Yesterday, Brad Plumer brought up the question of whether or not it'scheaper to leave the uninsured outside the system. From oneperspective, it obviously is: the insured use $2,484 of health careeach year, while the uninsured get only $1,253. But it's trickier thanthat.
Kaiser estimates that covering the uninsured would boost their annual earnings by 10%-30%, lift their educational attainment, and prolong their lives by 5%-15%. There's money to be had there, in higher purchasing power, in better productivity, and in longer work years (though there's also money to be lost, as longer lives may mean more costs), all of which may translate into larger government tax revenues and increased ability to pay for their own health insurance.
But the more interesting argument is who pays. Covering the uninsuredis, in some ways, a cost-shifting device. That's because theuninsured, for the most part, aren't poor. The poor have Medicaid. The uninsured are (generally) low-income folks above the poverty linewith full-time workers in the immediate family. Many of them are youngmen. Most of them are white. And a significant portion could, if theywanted, pay for insurance themselves.
To some degree, uninsurance is often a question of priorities. Sometimes thepriorities beating out health insurance are food and school clothes forthe kids. Sometimes, they're nights at the bar. Sometimes, laziness. Sometimes, an aversion to doctors. Under a basic universal coveragescheme, though, there'd be a mandate to buy baseline coverage, thosewho genuinely couldn't afford it would come in for subsidies, and thosewho could afford it would now be forced to buy in. That means they'dbe paying for much of their own insurance. That means, you'd be paying for less of it.
