Paul Krugman, from the New York Times thinks so, and he also thinks we can expand coverage AND still cut costs in health care. In the current haze of health care legislative pessimism, most people view these concepts as a dichotomy, rooted in the notion that an expansion of health care coverage would translate into a complete financial collapse of our health care system, but CMS projections don't support this assertion:
"Take the CMS projection of total health care spending in 2018: it’s more than $4.5 trillion. So the direct cost of expanding coverage — the initial bump in the [cost curve} — is less than 4 percent of total health care spending. That’s the amount by which, on the current trajectory, health spending rises every 7 months.
Against that you have to set the fact that this reform makes the first serious effort, ever, to rein in costs. It’s not at all hard to believe that after a few years this will lead to lower, not higher, spending."
Ok, so really- how does providing everyone with health care curb costs? Here's one take on it:
- Patients seeking care without medical insurance turn to the nation’s “Health Care Safety Net”, which is defined (not ironically) by the American College of Emergency Physicians as “providers who have a legal mandate/mission to offer medical care to all patients, regardless of their ability to pay.” This includes emergency departments, community health centers, public hospitals, and charitable clinics.
- According to an ACEP survey released in March 2003, emergency physicians estimated that one out of every three patients they personally treated were uninsured.
- Many of the nation's uninsured delay needed care and live with serious medical conditions because they do not have affordable access to health care when they need it and only turn to the "health care safety net" when their conditions turn dire, and unfortunately, expensive.
- 55% of emergency care goes uncompensated and hospitals and physicians shoulder the financial burden by incurring billions in bad debt.
- Outpatient care, including same-day hospital vists (aka, ER visits) is by far the largest and fastest growing part of the US health system, accounting for $436 billion or two-thirds of spending expected and 40% of health care spending.[i]
In short, my point is that by extending coverage to the uninsured we'll be cutting some of the 40% of health care spending being used to provide them with care, which is one of the major causes for the cost problem.
However, what happens if the CMS and CBO projections are wrong? Should there be a failsafe mechanism that requires the private industry to cut costs by a certain amount over the next ten years or an independent commission will intervene?
Log in or register to post comments!
[i] McKinsey Global Institute, Accounting For The Cost of US Health Care: A New Look At Why Americans Spend More, November 2008
