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Originally posted by byu71
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As John Goodman of the National Center for Policy Analysis has often pointed out, in Massachusetts, where an individual mandate was instituted in 2006, emergency room traffic is higher than ever before. Indeed, between 2005 and 2007, Massachusetts ER visits rose by 7 percent, and the state’s costs of caring for ER patients rose 17 percent between 2007 and 2009.
The uninsured don’t even account for their fair share of health expenditures. A Kaiser Family Foundation study found that, while the uninsured made up 15 percent of KFF’s surveyed population, the uninsured accounted for only 14 percent of total ER visits, and only 12 percent of aggregate ER expenditures.
By contrast, Medicaid beneficiaries accounted for 9 percent of the population, but 15 percent of visits and 9 percent of expenses. (For those with private insurance, the stats were 60%, 47%, and 54% respectively; for Medicare beneficiaries, 14%, 20%, and 22%.)
Why does this happen?
It’s pretty simple: if your health care is paid for, you are more likely to see the doctor more, and consume more tests and procedures, than if you are uninsured. Hence, people with insurance consume, on average, twice as much health care as do the uninsured.
This problem leads to more ER crowding, poorer access to emergency care for the truly vulnerable, and more losses for hospitals. Hospitals can’t make more money on patients if they are turning those patients away due to capacity constraints. (Remember that the biggest part of how PPACA covers the uninsured is by expanding Medicaid.)
[...]
As John Goodman of the National Center for Policy Analysis has often pointed out, in Massachusetts, where an individual mandate was instituted in 2006, emergency room traffic is higher than ever before. Indeed, between 2005 and 2007, Massachusetts ER visits rose by 7 percent, and the state’s costs of caring for ER patients rose 17 percent between 2007 and 2009.
The uninsured don’t even account for their fair share of health expenditures. A Kaiser Family Foundation study found that, while the uninsured made up 15 percent of KFF’s surveyed population, the uninsured accounted for only 14 percent of total ER visits, and only 12 percent of aggregate ER expenditures.
By contrast, Medicaid beneficiaries accounted for 9 percent of the population, but 15 percent of visits and 9 percent of expenses. (For those with private insurance, the stats were 60%, 47%, and 54% respectively; for Medicare beneficiaries, 14%, 20%, and 22%.)
Why does this happen?
It’s pretty simple: if your health care is paid for, you are more likely to see the doctor more, and consume more tests and procedures, than if you are uninsured. Hence, people with insurance consume, on average, twice as much health care as do the uninsured.
This problem leads to more ER crowding, poorer access to emergency care for the truly vulnerable, and more losses for hospitals. Hospitals can’t make more money on patients if they are turning those patients away due to capacity constraints. (Remember that the biggest part of how PPACA covers the uninsured is by expanding Medicaid.)
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As VC pointed out, the individual mandate was really a conservative idea and a Heritage Foundation proposal. Given that they realize that the government will just screw up the implementation and other reasons (...) they have now backed away from the idea:
Why has Heritage changed its mind?
Stuart goes on to give four reasons why he and Heritage no longer support the mandate: (1) a mandate isn’t necessary because “the new field of behavioral economics taught me that default auto-enrollment in employer or nonemployer insurance plans can lead many people to buy coverage without a requirement;” (2) “advances in ‘risk-adjustment’ tools are improving the stability of voluntary insurance,” as illustrated by the Federal Employees Health Benefits Program; (3) Obamacare’s mandate forces people to buy comprehensive coverage rather than catastrophic coverage; (4) Obamacare’s mandate is unconstitutional.
Stuart, of course, is perfectly entitled to change his mind, and the reasons he gives for having done so are ones I’d agree with. (I would also point out, as I do repeatedly in this space, that the “free rider” problem is grossly exaggerated, and that an individual mandate actually increases free-riding.)
Stuart goes on to give four reasons why he and Heritage no longer support the mandate: (1) a mandate isn’t necessary because “the new field of behavioral economics taught me that default auto-enrollment in employer or nonemployer insurance plans can lead many people to buy coverage without a requirement;” (2) “advances in ‘risk-adjustment’ tools are improving the stability of voluntary insurance,” as illustrated by the Federal Employees Health Benefits Program; (3) Obamacare’s mandate forces people to buy comprehensive coverage rather than catastrophic coverage; (4) Obamacare’s mandate is unconstitutional.
Stuart, of course, is perfectly entitled to change his mind, and the reasons he gives for having done so are ones I’d agree with. (I would also point out, as I do repeatedly in this space, that the “free rider” problem is grossly exaggerated, and that an individual mandate actually increases free-riding.)
The mandate should really just be for catastrophic coverage.
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