He also noted a possible countervailing force against medical inflation, reporting that California’s insurance commissioner, Dave Jones, believes that covering even a portion of state residents who are currently uninsured should sharply reduce the amount of uncompensated medical care, which is also driving up the price of health insurance. Hospitals must recoup their losses from uninsured patients who can’t pay, and they do that by shifting those costs to other payers— mostly insurance companies, who in turn build those costs into higher premiums for their policyholders. California families pay on average $1,400 in their annual premiums to cover the medical bills for the uninsured, the paper reported. Jones implies that the cost shifting from payer to payer that’s so prevalent in American healthcare might stop, since more people will have insurance.
But will it? The cost shift question is one to keep an eye on. On his Incidental Economist blog, Austin Frakt noted that “the Supreme Court’s ruling on the Medicaid expansion has made cost shifting from the uninsured a polite dinner topic again.” He goes on to explain how cost-shifting might still occur.
Terhune also notes a longstanding problem—a shortage of primary care physicians, which the ACA could exacerbate, given the number of newly insured people seeking treatment. He knows how to stay on the insurance story, cost shifting, doctor shortage, and all. His strong reporting could lead the way as implementation of the Affordable Care Act rolls along.