The Interconnectedness of Health Care Costs

If you are uninsured and cannot pay for life-saving emergency medical services, who gets stuck with the bill?

A lot of people… doctors, hospitals, insured individuals, businesses, and taxpayers. One of the reasons for rising premiums for the insured is that they are paying for the uninsured.

Do we want to stick with the status quo… or do we want to live in a society where the uninsured are simply not treated at all… or do we want to move toward shared responsibility? Unfortunately, without the individual mandate, we are back to square one. Welcome back, status quo.

Fighting the Individual Mandate
On its surface, the individual mandate forcing citizens to purchase health insurance from private entities sounds wrong. That’s why advocates for health care reform pushed so hard for the a single-payer system or a public option. Then again, whether you pay for health insurance or not, if you meet with tragedy and end up at the emergency room, efforts will be made to save your life — at great cost. 

The mandate to carry health insurance was deemed necessary in order to lower the cost of health care for everyone. Without the mandate, there is no incentive to purchase insurance until one is ill. And without the mandate, we could not expect insurers to sell policies to those with pre-existing conditions.

Massachusetts, under Republican leadership, added the individual mandate for its citizens in order to control costs and get most residents covered, resulting in less than six percent of residents remaining uninsured, according to Kaiser.

Meanwhile, a growing list of states, most notably Virginia and Missouri, are working to repeal the individual coverage requirement of the Patient Affordable Health Care Act.

This week primary voters in Missouri passed, by 71 percent to 29 percent, a ballot referendum that would prohibit the federal government from requiring people to have health insurance. It should be noted that the electorate was far higher on the Republican side due to a competitive Republican primary race. Recent national polls have shown a rise in support for the Affordable Health Care Act.

A federal judge this week ruled that Virginia’s case against the health insurance mandate will not be dismissed. The case is expected to be heard later this year.

From the White House blog (Aug 2, 2010):

“A federal district court in Virginia issued a procedural decision to allow a suit filed by Virginia’s Attorney General to move forward… Today’s decision merely said that the Virginia Attorney General has standing to challenge the lawsuit – which means that the court has jurisdiction to hear further arguments…

In order to make health care affordable and available for all, the Act regulates how to pay for medical services – services that account for more than 17.5 percent of the national economy. This law came into being precisely because of the interconnectedness of our health care costs. People who make an economic decision to forego health insurance do not opt out of the health care market, but instead shift their costs to others when they become ill or are involved in an accident and cannot pay.

We do not leave people to die at the emergency room door – whether they have insurance or not. Those costs – $43 billion in 2008 alone – are borne by doctors, hospitals, insured individuals, taxpayers, and small businesses in Virginia and throughout the nation. According to a recent study, this cost-shift added on average $1,100 to family premiums in 2009 and roughly $410 to an individual premium.

And many reforms provided by the law – such as the requirement that insurers cover individuals with pre-existing conditions – can only be effective if everyone is part of the system, which is why the minimum coverage, or shared responsibility requirement is part of the law.”

Uninsured Flock to Free Medical Clinic
While the politics of it all plays out on a state-by-state level, uninsured people from in around the District made their way to a free medical care clinic on August 4. Organized by the nonprofit National Association of Free Clinics (NAFC), the one-day event drew almost 2,000 people looking for basic health care from volunteer doctors and nurses. About 83 percent of the patients who go to free clinics are employed, but have no health insurance.

Upcoming Free Medical Clinics
The NAFC two-day free clinic will return to New Orleans on August 31 – September 1. This free clinic will help the uninsured of the Gulf Region as we approach the five-year anniversary of Hurricane Katrina and as the region is struggling with the current oil spill crisis.

To locate a free clinic in your state, see the NAFC free clinics list.


Photo used under Creative Commons License, via Flickr, courtesy of Rosser321


Erin R.
Erin R7 years ago

Thanks for the post.

Anna Drechsler
Anna Drechsler7 years ago

People, please don't panic and assume. US is the only developed country with no affordable health insurance for its citizens (illegals should form charity to pay for their trouble as far as I am concerned)
We should push our legislators to open the market for health insurance. country wide. Right now health insurance companies in US are exempt from anti trust law so we observe these comapnies getting bigger and bigger behemots and monopolise insurance market. Of course they get very powerfull and have incredible money in hand to influence politicians! If there is open health insurance market, the big ones will have to fairly compete for rates&services, possibly break down to keep down the adm costs and the small efficient companies will start mushrooming. After all, there are 46 mln customers to fight for! Just look at cell phone service market! Competition and market are the best regulators We need nothing more. Let's use capitalism, not interventionism! We#re biggest capitalistic country in the world!

