Ezra Klein: Health Insurance Matters

A nice point:

Ezra Klein: Insurance Matters: One of the common objections to universal coverage is that insurance coverage doesn't actually improve health outcomes all that much. This objection, unsurprisingly, is generally made by people with health coverage. It's also not very true.

More evidence for the importance of health coverage comes from a study in The New England Journal of Medicine this month, which tracks what happens when the previously uninsured become eligible for Medicare. It turns out that they -- surprise! -- need a whole lot more care than their demographically similar, but previously insured, brethren!

They have conditions that need to be treated and managed, exhibit higher rates of hospitalization and doctor's visits, and generally cost a whole bunch more money than those who've been availing themselves of the health care system for years. As the NEJM dryly concludes, "The costs of expanding health insurance coverage for uninsured adults before they reach the age of 65 years may be partially offset by subsequent reductions in health care use and spending for these adults after the age of 65." Add in what they cost the system in catastrophic health incidents before they become eligible for Medicare, and it begins to look like keeping the uninsured population uninsured is a much better deal for the insurers than it is for taxpayers, hospitals, or just about anyone else.

Comments

[mic]

"The costs of expanding health insurance coverage for uninsured adults before they reach the age of 65 years may be partially offset by subsequent reductions in health care use and spending for these adults after the age of 65."

As long as we believe that healthy people tend to live longer this is a rather questionable conclusion. 30 years of health spending on an adult who lives to 95 are likely to be more expensive than 5 years of health spending on someone who dies at 70.

This is not an argument against universal coverage but rather an observation that governement has somewhat perverse population longevity incentives.

[Ian Maitland]

"It's also not very true."

?What does that mean? How weasely can you get? Does "insurance matter[]" or doesn't it?Elsewhere Brad takes David Brooks to task for his dishonesty "in effect." If Ezra Klein can't bring himself to level with us then I hope he won't darken these pages anymore.