The South Bend Tribune has an editorial on the subject of providing health care to uninsured or underinsured Hoosiers, particularly children.
Indiana can’t afford for residents who don’t have health insurance to go without medical care. Neither can the state afford for uninsured residents to depend on emergency rooms to receive routine medical care. Most of all, Indiana cannot afford for Hoosier children from low-income families to go without either health insurance coverage or medical care.
They are right. Implicit in that statement is the fact that this isn’t a choice between paying for their healthcare or not paying for it. When someone who can’t afford health care really needs it, they don’t typically do without. Instead they wait until the problem is really bad, then they go to an emergency room, and the public pays for it, one way or another. Often times the emergency room is publicly funded. In addition, health care for those who can pay is more expensive to subsidize service provided to those who cannot pay. The subsidies can even take less obvious forms. For example, Perry County passed an almost certainly illegal Certificate of Need ordinance designed to prevent competition to its County Hospital, allegedly because competition to that hospital would take paying customers away and hurt its ability to serve the uninsured and underinsured.
I think we’d be hard pressed to design a system that was more expensive and less efficient if we tried.
The South Bend Tribune endorses efforts by FSSA, Hoosier Healthwise manged care providers, and school systems to work together to set up professionally staffed in-school clinics. I have mixed feelings about this. On the one hand, it makes sense. If you want to make sure kids are getting proper health care, you go to where the kids are: the schools. On the other hand, it seems like yet another function laid on the shoulders of already burdened schools which will be a further distraction from schools actually being able to educate children while they are at school.