The decentralized U.S. approach to health care financing and provision—a mix of public and private payers and prurier">—irks many who would prefer universal taxpayer-financed insurance. In 2000, 38.7 million Americans were not covered, with one in eight of the uninsured under age 18.
But an Urban Institute study released in March indicates that lack of access to taxpayer-funded health insurance isn't the problem. In 1999, three out of four uninsured kids in families of all income levels were eligible for either Medicaid, the federal-state insurance program, or the State Children's Health Insurance Program, the product of the 1997 Balanced Budget Act. And of the 6.5 million uninsured low-income children in 1999, 85 percent were eligible for taxpayer-financed insurance. All their parents had to do was sign up. The study's authors note, "Lack of eligibility for public health insurance is no longer the reason for uninsurance for most children; therefore there must be other barriers." And indeed there are: Parents of one in five of the eligible but uninsured children said they neither want nor need the programs.