Comments on: Covering The Uninsured: Calculating The Cost http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/?utm_source=rss&utm_medium=rss&utm_campaign=covering-the-uninsured-calculating-the-cost The Policy Journal of the Health Sphere Thu, 24 May 2012 07:58:29 +0000 hourly 1 By: Economists Take Critical View of Candidates Health Care Plans - SLUniverse Forums http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/comment-page-1/#comment-23353 Economists Take Critical View of Candidates Health Care Plans - SLUniverse Forums Tue, 16 Sep 2008 07:53:52 +0000 http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/#comment-23353 [...] which estimates the cost of covering uninsured Americans. Additional bloggers on the topic include Len Nichols of the New America Foundation and Tom Miller of AEI. Back-of-the-envelope estimates of the added [...] [...] which estimates the cost of covering uninsured Americans. Additional bloggers on the topic include Len Nichols of the New America Foundation and Tom Miller of AEI. Back-of-the-envelope estimates of the added [...]

]]> By: Health Care Tips » Blog Archive » Kaiser Daily Health Policy Report Feature Highlights Recent Blog Entries http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/comment-page-1/#comment-23261 Health Care Tips » Blog Archive » Kaiser Daily Health Policy Report Feature Highlights Recent Blog Entries Mon, 01 Sep 2008 17:34:09 +0000 http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/#comment-23261 [...] Nichols on the Health Affairs Blog calls a new paper that estimates the cost of covering the uninsured (here) “a major [...] [...] Nichols on the Health Affairs Blog calls a new paper that estimates the cost of covering the uninsured (here) “a major [...]

]]> By: Travis Broome http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/comment-page-1/#comment-23252 Travis Broome Fri, 29 Aug 2008 19:05:19 +0000 http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/#comment-23252 cpress points out one of the issues that everyone seeks to ignore. There are to few healtchare goods, especially doctors. With the highest average salary of any profession as a whole, you would think that the line to sign up would be out the door and it is. It is the available medical school spots that are the bottleneck. The U.S. does not even graduate enough doctors to fill all the (mostly government funded) available resident slots, much less to meet the real demands of the market. The refusal to ramp up medical education to meet demand is one of the major factors that keep our "system" broken and expensive. The lobbies that control medical education in this country do a superb job of controlling supply and keeping prices high. cpress points out one of the issues that everyone seeks to ignore. There are to few healtchare goods, especially doctors. With the highest average salary of any profession as a whole, you would think that the line to sign up would be out the door and it is. It is the available medical school spots that are the bottleneck. The U.S. does not even graduate enough doctors to fill all the (mostly government funded) available resident slots, much less to meet the real demands of the market. The refusal to ramp up medical education to meet demand is one of the major factors that keep our “system” broken and expensive. The lobbies that control medical education in this country do a superb job of controlling supply and keeping prices high.

]]> By: Christopher Hughes http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/comment-page-1/#comment-23239 Christopher Hughes Wed, 27 Aug 2008 15:48:16 +0000 http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/#comment-23239 ". For the formerly-uninsured, the out-of-pocket price of healthcare will decline, the result of which will be an increase in demand. (Indeed, for many proponents, this is the very point of insuring them–that they are now denied needed care.) Adding money and demand will push the total prices (borne by payers, not patients) up even more. So, prices (macroeconomic healthcare “costs” in common parlance) will rise faster than any model would predict, increasing the burden on taxpayers more than expected. $122 billion is almost certainly an underestimate unless it accounts for these dynamics. " I think it is important to discriminate the type of demand that will increase . If the primary care demand (i.e., the use of the medical home) increases, then theoreticlly, the overall costs per patient should decrease. By how much, who knows, but for many of us, even if it costs more, it is the right thing to do. I am one of those who beleives that the provision of minimal cost access to providers will be a boon to patients and providers alike, both medically and financially. In fact, I worry more about those who, even when given unlimited, low cost access to healthcare will not use it apporopriately, as we already see with Health Savings Account participants. Cheers, “. For the formerly-uninsured, the out-of-pocket price of healthcare will decline, the result of which will be an increase in demand. (Indeed, for many proponents, this is the very point of insuring them–that they are now denied needed care.) Adding money and demand will push the total prices (borne by payers, not patients) up even more. So, prices (macroeconomic healthcare “costs” in common parlance) will rise faster than any model would predict, increasing the burden on taxpayers more than expected. $122 billion is almost certainly an underestimate unless it accounts for these dynamics. ”

I think it is important to discriminate the type of demand that will increase . If the primary care demand (i.e., the use of the medical home) increases, then theoreticlly, the overall costs per patient should decrease. By how much, who knows, but for many of us, even if it costs more, it is the right thing to do. I am one of those who beleives that the provision of minimal cost access to providers will be a boon to patients and providers alike, both medically and financially.

In fact, I worry more about those who, even when given unlimited, low cost access to healthcare will not use it apporopriately, as we already see with Health Savings Account participants.

