Much of the debate relating to the American healthcare system revolves around the 'uninsured'. Even President Obama seems to be struggling, unable to get his figures straight: claiming 47 million, or is it 46 million are uninsured. Perhaps the best annual report is the US Census Bureau's Income, Poverty and Health Insurance (the 2008 survey will be out later this month). They give a headline figure of 45.657m uninsured Americans, or 15.3%.

We'll forgive the President's discrepancy of 343,000 but we'll examine who exactly constitutes this uninsured mass. For example 9.737m, 21.3% are not US citizens. But what of the remaining 35.920m. Overall 32.118 million people are in households that earn more than $25,000 per year (including 9.115m uninsured people in households that earn $75,000 or more). Insurance plans to individuals are costly but would not take much from an annual income of over $25,000. Obviously there is some overlap and we can't remove 32.118m from the overall figure based on their average annual earnings, but it does beg the question as to why they feel they can't afford insurance? Even if we lean to the extreme and exclude those earning over $50,000 it removes some 17.503 million dragging the total excluding non-citizens to 18.417m.

But what of the age breakdown? There are only 686,000 over the age of 65 who aren't covered. This compares to the 18.320 million between 18-34. who are the least likely to fall ill, which could explain why many choose not to take coverage. The picture of uninsured in America is a clouded affair. It has to be said that the real number 'in need' of health insurance falls some way off the 45.657m that is misquoted by those seeking to overhaul healthcare.