In an effort to undermine health care reform, some fairly prominent conservatives argue that the estimated number of uninsured Americans (currently 45.7 million) is inflated. Some Americans are uninsured by choice, they contend, pointing to the 11-13 million uninsured Americans in their 20s who allegedly “shun insurance either because their age makes them feel invulnerable.” Here is a sampling:

BOB DOLE: Where do you get the number 47 million? When you watch CBS, they may tell you that number. However, 11 million of that total are illegal immigrants. Ten million more are people who can buy their own insurance. Finally, another 10 million are people your own age who think they are never going to get sick or hurt and are not vulnerable. [Tufts Daily, 12/2008]

MIKE HUCKABEE: Of those 47 million, one-third don’t have it because they are self-insured. Another one-third don’t have it because they think they’re healthy and invincible. There is one-third that don’t have it because they can’t afford it. [FactCheck.org, 12/11/2007]

But as today’s New York Times points out, a great majority of these so-called “young invincibles” lack insurance because they can’t afford it:

Young adults are the nation’s largest group of uninsured — there were 13.2 million of them nationally in 2007, or 29 percent, according to the latest figures from the Commonwealth Fund, a nonprofit research group in New York. … In dozens of interviews around the city, these so-called young invincibles described the challenge of living in a high-priced city on low-paying jobs, where staying healthy is one part scavenger hunt and one part balancing act, with high stakes and no safety net.

Indeed, as James Kvaal and Ben Furnas reiterate in a forthcoming report, [chart on the right], approximately “66 percent of people aged 18-34 without insurance are poor or near-poor.”

Former Gov. Howard Dean (D-VT) chimes in on the manufactured controversy surrounding comparative effectiveness research (CER):

When I do something for a patient, I want the scientific research that tells me its the best course for my patient. But the far right, led by people like Rush Limbaugh, hopes to somehow convince Americans that more and better research is a bad thing. Medicine is and should always be science based – not driven by ideology.

A doctor’s perspective has a way of swaying skeptics, and Dean’s testimony goes a ways in unraveling the fear-based arguments of the other side. He pits pragmatism and common sense against the right’s orgy of emotional hysteria.

Dean personalizes this debate — comparative effectiveness can help save patient lives by keeping doctors informed on the latest medical treatments — and couples it with some reasoned debunks. Progressives tend to focus on the latter wonky responses without considering the real-world consequences of CER for individual patients.