Societal Costs

Estimates of the additional costs incurred by covering the uninsured are more than offset by estimates of the value gained. In addition, coverage for all is consistent with longstanding American ideals about fairness and equality.

• A recent, widely cited estimate of the net cost of providing insurance coverage to all uninsured people is $34 billion per year for public coverage and $69 billion per year for private coverage.¹ In contrast, the Institute of Medicine reports that the value of covering the uninsured measured primarily in terms of better health and longer life is between $65-$130 billion annually.²
• For society as a whole, the cost of uninsurance extends beyond the lost value due to worse health outcomes for individuals (i.e., more illness and shorter life) – important as this is. Additional costs to society are associated with assorted consequences of uninsurance, including:

  - Developmental deficiencies rooted in childhood
  - Expenses borne by families, especially those with a member who suffers a chronic health condition, catastrophic illness or injury
  - Lost income due to reduced employment and job productivity
  - Constrained capacity of the public health system
  - Diminished public health (e.g., due to low immunization rates, lack of access to preventive health)
  - Uncompensated care (worth about $35 billion in 2001; an estimated 75-85 percent is paid from public sources.³ )
  - Higher public program costs (Medicare, Social Security Disability Insurance, the criminal justice system)
  - Social inequality.⁴

• More than 3 million adults have schizophrenia or manic-depressive disease and 20 percent of them are uninsured. "Ironically," concludes the Institute of Medicine, "contact with the criminal justice system increases the chances that someone with a severe mental illness will receive specialty mental health services."⁵
• Disparity in access to effective health care services that improve health and extend survival⁶ is a consequence of a society that fails to provide coverage to a sizeable percentage of its population. This inequality runs counter to American ideals of equal opportunity, fairness and justice.⁷