculate the 30 million Americans with no health insurance.  The numbers are definitive and accurate.  However, upon further examination, this number could be as high as 159,000,000.  Why?  It’s called pre-existing conditions.  According to a recent study by the US Department of Health and Human Services, as many as 129 million Americans could be denied health insurance coverage due to pre-existing conditions.

“By the time the COVID-19 crisis is over, the country may well have another 12-15 million people with pre-existing conditions as a result of having tested positive for the virus.”

Add 129 million to the 30 million without health insurance and the potential number of Americans who may not be able to receive medical treatment and you get the magic number – 159,000,000 – a number that is exactly equal to those Americans who “assume” they are insurable under their employer-sponsored health plan.  Can you imagine being an employer and doing the right thing by trying to provide the best employer-sponsored health care as you can afford only to have an employee’s minor dependent denied coverage because of a pre-existing condition?  What if that employee is in a safety sensitive position where a mistake due to worry and stress could cost someone their life?  That was my position a few years ago as an employer paying $18,500 per family to provide the best coverage that I could find only to be denied because of a kid with asthma or some other treatable  condition.  

If 159 million isn’t a big enough number, let’s fast forward to the year 2020.  There are now approximately 8 million fewer full-time workers in the United States than in the same period in 2019 due to the COVID-19 pandemic.  Odds are that a majority of those workers have lost their employer-sponsored health plans so we can easily add another 6 million to our number of uninsured.  By the time the COVID-19 crisis is over, the country may well have another 12-15 million people with pre-existing conditions as a result of having tested positive for the virus.  That brings our number of potential uninsured to as many as 180 million American souls.

But wait, that’s not the worst-case scenario.  Another key number directly related to our health care debacle is six – yes, six.  That’s the number of conservative judges that are now on the Supreme Court of the United States.  Those six Justices could very well vote to overturn the Affordable Care Act (ACA) before the end of 2020.  In that unfortunate and unjust case, add another 20 million to the number of newly uninsured.  In this scenario, we have an even 200,000,000 potential uninsured Americans.

“As many as 200 million people of all political persuasions, all races, and all religions are depending on 100 million of us to cast one vote in the direction of human rights and dignity.”

When you boil it all down, the most important number is one.  Yes, ONE.  That is the number of votes that each eligible American citizen can cast just six days from now.  The country needs those votes – 200 million people are depending on simple math: 1 x 100,000,000 = 100 million.  That’s how many votes need to be cast for Democratic candidates on November 3rd in order to provide a landslide victory – not just for Democrats, but for the health and prosperity of our nation.  The only chance that health care security has for the foreseeable future is the defeat of the Republican Party from the top of the ticket to the bottom.  As many as 200 million people of all political persuasions, all races, and all religions are depending on 100 million of us to cast one vote in the direction of human rights and dignity.

So, I suppose that my critics are correct in this case – health insurance is nothing but an elementary math problem.


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During his 35 year professional career, Scott Terry has a demonstrable track record of success in leading commercial, government, and academic organizations. A proven aviation industry executive, Scott also started a highly acclaimed magazine that won multiple Addy Awards during its first full year of publication and founded an internationally recognized 501(c)3 corporation that received multiple humanitarian awards for its work delivering medical and food supplies in Africa and providing emergency medical transportation for seriously ill infants from the Caribbean Region to the USA for treatment.