In a relatively optimistic editorial – HELP Is on the Way
But last week the budget office scored the full proposed legislation from the Senate committee on Health, Education, Labor and Pensions (HELP). And the news — which got far less play in the media than the downbeat earlier analysis — was very, very good. Yes, we can reform health care.
Let me start by pointing out something serious health economists have known all along: on general principles, universal health insurance should be eminently affordable.
After all, every other advanced country offers universal coverage, while spending much less on health care than we do. For example, the French health care system covers everyone, offers excellent care and costs barely more than half as much per person as our system.
And even if we didn’t have this international evidence to reassure us, a look at the U.S. numbers makes it clear that insuring the uninsured shouldn’t cost all that much, for two reasons.
First, the uninsured are disproportionately young adults, whose medical costs tend to be relatively low. The big spending is mainly on the elderly, who are already covered by Medicare.
Second, even now the uninsured receive a considerable (though inadequate) amount of “uncompensated” care, whose costs are passed on to the rest of the population. So the net cost of giving the uninsured explicit coverage is substantially less than it might seem.
Putting these observations together, what sounds at first like a daunting prospect — extending coverage to most or all of the 45 million people in America without health insurance — should, in the end, add only a few percent to our overall national health bill. And that’s exactly what the budget office found when scoring the HELP proposal.
Is Krugman right? Who really knows? Estimates always depend on assumptions, and we should always show appropriate skepticism about estimates.
Would a public plan ruin private insurance? I doubt that a public plan would ruin private insurance, but I do believe private insurance would have to adapt. And that would be good for physicians and patients.
