 |
| Maybe a guy who can't count shouldn't mess with your health insurance. |
One good estimate of the cost of uncompensated hospital and doctor care in 2008 was just $43 billion, or 5.7% of a hospital care economy of $750 billion that year. But total spending on health care is much higher than that. For example, for 2011 the total size of the healthcare economy has been estimated at $2.7 trillion.
Consistent with that, Megan McArdle recently cites an Urban Institute estimate here for the following year, 2009, showing costs of all uncompensated care, not just for hospitals and doctors, at $62 billion, saying "this is a relatively small amount of overall health spending ... in the trillions."
She's right. $62 billion is just 2.3% of a $2.7 trillion healthcare economy.
The spread between those two numbers for 2008 and 2009 is $19 billion. Assuming a 4% increase in the costs of the hospital/doctor portion only from 2008 to 2009, the spread declines to $17 billion. That's the non-hospital side of the free-rider problem in 2009, less than 1% of all healthcare spending in 2011. Passing ObamaCare to fix that is like firing a bazooka to kill a gnat.
Clearly the bulk of the free-rider problem has been in the hospitals, which will continue to experience problems with uncompensated care despite Obama's Affordable Care Act.
That problem exists because of Ronald Reagan's 1986 signature on EMTALA, requiring hospitals to provide care regardless of citizenship, legal status or ability to pay. It drove up visits to emergency rooms over 26% in the first 15 years, and uncompensated cost totals over 600% since 1983, when they were just $6 billion compared with over $45 billion today. Those costs have been paid by all of us over time in a variety of ways, not the least of which have been increased healthcare insurance premiums, higher taxes, and longer waits in fewer available ERs.
While we're at it trying to overturn ObamaCare, EMTALA should be scrapped with it.
