Cost of Covering the Uninsured: Health Affairs

Covering The Uninsured In 2008: Current Costs, Sources Of Payment, And Incremental Costs

"Providing full-year coverage to all Americans currently uninsured for any part of the year would increase their medical spending by $122.6 billion in 2008, over and above their current spending (while uninsured) of about $86 billion. The increase in total spending corresponds to 5.1 percent of total health care spending and 0.8 percent of gross domestic product (GDP). For comparison purposes, a recent analysis estimated that the tax subsidy received by privately insured workers with employer-sponsored insurance was more than $200 billion in 2006.27 The 5 percent increase is also smaller than the average annual increase in total health spending of 7.6 percent per year since 2000.28

"The estimate implicitly assumes that the uninsured's new coverage would reflect the distributions of public and private coverage and benefits held by lower-income and lower-middle-income insured people and that their medical care use would also be similar. The cost estimate would change if the new coverage were either much more generous (very low cost sharing, as in Medicaid) or less generous (high deductibles) than current coverage. Similarly, it assumes that provider payment rates and administrative costs under various public and private plans would stay largely the same. Various health system reforms, such as competing private health insurance plans within purchasing pools, greater use of public programs' fee schedules, or expanded use of health information technology, could reduce the estimated incremental resource cost of expanding coverage. A recent report from the Commonwealth Fund estimates that a menu of fifteen savings options could reduce health spending by $1.55 trillion over ten years.29"

Perhaps I am being hyperbolic, but this reminded me of Steinbeck:

"There is a crime here that goes beyond denunciation. There is a sorrow here that weeping cannot symbolize. There is a failure here that topples all our success. The fertile earth, the straight tree rows, the sturdy trunks, and the ripe fruit. And children dying of pellagra must die because a profit cannot be taken from an orange. And coroners must fill in the certificates – dies of malnutrition – because the food must rot, must be forced to rot.
" The people come with nets to fish for potatoes in the river, and the guards hold them back; they come in rattling cars to get the dumped oranges, but the kerosene is sprayed. And they stand still and watch the potatoes float by, listen to the screaming pigs being killed in a ditch and covered with quicklime, watch the mountains of oranges slop down to a putrefying ooze; and in the eyes of the people there is the failure; and in the eyes of the hungry there is a growing wrath. In the souls of the people the grapes of wrath are filling and growing heavy, growing heavy for the vintage."

Cheers,

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