Monday, June 8, 2009

The $1000 those of us who are insured pay for the uninsured

I'm sure many of you saw a few weeks ago when there was a report on how much those of us with insurance pay on average (through premiums) for people without insurance. If not, here is a link to a story about the study
( The key question is what should policy makers do about this.

One answer may be nothing. Sure it not great to have millions of uninsured people who have problems getting care but we as a society have tolerated that for a long, long time. In that case, there are still ways for those who are uninsured to get at least some care, we can say that we will still leave things to the market (which some favor), and we know how much it is costing people with insurance to subsidize. Some people fear that if we do anything other than leave it alone, those of us who are already insured will end up paying more. Maybe--but if we could pay more and have better protection from ever being uninsured some people might find that worthwhile?

Other than leaving things as they are, we can think about requiring everyone to be insured. That would probably relieve some of the burden on us. However even if everyone paid their own way through a premium, we would still have to subsidize some poor families. In that case, we would not see the $1000 through our premiums but I bet we'd see at least a part of the $1000 through our taxes. And, it might even be the full $1000--some people could pay at least part of the premium but the overall use of health care may go up as people had to pay less out of pocket.

We could also switch to a single payer system in which case the entire system would be tax based.

Not clear which of these would be best for those already with insurance--although people in general don't like change. Nevertheless, the more we stay with exactly what we have the more we will go on paying for others' care in ways that are not obvious and be at risk of loosing our own health insurance some day.

No easy choices.

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