Are people going to become sicker simply because a universal-healthcare bill gets passed? Of course not.
Will the cost per treatment go up if such a bill gets passed? It shouldn't.
Will people insist on unnecessary treatments, e.g., operations, simply because the government is paying the cost? Not likely, since treatments are not fun. And, in any case, treatments would have to be based on a diagnosis and a referral, just like today.
Or are we now somehow saving money by not treating condidtions that need treatment?
In 1986, Ronald Reagan signed the Emergency Medical Treatment and Active Labor Act (EMTALA); per the Wikipedia:
The Emergency Medical Treatment and Active Labor Act (42 U.S.C. §1395dd, EMTALA) is a United States Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act. It requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions.
More than half of all emergency room care in the U.S. now goes uncompensated. Hospitals write off such care as charity or bad debt for tax purposes. Increasing financial pressures on hospitals in the period since EMTALA's passage have caused consolidations and closures, so the number of emergency rooms is decreasing despite increasing demand for emergency care. ...
EMTALA was passed to combat the practice of "patient dumping", i.e., refusal to treat people because of inability to pay or insufficient insurance, or transferring or discharging emergency patients on the basis of high anticipated diagnosis and treatment costs. The law applies when an individual with a medical emergency "comes to the emergency department," regardless of whether the condition is visible to others, or is simply stated by the patient with no external evidence.
Americans, like the rest of the civilized world, can't bear to see people dying and babies being born on the lawns of hospitals.
So, everyone in the U.S. now gets healthcare, once their condition becomes active labor or a certifiable emergency. But, that's a crazy way to deliver healthcare; it's both expensive and inhumane:
- Clinic care is much less expensive than emergency-room care.
- Early treatment is less expensive than delayed treatment and yeilds much better outcomes.
- Untreated members of a population are a breeding ground for epidemics, which are expensive to eradicate.
- EMTALA recipients get billed for the full cost of their care, which often drives them into bankruptcy.
Note that we are already paying for this expensive universal healthcare, since the uncompensated emergency-room care is reflected in higher per-treatment costs to the insured, which in turn is reflected as higher premiums for healthcare insurance. So, why does the Congressional Budget Office think that it will cost more to treat the uninsured early and in clinics rather than in the emergency room?
I fear that they've neglected the fact that those costs are already being paid and don't have to be paid a second time. A simple tax on health insurance equal to the amount that rates will drop once all emergency room care is compensated would balance the books. And those rates will surely drop, when insurers have to compete with a public option.