How Do Taxpayers Pay for the Uninsured?

cut and paste king 2013/03/25 13:54:11
Uninsured people go to the emergency room for care.
In both obvious and obscure ways, everyone pays for healthcare for uninsured people. A lack of insurance does not mean a lack of illness, and sometimes that illness must be addressed for the good of the community. Uninsured people who are injured go to emergency rooms, which are required by law to treat them regardless of financial means to pay for the treatment. More subtly, uninsured people take more sick days, reducing overall production and increasing costs of all goods for everyone.
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Subsidies for Last-Resort Medical Centers
Emergency rooms are legally required to at minimum examine and triage the sick and injured who show up at their waiting rooms, regardless of ability to pay. In the beginning, this law was intended to take advantage of emergency room down time; in practice, it has resulted in emergency rooms being forced to raise their prices for everyone so that they do not run a net loss.

In order to offset some of these losses, federal and state governments provide subsidies for hospitals identified as critical or last-resort medical centers; often, these centers are university teaching hospitals or hospitals located in very poor areas. Subsidies are paid for with tax money, but these hospitals run a loss even with the subsidies. Universities often underwrite teaching hospitals (usually with federal grant money) and remaining costs are spread equally in the form of higher prices for insurance companies and private payers.

Higher Medical Care Prices
Uninsured people are more likely to declare bankruptcy due to medical bills than people who have health insurance. The costs incurred in medical bills that are bankrupted do not vanish; instead, they are added to everyone else's medical bill as a sort of "cost of doing business" expense. In other words, if George down the street declares bankruptcy because he can't pay for the surgery on his leg, you pay for part of that surgery.

Hospitals may also declare some people indigent--that is, they do not have the resources to pay for their medical care that the hospital is legally required to provide. The hospital writes off their bill, using the writeoff as a tax deduction and/or rolling it into an annual state or federal grant request for indigent care. The costs of that care come out of tax money or higher bills to customers who are not indigent.
Contagious Disease Control
Even if an uninsured person never sees a doctor, the public at large may incur expenses due to her health. When an uninsured person has the flu, for instance, she is less likely to seek medical attention and more likely to go to work than someone who does not have insurance. This means she is contagious for longer than insured people, and she spends more of that contagious time in contact with people. This means more people in general go to the doctor for the flu, which results in higher prices for everyone.

The Centers for Disease Control (CDC) researches ways to keep uninsured people from spreading disease, whether it's a construction worker with the flu or an illegal immigrant with drug-resistant tuberculosis. Taxpayers fund the CDC and its projects.

Reduced Emergency Room Services
Insured people are more likely to go to a doctor's office or immediate care center when they get sick. Uninsured people are more likely to go to the emergency room, where the hospital is required to accept them regardless of insurance status or means to pay.

Not only do taxpayers have to make up the lost funding of an emergency room that accepts people who cannot pay for services, they suffer from the reduced availability of emergency room services. Though this is not directly a financial burden, packed emergency rooms are less able to triage patients and appropriately serve critical cases. Taxpayers pay in the form of reduced access to emergency rooms, higher levels of stress in emergencies and sometimes more severe illness than they would otherwise have had.

Public Medical Assistance
Ultimately, people with no insurance may seek public medical assistance in the form of Medicaid or the Children's Health Insurance Program (CHIP). This is state-sponsored insurance for people with very low incomes. Fees paid by these public health coverage programs are set at levels that are often below the costs incurred to treat patients. This means that for every Medicaid patient a doctor accepts, he must also have a paying privately insured patient to make up the loss he will incur. Public medical assistance programs are all taxpayer-funded.

Indirect Illness-Related Revenue Reduction
People without insurance are, in general and with all other variables like age being equal, less productive and more likely to take sick days than those who have insurance. This is because they are less likely to seek out preventive medical care. Indirectly, this reduced productivity impacts the prices we pay for every good, service or commodity. Everyone ends up paying for those who do not have health insurance
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  • EDRN 2013/03/25 14:03:20
    Everyone deserves health care. Having said that Most hospitals have a policy that is posted in the Emergency Room. "Everyone has the right to be seen by the ER MD and emergencies will be treated, non emergencies will be referred to their Primary Caregiver or a clinic" The problem is that hospitals don't follow their own policies. The ER MD will see these non emergent patients, run a series of time consuming tests and take ER beds from real emergencies. Today, hospital emergency rooms have become free health clinics.
  • cut and... EDRN 2013/03/25 14:08:33
    cut and paste king
    and hospitals are bankrupted remember that a lot of this hospitals merged and are public companies owned by wall street
  • EDRN cut and... 2013/03/25 14:18:46
    That is true

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