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Total Health Care Costs Fall When Poor Are Provided Insurance

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Total Health Care Costs Fall When Poor Are Provided Insurance: Study

The concept of support for universal health care is taboo among Republicans who scrutinize the Affordable Care Act -- dubbing it the "Job-Killing Health Care Law Act" -- and call for its repeal. But a new UC Irvine study challenges the GOP argument that the health care law is too costly, with data illustrating that health care costs on the whole fall when poorer, uninsured patients are provided with insurance.

"In a case study involving low-income people enrolled in a community-based health insurance program, we found that use of primary care increased but use of emergency services fell, and -- over time -- total health care costs declined," David Neumark, a co-author of the study, said in a release accompanying the findings.

The study -- which focused on uninsured people in Richmond, Virginia who fell 200 percent below the poverty line -- found that over three years, health care costs fell by almost 50 percent per participant, from $8,899 in the first year to $4,569 in the third after they received insurance. Participants who enrolled in health coverage made fewer trips to the emergency room, which are notorious for running up patient bills. Instead, insured participants went for more primary care visits.

"A lot of the debate about health care reform surrounds the issue of whether we're setting up something that's going to cost us more by increasing use of medical services or something that will cut costs through more appropriate and timely use of medical services," Neumark said in the release. "[O]ver time, costs can be reduced through increased use of primary care and reductions in emergency-department visits and hospital admissions, but it may take several years of coverage for substantive savings to occur."

Health care spending in the U.S. has been on the rise for years. Americans spent more than three times on health care in 2008 than they spent in the 18 years before, according to a Kaiser report.

Low-income, uninsured individuals tend to rack up exorbitant health-care bills because they often rely on emergency room visits instead of primary care. In the long run, these bills are paid by taxpayers. The Affordable Care Act "is set to extend Medicaid benefits to about 16 million uninsured, low-income adults and children by the end of 2014," according to the study.

In an extreme example of the societal cost of leaving some uninsured, New Yorker writer Malcolm Gladwell once chronicled the medical costs of a homeless man in Nevada who "used more health-care dollars, after all, than almost anyone in the state."

"It would probably have been cheaper to give him a full-time nurse and his own apartment," Gladwell wrote.

Mandatory health care already saw some success in Massachusetts last decade, when current GOP presidential candidate and then-Massachusetts governor Mitt Romney signed a health care law that inspired the Affordable Care Act. Today, Massachusetts has the highest percentage of insured residents of any state.

Though he initially supported the plan, Romney's rival, GOP candidate Newt Gingrich, continues to slam Romney for enacting the health care law.

"Your plan essentially is one more big-government, bureaucratic high-cost system." Gingrich said. Gingrich's views are reflective of a majority of Americans who say they are in favor of repealing the health care law.

A repeal of the act could potentially add "at least a trillion dollars to the deficit," according to HealthCare.gov.

See original article for embedded links at:

http://www.huffingtonpost.com/2012/02/10/health-care-costs_n_1266442.html

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If the above is true is it an accounting "improvement"? At least, partially?

For instance, if an ER charges $100 to an indigent person for care and eventually the taxpayers pay for this (at some agreed upon rate), does having Medicaid, also paid for by taxpayers, charging $50 for the same care really equal a $50 savings?

There is no doubt in my mind that prevention costs less in the long run than cures. However, many, many ailments are "only" treatable, either long term or when acute. Which is cheaper? Only the Shadow knows.

Best regards,

RA1

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If the above is true is it an accounting "improvement"? At least, partially?

For instance, if an ER charges $100 to an indigent person for care and eventually the taxpayers pay for this (at some agreed upon rate), does having Medicaid, also paid for by taxpayers, charging $50 for the same care really equal a $50 savings?

There is no doubt in my mind that prevention costs less in the long run than cures. However, many, many ailments are "only" treatable, either long term or when acute. Which is cheaper? Only the Shadow knows.

Best regards,

RA1

Except that often prices aren't directly reimbursed by the government, they are passed on to paying customers of the hospital via bs like $7 Tylenols. Insurance negotiates it down to $1, but people who don't have insurance are faced with an unpayable bill--that may well drive them into bankruptcy, passing the cost of their care onto others as well.

Eventually the Ponzi-scheme of for-profit medicine collapses on itself and you end up with large areas entirely without emergency rooms and ever-escalating costs.

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You will pay for it one way or another, it's just this horrible Republican tendency to focus only on short term gain for the very few while entirely ignoring the clear long-term good for everybody--themselves included--which somehow fools people. Until their precious daughter dies needlessly in a car accident on the 10 because all the advanced trauma centers on that side of town went under!

But that's the dirty filthy immigrants fault! Because a nationality and means test should come before triage and stabilization! Remember that on your next vacation!

And when they get called on that, it's time to break out the Fear, Uncertainty and Doubt.

Medicare Fraud! Boooga booga boooga! 5% of Medicare funds go to administration and fraud. Over 20% of private insurance funds go to administration, profit, advertising, etc.

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Here's what I don't get...

*Everybody* hates the mandate. Can somebody please tell me what the fuck the objections are to *this* modest proposal...?

:sorcerer: Everybody is eligible for Medicare. :sorcerer: There's a scale where the very poorest can get it free/steeply discounted--just like Medicaid now, from there to a reasonable percentage above the poverty line can get it for cost, and everybody above that can get it for cost plus 20%.

That 20% pays for any expansion of the medicaid total, but provides much more, back-filing the deficits caused by the baby boomer generation, making the entire system solvent, even providing room to make improvements.

The 20% also gives private companies room to compete. The crux of this whole damn argument is that private enterprise can do it better--despite plenty of evidence to the contrary, so here they go! If they can honestly provide better value to people for less than the medicare mark--or better faster service for more, godspeed! But you do need apples to apples regulation to make sure they're not promising more than they're actually providing.

What *the fuck* is wrong with this plan?

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Here's what I don't get...

*Everybody* hates the mandate. Can somebody please tell me what the fuck the objections are to *this* modest proposal...?

Everybody is eligible for Medicare. There's a scale where the very poorest can get it free/steeply discounted... from there to a reasonable percentage above the poverty line can get it for cost, and everybody above that can get it for cost plus 20%.

----

What *the fuck* is wrong with this plan?

It has the not inconsiderable additional value of being an extension of an existing program that most people are already familiar with & can readily understand. :thumbsup:

Works for me, but it gores a lot of folks in the health-care business besides the insurance crowd. Probably why it ain't on the table.

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It has the not inconsiderable additional value of being an extension of an existing program that most people are already familiar with & can readily understand. :thumbsup:

Works for me, but it gores a lot of folks in the health-care business besides the insurance crowd. Probably why it ain't on the table.

Yep! But notice the hypocrisy--even given 20% off the top they know it'd be *very* hard to compete with medicare. Even though they'd be able to turn people down (but *not* dump them and not invalidate the coverage if they dig up something way after the fact...). But of *course* they all prefer the current system with 10-20% of the money going right into their profits and all they have to do to increase that is screw a couple thousand more people out of coverage...

Every time one of these asshat politicians has something to say about medicare, I wish somebody in the audience would stand up ask if it's so bad, why is it good enough for your parents/grandparents?

Mitt's probably the only one so rich none of his family is in it!

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