Beth Capell, Ph.D. responds on safety net funding and the uninsured:
Don:
Your comment may unintentionally encourage those who wish to defund the safety net in order to fund coverage expansions for other Californians.
As the CAPH report demonstrates, the current safety net is badly underfunded. If the safety net for the uninsured were funded at the same level as care for the insured, California would spend $12-$14 billion on community clinics and public hospitals—instead of the $4-$6 billion now spent.
It is important to acknowledge, as you have in other Quotes of the Day, that the uninsured get half as much care as the insured–and that they pay more for less care.
Every reputable estimate of the cost of covering the uninsured includes the cost of doubling the amount of care they receive. This is incorporated in the Lewin analysis of the various single payer options reviewed in the Health Care Options Project.
The reason that a single payer system can absorb the increased cost of providing a decent level of care for all Californians is the dramatic cost savings achieved by eliminating the administrative overhead of an insurance model of financing.
Those who say the costs are already in the system are right–but only if they are talking about money spent on unnecessary overhead and administrative costs.
It is not true that the uninsured get the care they need. Not at the emergency room, not at doctor’s offices, not at underfunded community clinics and public hospitals, not anywhere.
The cost of care for the uninsured is absorbed by the uninsured—in premature deaths, in avoidable illnesses, in misery from untreated illnesses and chronic conditions. They don’t get the care they need and we should say it.
Beth Capell, MD