We propose several definitions of affordability and examine the
implications of alternative definitions for estimates of the proportion
of uninsured who are unable to afford coverage. We find that, depending
on the definition, health insurance was affordable to between
one-quarter and three-quarters of the uninsured in the United States in
2000.
That is Kate Bundorf and Mark Pauly, here is the paper. The pointer is from the new AEI magazine, The American, which so far has been consistently interesting.
That is pretty damning of the status quo, no?
Catastrophic insurance should be affordable in any meaningful sense, for almost everyone, as long
as it’s *really* insurance. That is, hedging against major, infrequent, locally unpredictable, medical
expenses. The problem is that that, to my knowledge, it isn’t offered, for various reasons.
Where can someone buy (not through an employer) a policy that *only* covers catastrophic conditions and
has a $5,000 or $10,000 deductible?
This is why I have to roll my eyes at those who say that “medical care is expensive because here in the US
we get great, top-of-the-line, boutique care!” That wouldn’t explain why people can’t afford, or can’t
purchase if they *can* afford, even the lower-grade stuff for catastrophic events.
A more interesting question is if health care is affordable for people without insurance. The problem with the status quo is that people get locked out of the system if they don’t have coverage. If you walk into a doctor’s office with a wad of cash in your hand, you end up paying two to three times the price for the service as someone with insurance.
I think if people talked less about providing insurance for people and more about healt care itself, we would realize that insurance companies are the primary cause for our current health care crisis.
“Between 1/4 and 3/4s”? That’s a little imprecise, don’t you think? It’s like saying somewhere between nobody and everybody.
The average person can afford the average policy, but can the average uninsured afford the average policy for the uninsured? They probably aren’t 21 year old females. Most likely they can’t afford it, or can afford it only until they need it when a lack of income would lead to loss of coverage.
The Japanese have the best life expectancy, they pay half of the US cost as a percent of GDP, they have a totally free market for medical care and it is through private insurance. A conundrum? No. First, it is illegal for a care giver to discriminate in price. Unlike the US where Medicare/Medicaid shift billions onto young workers, there is honesty in costs in Japan. Then, Japanese care is delivered in large part by entrepreneurial MDs in small clinic settings. Next, medical care is compulsory. All are insured. Employers pay at least 50% of the cost. There are three risk pools – the 1,800 largest employers, small employers and the unemployed/retired. Tax subsidies and moderate employer contributions help fund the third pool. What’s so hard about that?
The sad thing is, my family is already paying for health care, just not for ourselves. This is the case for all the working uninsured or underinsured who are contributing to medicare through their taxes. We can only afford a minimal plan right now and I’m shopping for better and financially fair coverage for us, but every paycheck a big fat chunk goes to cover the healthcare needs of others while we can’t afford decent coverage ourselves. We don’t have cable, we review every purchase, the only reason we even have internet is because I use it for work. I’m trying to cut back to afford premiums, but when you have the choice between paying out money just in case and you know you won’t meet your deductible this year anyway, it’s a conundrum compared to banking the money. More simply put, for people in that marginal income area, it’s a choice between going in debt slowly now by trying to pay for the high premiums or go in debt quickly later if there is a major medical problem.
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