N.H. Debate: The GOP Field

This idea – that most uninsured Americans simply don't feel like having health insurance – has been heard before from this year's GOP field. We addressed it here, after Huckabee claimed at a Dec. 10 debate that a third of the uninsured "think they're healthy and invincible." Experts say this is simply not the case: Most people who are offered insurance do not turn it down, neither because of perceived invincibility nor from an unwillingness to "play" the insurance game.

The National Academies report that "only 4 percent of all workers ages 18 to 44 (roughly 3 million people) are uninsured because they decline available workplace health insurance, and many do so because they cannot afford the cost." A 2007 study published in Health Affairs found that 56 percent of the uninsured were neither eligible for public coverage nor able to afford insurance without assistance.  This study also found that 20 percent of the uninsured could have afforded coverage, but even leaving aside other factors like being turned down for insurance, that's hardly 47 million people refusing to "play."

Romney is also misleading when he implies that the uninsured are simply choosing between toeing the line and freeloading as two roughly equal ways of obtaining health care. While uninsured individuals can get a certain amount of free emergency care, it is by no means comparable to the care given to those with insurance. The Kaiser Family Foundation reports that the uninsured have less access to care, are more likely to be hospitalized, are often financially unable to follow treatment plans, get less preventive care and are in general poorer health than the insured. Poorer health among the uninsured could also affect their ability to purchase private coverage, since insurance companies often reject individuals with preexisting conditions.

Rudy's Historic Rewrite
Giuliani falsely blamed President Clinton for cuts in the military that happened mostly under a Republican administration:

Giuliani: Bill Clinton cut the military drastically. It's called the peace dividend, one of those nice-sounding phrases, very devastating. It was a 25, 30 percent cut in the military. President Bush has never made up for that. We – our Army had been at 725,000; it's down to 500,000.

Actually, most of the cutting to which Giuliani refers occurred during the administration of George H.W. Bush. At the end of fiscal year 1993 (which was Bush's last one in office), the Army had 572,423 active-duty soldiers – a far cry from 725,000. In fact, to get to that number, one has to go back to 1990, during the first gulf war. Moreover, Clinton's cuts in the military, while large, were nowhere close to 25 percent to 30 percent. Between 1993 and 2001, the Army went from 572,423 to 480,801, which is a decline of 16 percent. The entire military went from 1,705,103 to 1,385,116, a decrease of 18.8 percent.