Tricia H.
Tricia Hamilton7 years ago

Alot of people are misinformed and don't understand what is going on. If you are living with your parents, you are insured with them, under their policy. Yes, we are paying for people who are not insured but there are so many loopholes. Check it out.

Janice P.
Janice P7 years ago

(cont.) I had no insurance. It was ONLY AFTER she signed papers assuming responsibility for my bill that they began treating me, i.e., giving me blood, etc.

The bill for my 3-day stay was over $16,000. I did not have surgery. I only got blood, fluids, and some intravenous pain medication. A woman I know, who has insurance, had the same problem. Her hospital bill: under $4,000, most of which was paid by her insurance company. I, without insurance, subsidized HER bill.

It is a mistaken notion that the insured subsidize the uninsured. The insured have companies, which negotiate prices for them, The uninsured have no such benefit. We have to pay FULL PRICE. Those with insurance pay a deeply discounted price. We are subsidizing those with insurance.

Please take another look at what is REALLY happening in medical care and take note of the serious inequities between the haves and the have-nots. I was almost a statistic of it.

Janice P.
Janice P7 years ago

Kimberly is absolutely correct. This was nothing but a gift to the insurance companies, which HEAVILY spent and campaigned against the single-payer plan. Now, why do you suppose that was? As a resident of Missouri, I can tell you why we voted against this plan. The government has no business mandating its citizens, particularly under penalty of law, to purchase anything that costs thousands of dollars from a private company, so that it can make more profit on the backs of sick people. Those companies are already over-bloated and under-regulated leeches on society as it is. They produce nothing. Nor do they add anything to the economy. They just suck it dry.

Moreover, although I love Ann Pietrangelo, she is wrong about a few things. First, we DO let patients, who have no insurance, die. I ruptured my esophagus 5 years ago. I threw up blood for over 10 hours. I was taken by ambulance to the hospital, where, even though it was in a very wealthy neighborhood, I was left in a room alone on a gurney for over 6 hours without blood or other care of any kind, until my 85-year-old mother arrived in the middle of the night and agreed to assume responsibility for my bill. They did not even put me in a bed. My mother's neighbor did. They had simply left me on a gurney next to the bed. I was going to die. I had 1/3 the amount of blood that a person is supposed to have. It was clear to my mother and her neighbor, that the hospital was going to let me die because

Kimberly Bennett
Kimberly Bennett7 years ago

All the government care about was for the insurance companies and medical personnel. The government should be paying for all of our medical since we pay outrageous taxes. We can't own our homes and they keep screwing us over here and there.

they can afford and nobody should be force to buy something in which there is no money for in the first place. The insurance companies only want our money not any claims. Our government is wrong and needs to get out of office.

Morgan G.
Morgan Getham7 years ago

And my jerk of a Democratic congressman who voted for this killer bill and for the Health Care Bill won't answer my letters about this incident. I wonder why not?

He's headed for retirement in November.

Morgan G.
Morgan Getham7 years ago

Yup, Health costs are related. Cancer survivors, for example, are a lot more likely to live if they can detect recurrence of their cancers very early.

In order to pay for Obamacare, the Medicare Modernization Act is pulling a deadly hoax on seniors. Once a senior cancer survivor has been symptom free for one year, Medicare (as of June 1, 2010) will no longer pay for annual MRI's to detect cancer early. They now have to wait until SYMPTOMS return ... when it's often too late to begin effective treatment.

See for a newspaper account of a patient experience from here in Indiana.

Hey ... it's all connected. If Obama can kill off all those pesky senior citizens by denying them medical care when they need it, he can afford to extend insurance to others. But you may not like it when your insurance bureaucrat tells your doctor that you can't have a procedure that you doctor thinks will help save YOUR life.

Didn't they try to tell us that there would be no rationing, that the patient and doctor could always decide on the proper course of care? Well, of course, this is not PART of the Health Care Bill. It's a SEPARATE bill that they passed to PAY for the Health Care Bill. So I guess there they CAN jump in and deny needed care to our most vulnerable people and it's OK.


Jennifer Knoche
Jennifer Knoche7 years ago

In the overall skeem of life, money isn't real. People's lives are. So we should all have access to health care when we need it, it's that simple...

Lynn Marie M.
Lynn Marie M7 years ago

Thanks for the post.