Cheers,

]]> By: cpress http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/comment-page-1/#comment-23238 cpress Wed, 27 Aug 2008 12:15:53 +0000 http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/#comment-23238 The costs of the uninsured should already be in the system in the form of cost-shifting--if demand were to remain in a steady state. So the questions are all around the dynamics (not statics) of: the effect on the demand for healthcare of insuring 45 million people (it should increase it) and; the effect of the increased demand on healthcare prices. There is already too much money chasing too few healthcare goods, and the predicted effects are further inflationary. For the formerly-uninsured, the out-of-pocket price of healthcare will decline, the result of which will be an increase in demand. (Indeed, for many proponents, this is the very point of insuring them--that they are now denied needed care.) Adding money and demand will push the total prices (borne by payers, not patients) up even more. So, prices (macroeconomic healthcare "costs" in common parlance) will rise faster than any model would predict, increasing the burden on taxpayers more than expected. $122 billion is almost certainly an underestimate unless it accounts for these dynamics. On the other hand, to suggest that for an average of about $225 per month at the margin ($122 bil/45 mil/12) we could insure 45 million people now estranged from the health insurance market is difficult to swallow; the current per capita average monthly spending is over $500 per month. Again, one must either believe that fixed costs account for a remarkable proportion of the system--and that they will not increase as capacity is added to absorb the additional demand (which is a preposterous notion in many regards)--or that demand and prices will be unaffected. The costs of the uninsured should already be in the system in the form of cost-shifting–if demand were to remain in a steady state. So the questions are all around the dynamics (not statics) of: the effect on the demand for healthcare of insuring 45 million people (it should increase it) and; the effect of the increased demand on healthcare prices.

There is already too much money chasing too few healthcare goods, and the predicted effects are further inflationary. For the formerly-uninsured, the out-of-pocket price of healthcare will decline, the result of which will be an increase in demand. (Indeed, for many proponents, this is the very point of insuring them–that they are now denied needed care.) Adding money and demand will push the total prices (borne by payers, not patients) up even more. So, prices (macroeconomic healthcare “costs” in common parlance) will rise faster than any model would predict, increasing the burden on taxpayers more than expected. $122 billion is almost certainly an underestimate unless it accounts for these dynamics.

On the other hand, to suggest that for an average of about $225 per month at the margin ($122 bil/45 mil/12) we could insure 45 million people now estranged from the health insurance market is difficult to swallow; the current per capita average monthly spending is over $500 per month. Again, one must either believe that fixed costs account for a remarkable proportion of the system–and that they will not increase as capacity is added to absorb the additional demand (which is a preposterous notion in many regards)–or that demand and prices will be unaffected.

]]> By: RobertBurney http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/comment-page-1/#comment-23235 RobertBurney Tue, 26 Aug 2008 20:38:55 +0000 http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/#comment-23235 What this and other sites assume is that the cost of providing healthcare services is fixed. Under that assumption, if you add more patients to the system, it will cost more money. This is not true. There is a large amount of waste within the mechanisms for providing care. With price competition for individual healthcare services, hospitals and other providers would be forced to identify and eliminate this waste in order to compete. Costs of services would decline, and we could purchase healthcare for the currently uninsured without any additional expenditure. What this and other sites assume is that the cost of providing healthcare services is fixed. Under that assumption, if you add more patients to the system, it will cost more money. This is not true. There is a large amount of waste within the mechanisms for providing care. With price competition for individual healthcare services, hospitals and other providers would be forced to identify and eliminate this waste in order to compete. Costs of services would decline, and we could purchase healthcare for the currently uninsured without any additional expenditure.

]]> By: Harold Nelson http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/comment-page-1/#comment-23233 Harold Nelson Tue, 26 Aug 2008 15:53:55 +0000 http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/#comment-23233 I'm one of those academic economists who always has to ask a question. Where do those prices, which the uninsured can't pay, come from? I think they come from the willingness of our insurers to pay them. Does anybody think they really represent true incremental resource costs? Suggesting that the insurance companies and their clients are forced to subsidize the costs ot the uninsured is really blaming the victims. I’m one of those academic economists who always has to ask a question. Where do those prices, which the uninsured can’t pay, come from?

I think they come from the willingness of our insurers to pay them. Does anybody think they really represent true incremental resource costs?

Suggesting that the insurance companies and their clients are forced to subsidize the costs ot the uninsured is really blaming the victims.

]]> By: Blogtica.com » Covering The Uninsured: Calculating The Cost http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/comment-page-1/#comment-23232 Blogtica.com » Covering The Uninsured: Calculating The Cost Tue, 26 Aug 2008 13:15:00 +0000 http://healthaffairs.org/blog/2008/08/26/covering-the-uninsured-calculating-the-cost/#comment-23232 [...] post by Len Nichols and software by Elliott [...] [...] post by Len Nichols and software by Elliott [...]

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