Caring for Uninsured Costs Society Between $65B-$130B, Report Says

The estimated 41 million U.S. residents who lack health insurance cost U.S. taxpayers between $65 billion and $130 billion per year in lost productivity, according to a report released on June 17 by the Institute of Medicine, Bloomberg/Hartford Courant reports (Bloomberg/Hartford Courant, 6/18). The costs result because many uninsured U.S. residents do not receive adequate medical care, a trend that can lead to decreased quality of life and shorter lifespan, the report's authors concluded. The report, assembled by the 22-member IOM Committee on the Consequences of Uninsurance, found that each uninsured U.S. resident loses between $1,645 and $3,280 per year in lost wages and benefits and in the value that improved quality of life and longer lifespan would provide. The estimated cost in the report does not include the cost of medical care (Stein, Washington Post, 6/18). The United States would have to spend about $34 billion to $69 billion per year to provide required medical care to uninsured residents at the same level as those with health coverage, the report found (CongressDaily, 6/17). In 2001, the cost of medical care for uninsured U.S. residents totaled $98.9 billion, the report found ("Hidden Costs, Value Lost: Uninsurance in America," 6/17). According to the report, the United States spends about $35 billion per year to provide uninsured residents with medical care, often for preventable diseases or diseases that physicians could treat more efficiently with earlier diagnosis (Bloomberg/Hartford Courant, 6/18). The report also found:

• Uninsured U.S. residents account for "well below half of average spending" for health care by all residents younger than age 65.
  
• Uninsured U.S. residents pay out-of-pocket for 35% of the health care that they receive, compared to 20% for those with health coverage, but they have comparable total out-of-pocket expenditures.
  
• Uninsured U.S. children face a higher risk of developmental delays than those with health coverage;
  
• The cost of state health care programs "fall disproportionately on the local communities where care is provided."
  
• High rates of uninsured residents can affect the financial viability of providers in local communities and can result in reduced access to medical care.
  
• Public programs, such as Medicare, Social Security Disability Insurance and the criminal justice system, "almost certainly have higher budgetary costs than they would if the U.S. population in its entirety had health insurance up to age 65" ("Hidden Costs, Value Lost: Uninsurance in America," 6/17).

Reaction
Mary Sue Coleman, president of the University of Michigan and co-chair of the IOM committee, said that as part of health care reform proposals, Congress should consider the amount that the United States could save through expanded access to health insurance (Schmid, AP/Las Vegas Sun, 6/17). Arthur Kellermann, professor and chair of emergency medicine at the Emory University School of Medicine and co-chair of the committee, said that the "tremendous costs" of medical care for uninsured U.S. residents "are borne by all of us through higher taxes, higher insurance premiums and other mechanisms" (Bloomberg/Hartford Courant, 6/18). The report is the fifth in a six-part series on issues related to the uninsured population in the United States. The final report will likely identify proposals to address health care problems related to uninsured U.S. residents (Washington Post, 6/18). The report is available online. In addition, a HealthCast of the briefing to release the report is available online.