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Uninsured Get Less Health Care Than Insured

MONDAY Aug. 25, 2008 -- Uninsured Americans will spend $30 billion out of pocket for health care, and receive $56 billion in uncompensated care in 2008, new research shows.

Uncompensated care is defined as health care that is received but not paid for by the uninsured or a health insurer.

In a report appearing in Monday's online edition of Health Affairs, Jack Hadley, of George Mason University, and John Holahan, Teresa Coughlin and Dawn Miller, of the Urban Institute, analyzed data on medical spending in people who are insured versus those who are uninsured.

They found that people uninsured for any part of 2008 receive about half as much care as those who are fully insured. A person who is uninsured all year will average $1,686 in medical costs, while someone who is privately insured will average $3,915.

And, the researchers pointed out, the uninsured pay an average of $583 (35 percent) of their costs, while the insured pay an average of $681 (17 percent).

"The uninsured receive a lot less care than the insured, and they pay a greater percentage of it out of pocket. Contrary to popular myth, they are not all free riders," study author Hadley, a senior health services researcher at George Mason, said in a news release from the journal.

The researchers also estimated that the federal government pays for about three-quarters ($43 billion) of the uncompensated care bill, including roughly $18 billion in special payments to hospitals by Medicare and Medicaid; $15 billion in tax appropriations and indigent care programs by state and local governments; and almost $10 billion in spending by the Veterans Health Administration, the Indian Health Service, community health centers and similar direct-care programs.

Finally, the researchers estimated that if all people uninsured for all or part of 2008 were to gain health-care coverage, the uninsured would increase their medical spending by $122.6 billion -- an amount equal to about 5 percent of current health spending.

"From society's perspective, covering the uninsured is still a good investment. Failure to act in the near term will only make it more expensive to cover the uninsured in the future, while adding to the amount of lost productivity from not insuring all Americans," Hadley said.

More information

The Agency for Healthcare Research and Quality has more about health insurance.

Posted: August 2008


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