Rhode Island Can Afford Health Care for All
By: Solutions for Progress, Inc. and the Health Reform Program at Boston University School of Public Health
Authors: Alan Sager, Deborah Socolar, Robert Brand, and David Ford
Published: November 25, 2002
Financed by: Not listed.
Legislation analyzed: none, plan analyzed developed by the authors.
Our main findings:
- Spending less: Rhode Island could provide all necessary care to all its people this year while saving approximately $270 million, or 3.6 percent of current health spending.
- Covering everyone: Universal, comprehensive care reforms would cover everyone in Rhode Island, providing medical security to people now under-insured and uninsured.
- More care for less money: Universal health care with streamlined administration, means more care without more cost, with more of each health care dollar used for actual care. Funds for actual physician care alone would rise an estimated 24 percent.
- Added costs of coverage: The biggest added costs and biggest volume of added services would be filling gaps in coverage for people who are now partly insured. Of $1.03 billion in added costs in 2002, $818 million would go to ending uncovered benefits and patient cost-sharing. These projections allow for use of dental care, for example, to rise 65 percent, and home care use, 17 percent, as a result of ending under-insurance.
- Administrative savings: Covering everyone in one plan wins large administrative savings—about $750 million, or over one-tenth of total health spending. So that sum can finance care, not paperwork. Over half these savings reflect reduced claims processing and related burdens for caregivers, freeing up their time for patient needs.
- Ending patient cost-sharing would eliminate about three-quarters of out-of-pocket spending for Rhode Island health care. This “sick tax” deters use of needed care, fails to truly cut costs, often shifts costs to caregivers, and boosts administrative costs.
- Clinical and other savings: Conservatively, reforms will win an additional $528 million more in non-administrative savings—mainly through more appropriate use of hospital and physician care, bulk purchasing or negotiated price cuts for prescription drugs and medical equipment, and capital budgets.
- Quality will be enhanced: Covering everyone and ending today’s financial pressures on caregivers to do less will protect quality of care, restoring trust.
- Incrementalism is unaffordable: Incremental coverage improvements are better than none but inevitably cost more. This path to universal, comprehensive coverage would be unaffordable, requiring health spending of at least $8.5 billion in 2002.
- Benefiting all Rhode Island residents and workers: Insuring the uninsured is one vital gain from such reforms, but many aspects would benefit all the state’s people.
- Delay is dangerous: Rhode Island cannot afford to wait for Congressional action. Nor can the state afford to wait for a deeper crisis. Beginning to plan now for such reforms is essential to avoid great harm to patients, to the trustworthiness of care, and to hospitals, physicians, nursing homes, and other valued health care resources.
Health care for all is affordable, and achieving it can be a win for all parties because current spending is already enough. Rhode Island can have health care security, health care freedom, and lower costs.