The new and remarkably large health care law, based on the vision of President Obama, will phase in quickly over the next several years. At its heart is the belief that every American should have health care soon. What that will cost is only a guess, with a large number of estimates already part of an argument over whether the United States can afford the plan. What is certain is that the size of the uninsured population is massive, and among some demographic groups it is growing. That momentum may make the health care plan more difficult to implement.

According to new Gallup data:

Fewer 18- to 25-year-old Americans are uninsured in the third quarter of 2012 than in past years, with the 23.4% now lacking coverage down from a high of 28.7% in the third quarter of 2009. But, at 19.4%, the percentage of uninsured 26- to 64-year-olds is still trending higher.

The problem has been partially self-correcting among the young. A closer look at the Gallup data shows that is not true at all among the old. The percentage of those over 65 that is uninsured is 2.7% now, compared with 3.4% in 2009. The figure does not seem like much, until the extent that the elderly need and use the health care system is taken into account.

One constant of bureaucracy, particularly in a system as large as the U.S. government, is that it is unbelievably slow to institute change, even with a strong mandate to do so. That means that the 20% to 25% of people without health insurance will not instantly get it because the government “says so.” While the federal government has been mandated to get virtually every American insured in short order, the hurdle created by the number of people who are uninsured is tremendous. Although the target date to get these citizen insured is 2014, that is impossible.

The uninsured problem will remain unsolved for a longer time than expected. The universe of people who need help is just too large.

Methododoly: Results are based on telephone interviews conducted as part of the Gallup-Healthways Well-Being Index survey July 1 to Sept. 31, 2012, with a random sample of 90,998 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia, selected using random-digit-dial sampling.

Douglas A. McIntyre

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