According to this new Census Bureau report " Income, Poverty, and Health Insurance Coverage in the United States: 2009 ," there were 50.67 million uninsured Americans in 2009, up from 46.34 million in 2008.

The chart above shows the household income levels of those 50.67 million uninsured Americans. There were 10.6 million uninsured Americans living in households making $75,000 per year or more, and this group represents more than 1 out of every 5 uninsured (20.8% of the total number of uninsured). There were about 9.4 million Americans without health insurance in households making between $50,000 and $75,000, representing 18.5% of the uninsured. For those two groups combined, 39.3% of Americans without health insurance (20 million people) were living in households last year with $50,000 or more of household income in 2009 (see Table 8 in the Census report for these data).

Q: With $50,000 or more in household income, wouldn't many or most of those 20 million Americans be without insurance voluntarily? That is, couldn't many of those households afford health insurance? Alternatively, with those income levels (especially the 10.6 million with household income above $75,000), couldn't many of those households choose to forego health insurance in favor of being "self-insured," at least for routine health procedures? Given the widespread availability of more than a thousand convenient and affordable retail health clinics around the country at Wal-Mart, Target, Meijers, CVS and Walgreen, these households could easily be on the "pay-as-you-go" model of self-insurance for health care, at least for routine medical services.

It's also the case that more than 4 out of 10 uninsured Americans (41.8%) in 2009 were between the ages of 18 and 34 years, and the young people in that age group may also voluntarily choose not to be insured, and be "self-insured," because they are young and healthy and elect not to spend money on health insurance.

As

Thomas Sowell wrote

last year:

"As for those uninsured Americans who are supposedly the reason for all this sound and fury, there is remarkably little interest in why they are uninsured, despite the incessant repetition of the fact that they are. The endless repetition serves a political purpose but digging into the underlying facts might undermine that purpose. Many find it sufficient to say that the uninsured cannot "afford" medical insurance. But what you can afford depends not only on how much money you have but also on what your priorities are. Many people who are uninsured have incomes from which medical insurance premiums could readily be paid without any undue strain (see chart above)."