Current Events

Does Health Insurance Matter?

In this case, the answer is yes:

[Dr. David] Dupree said she sought medical help on June 4, just days after her 65th birthday, when she would qualify for Medicare, the U.S. healthcare program for seniors.

‘The reason she didn’t go earlier was because she had no insurance,’ he said.

By now, she weighed more than 170 pounds, her legs were swollen with trapped blood, she was badly dehydrated, and, scans showed, the tumour – a malignant sarcoma – was crushing her inferior vena cava, one of the main veins returning blood to the heart, and putting her life in danger.

The reader may be thinking, ‘why did she wait so long?’ Many doctors have a similar logic.

Dupree said he would advise uninsured patients to see a doctor immediately if they knew they were unwell no matter how near their 65th birthday might be. He said the hospital would have operated on Evelyn regardless of her insurance status, but added he did not know whether doing so would have cost her more money.

This example shows that discontinuities in health insurance coverage can cause patients to delay care with sometimes disastrous consequences. One question is why the patient did not have health insurance?  Did she fail to sign up for Medicaid?  Did she choose to not have health insurance due to the expense?  Ex ante, would an individual mandate have compelled her to buy insurance?  Ex ante, would an individual mandate with a health insurance voucher have compelled her to purchase insurance?  If so, how much would the voucher need to be worth?

Health Reform aims to reduce the number of cases where discontinuities in health insurance reduces access to needed care.  Would an individual mandate and health insurance exchange increased the probability that the patient i) would seek treatment earlier and ii) could afford the treatment?

3 Comments

  1. If she had been covered by the universal insurance of Canada or England, would she have died on a waiting list?

    The Difference Between Canada and the U.S. Health Care Systems (video 7:34)
      Sally C. Pipes understands and lived under Canada’s national health care system. She gives some personal stories and other facts.

    UK announces more health care rationing
    UK saves money with unofficial negligence
    UK hospitals intentionally delay treatment

    The Telegraph UK – National Health Service makes patients wait “to lower expectations”.
    === ===
    [edited]  At least 10 primary care trusts (PCTs) in Britian have told hospitals to increase the wait to treat patients, to save money.

    Some patients endured delays of 12-15 weeks after their doctors decided on surgery, although hospitals could have seen them sooner. The allowed maximum is 18 weeks.

    One manager said “short waiting times create more demand for treatment”. An NHS watchdog suggested that long wait times cause patients to remove themselves from the lists “either by dying or by paying for their own treatment”. PCTs have gamed the system, using maximum limits to delay treatment.
    === ===

  2. Many Americans rely on their automobiles to get to work. No automobile means no job, no rent or mortgage money, no food. A single parent, struggling to make ends meet in the suburbs with 100,000 miles on the odometer, would presumably welcome the guaranteed opportunity for low-priced insurance that would take care of every possible repair on her auto until the day that it reaches 200,000 miles or falls apart, whichever comes first.
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  3. Health insurance without a doubt matters today likewise life insurance and long term care insurance. People live much longer these days, which also means they will most likely succumb to illnesses that will require long term care and other forms of healthcare. If you’ve done long term care planning, you know that relying on government programs such as Medicare or Medicaid will not be enough to provide you the care you need. So for me, it’s recommended to purchase insurance rather than leave your fate to these programs.

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