Comments

Health Affairs encourages readers to engage in discussion via comments on our Web site.

• To RESPOND to a particular article: Click on the link "Submit a response to this article" in the box at the top right-hand corner of the article.
• To READ responses to a particular article: Click on the link "View responses" in the box at the top right-hand corner of the article.

Comments to:

Wilhelmine Miller, Elizabeth Richardson Vigdor, and Willard G. Manning, Covering The Uninsured: What Is It Worth?, Health Affairs Web Exclusive, March 31, 2004 [Abstract] [PDF] [HTML Version][Related Papers] [Reprints & Permissions]

Comments:Submit a response to this article

Comments published:

A Contrasting Study

Scott A. Becker   ( 1 April 2004 )

Re: A Contrasting Study

Wilhelmine Miller   ( 1 April 2004 )

A Contrasting Study 1 April 2004
Scott A. Becker, Attorney Self-employed Send comment to journal: Re: A Contrasting Study sabecker{at}sabeckeratlaw.com Scott A. Becker	Assuming for a moment that your hypothesis is true that uninsured Americans live less healthy lives than the insured, I would be interested to see a contrasting study, then, why the HMO concept for insured people to visit the doctor as often as necessary for the slightest medical matter has not necessarily reduced health care costs, presumably making insured people healthier, but nay, has increased health costs to 15 percent of our GNP. There seems to be a contradiction between your hypothesis and these results in America. My hypothesis is that the uninsured are not necessarily, as a class, less healthy, but that when they actually seek treatment it is now more expensive because the insurers and medical providers have conspired to make it so. Mix in the pharmaceutical companies, which have resorted to pushing sex-enhancement drugs at the American public, and a trio of industries exists to cause problems that no universal health care program would solve.
Re: A Contrasting Study 1 April 2004
Wilhelmine Miller, Senior Program Officer Institute of Medicine Send comment to journal: Re: Re: A Contrasting Study wmiller{at}nas.edu Wilhelmine Miller	It is well documented (citations are in our paper) that people who lack health insurance have worse health and shorter lives than otherwise comparable people with coverage. It is also true that there is some degree of wasteful and inefficient use of health care by people with coverage of every kind -- not just by those in prepaid health plans but by those with fee-for-service insurance as well. And those without any insurance do face high prices and use services more sparingly (but not as effectively nor more efficiently) than those with coverage. As imperfect as insured health care is, it benefits the health and longevity of those who are insured more than uninsured health care benefits the uninsured. I agree that extending coverage to those who now lack it would not, by itself, solve the problems of inefficiency and waste in the overall health care system. Reforming incentives and financing structures to achieve greater efficiencies just might be more feasible, however, if the ad hoc mechanisms to provide and pay for the care needed by uninsured Americans were no longer necessary.