Before we panic over how to cover the 45 million we are told are uninsured (“Rise In Number of Poor and Uninsured,” Sept. 12-18), let us look at a few facts, starting with the fact that many of the uninsured choose to be.

Of the 35 million uninsured adults, one in four are under 24, and half are under

35. Thinking like young adults, rather than presidential candidates, many of the young and healthy with limited resources and a sense of invincibility choose not to purchase health insurance. Among workers who have access to employer-subsidized insurance, one in five declines it. And the uninsured aren't the same people from year to year or even month to month. Three-quarters of the uninsured remain so for less than a year.

Of the uninsured, one out of three lives in a household earning more than $50,000 a year. One in seven lives in a household with an annual income exceeding $75,000. And the Census Bureau counts as “uninsured” individuals who are eligible for Medicaid and the State Children's Health Insurance Program but are not enrolled. Deven Herrick of the National Center for Policy Analysis estimates that as many as 14 million children and adults fall into this category.

And we may have already fixed the problem. Tucked away in last year's prescription-drug benefit bill was a provision establishing health savings accounts (HSAs) which combine a high-deductible catastrophic health insurance policy with a tax-free medical savings account to cover routine expenses.

HSAs offer portability and ownership. They can pay for health care and insurance between jobs. The cash accounts belong to the individual forever, whether they change jobs, lose jobs or retire. They encourage people to be both health conscious and cost conscious and don't increase the federal budget by a single dime. The downside is they don't buy votes, either.

DANIEL JOHN SOBIESKI

Chicago