2009/7/23
By John Goodman Filed under Uncategorized on July 23, 2009 with 3 comments
Senate committee votes to require Congress to join the “public” plan. Don’t count on it.
Health Savings Accounts for every member of Congress. Pushed by Matt Miller in the New York Times, followed by the plea to let every American have what Congress has.
Sebelius: Uninsured account for 20% of emergency room visits. Massachusetts: After they are insured, they still use the emergency room.
For a liberal, Matt Miller isn’t that bad.
I am very confident the members of Congress will not be joining the public plan.
The hoary old “we need health insurance for all to keep emergency department costs down” is apparently being resurrected.
For the record, people on government insurance are more likely to use the ED than anyone else. Here is the full quote from the February 2008 HCUP statistical brief on Emergency Department Visits for Adults in Community Hospitals from Selected States, 2005 (the selected states were 23 in number, no word on why they were selected):
“…While 15.9 percent of adults were covered by Medicare, 25.7 percent of ED visits were billed to Medicare. Similarly, 7.4 percent of the adult population was covered by Medicaid, but 15.9 percent of ED visits were billed to Medicaid. ED visits that were covered by commercial insurance showed the opposite pattern: 61.9 percent of adult patients in the 23 study states had some type of commercial insurance coverage, but private insurance was billed for only 34.1 percent of ED visits. About 14.8 percent of adults lacked health insurance in 2005–these uninsured individuals accounted for 18.1 percent of ED visits in the 23 study states.”
“…Forty percent of Medicare ED visits resulted in hospital admission, compared to ony about 14 percent each of Medicaid and privately insured visits…Uninsured visits were the least likely cases to be admitted, with only 7.4 percent of uninsured visits resulting in a hospital stay.”
Note that uninsured simply means “self-pay.” It doesn’t mean that the hospital didn’t get paid as those in favor of government insurance would like one to think. People who pay cash may be listed as uninsured. In my experience a lot of places assume one is either insured or not. They don’t seem to have a check-box for “I’m insured but my insurer isn’t going to pay this as it is not anywhere near my deductible so just given me your discounted cash price.”
Problem is that if one is insured, some places won’t give their cash price regardless of deductible. Often the business office person will suggest being listed as uninsured just so that one doesn’t have to pay the inflated insurance price.