Helping the Uninsured

I had a brief debate via Twitter (I guess it is impossible to have anything but a brief debate on Twitter) with a staffer for the Pennsylvania House Democrats over health care policy. At the source of contention was HB 1(see a previous critique of this bill) – he claims it proves that Democrats care more because it “will help the uninsured”. I suggested our proposals for health care reform – specifically allowing individuals and families to shop across state lines for insured – would help both the uninsured and insured.

His rebuttal was that a) HB 1 would help the uninsured, and the insured by lowering the “cost of the uninsured” and b) Buying across state lines, or other reforms to lower the cost of insurance or of health care, wouldn’t help. Here are some reasons he is wrong:

Here are some reasons I am right:

  • One estimate suggests interstate competition would reduce the number of uninsured for 25% to 33% for no cost.
  • We have called for an overhaul of the Pennsylvania’s Medicaid system, similar to the reforms of Florida, that would help recipients by private insurance. This would improve quality, save costs to taxpayers, and reduce the cost of private insurance by eliminating cost shifting. I’m not sure where the House Democrats (or Republicans for that matter) are on this issue, if they’ve even thought about it.
  • State mandates drive up cost of coverage; Pennsylvania had 38 mandates at last count, but enacted a few more since then. A recent study finds that each mandate results in about a 0.25% increase in the number of uninsured – which would account for a large chunk of Pennsylvania’s uninsured population.
  • State laws drive up cost of prescription drugs, requiring higher prices than places like Wal-Mart would otherwise charge. Patients with insurance might be ok with this, if their coverage includes prescription drugs. For the uninsured, it means more money out of their pocket.

Until such time a Democrats (or Republicans) start moving to repeal laws and reform programs which make health care and coverage more expensive they have no room to talk about how much they care.