We all know people who lack health insurance. We just may not know that they lack health insurance. They know.
Of course, some people's need is obvious — they put it forward in disease groups or through pharmaceutical assistance programs. But the quietly uninsured, they have been in a kind of "don't ask, don't tell" place for some time. If we had asked regularly and recorded their responses and then thought about aggregating the data, we might have had to do something programmatic with what we knew.
Our deeply unprogrammatic safety net patch work for the uninsured comes back to haunt us now. How to find the uninsured, now that we (more so in some states, less so in others) want to do something programmatic? Here's a fascinating article about how the state of Maryland is looking for tracings of uninsurance in things like emergency department overuse: http://www.baltimoresun.com/health/health-care/bs-hs-health-care-uninsured-20130907,0,2157047.story. Of course, those tracings are also somewhat consistent with under-insurance. It ought to be interesting to see — now that we officially care to know — how we sort the two out.
Missouri State of Mind 