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#1 CLAIM: Those without insurance, or not enough insurance, are to blame for rising health care costs.


Those without insurance, or not enough insurance, do contribute to rising health care costs. = TRUE

As many as 40% of Americans between the ages of 18 and 64 cannot count on having full access to health care when they need it. Three out of 10 working-age Americans are under-insured – they don’t have adequate coverage; 16% are completely uninsured.

¤ Common sense: People without health insurance or with deductibles and copays they can’t afford tend to not go to the doctor. When an infection has spread or a minor injury now needs surgery or a condition becomes serious, the cost of treatment becomes much higher than it would have been had they gotten medical care in the beginning.

¤ A 2005 Families USA study found that the uninsured actually do pay about 1/3 of their medical bills – what they can afford. At the same time, by 2010, the unpaid portion of providing the uninsured with health care will increase the premiums paid by private employers for families by about $1502.

The only thing causing high costs is the number of uninsured. = FALSE

The other popular theory is that the uninsured clog up our hospital ER rooms, and cause costly delays in treatment for everyone else.

  • An uninsured person is twice as likely to use emergency services as someone with insurance,
  • BUT most people who visit emergency rooms (46 million of the 65 million ER visits in 2005) have private health insurance.
  • Hospitals collect more on debts from the insured (50 cents on the dollar) than from the uninsured (8-12 cents on the dollar),
  • BUT uninsured people have more hospital debt to begin with – they are typically billed the highest prices for because they don’t have access to the huge discounts negotiated by government and commercial insurers
  • AND YET the fastest-growing segment of hospitals’ unpaid patient bills is from people with health insurance.

In 2004, what was owed for medical care that was received but not fully paid for neared $41 billion. The uninsured did cause the majority of that – $26.3 billion (65%). But total unpaid medical care made up only 3% of all health care spending for the year, which was $1.5 trillion! In other words, covering the costs of health care for the uninsured accounts for less than 2% of all U.S. health spending.


It’s going to take more than just getting everyone insured to keep health care costs from increasing. We certainly need to make sure that everyone has access to health coverage. Once that happens, the insured won’t have to bear the costs of the uninsured. But universal access does not necessarily lead to affordability.

There are lots of other things contributing to high health care costs. Read on.