Become informed and defend your freedoms.  This is a website for citizens by an independent citizen.

uninsured in America need to be understood

Target Reforms

The uninsured typically get good health care. The uninsured receive care at a level similar to patients insured by Medicare, managed care, and fee-for-service (Asch et al. 2006).  They receive only about 50 percent of the care received by those covered by low-deductible employer-provided health insurance, but this is testimony to the over-use of routine health care services by the latter rather than denial of service experienced by the former (Hadley and Holahan 2003).

Federal and state governments spend more than $300 billion annually on public health insurance such as Medicaid and state children’s health insurance programs (SCHIP). Government and private charity care spending on the uninsured totals about $1,000 per full-time uninsured individual (Thorpe and Goodman 2005).

Reforms that target their needs include:

! Establish high-risk pools, which provide subsidized comprehensive health insurance to those with serious medical conditions. Such pools are typically funded by a combination of state subsidies and tax credits for insurer assessments.  Thirty-four states had high-risk pools in 2006 (Wieske 2007).

! Replace the tax exemption for employer-provided health insurance with a tax credit or personal deduction that can be used to purchase health insurance and make deposits into Health Savings Accounts.

! Repeal community rating and guaranteed issue laws, particularly in the individual market, that force the healthy to subsidize the unhealthy, driving many people out of the private insurance market.

! Restrict eligibility for government health insurance programs, such as Medicaid and SCHIP, so that private insurers can sell affordable insurance products to middle-income families that can afford to pay the premiums without public aid.

! Expand Health Savings Accounts, which give those who are uninsured for short periods of time the funds needed to pay directly for health care. The public policy challenge is not to persuade people to do what is not in their best interest, and certainly not to force them to make such a choice. Rather, it is to allow people to buy real health insurance without mandated coverage for seldom-used and less valued services, and to hold accountable those who decide not to purchase insurance for whatever costs they impose on others.