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John Gruber: Covering the Uninsured in the U.S.

John Gruber (2008), "Covering the Uninsured in the U.S.:.. He writes:

One of the major social policy issues facing the U.S. in the first decade of the 21st century is the large number of Americans lacking health insurance. This article surveys the major economic issues around covering the uninsured. I review the facts on insurance coverage and the nature of the uninsured; focus on explanations for why the U.S. has such a large, and growing, uninsured population; and discuss why we should care if individuals are uninsured. I then focus on policy options to address the problem of the uninsured, beginning with a discussion of the key issues and available evidence, and then turning to estimates from a micro-simulation model of the impact of alternative interventions to increase insurance coverage

Tyler Cowen says:

Marginal Revolution: What would it cost to cover the uninsured?: Jonathan Gruber has just written a very useful and comprehensive paper on health insurance (I don't yet see ungated versions).  He estimates that without a universal mandate, but using subsidies, a typical plan for covering the uninsured would cost $4500-$5000 a year per person, and that is cost in the narrow budgetary sense.  With a mandate the fiscal cost of the government (again, not social cost, which includes the cost of paternalistically forcing people to buy health insurance) is estimated at $2732 per person per year.  Of course it is cheaper to tell people what to do, comparing to paying them to do it.  That cost estimate is assuming that the mandate is effectively enforced, which I do not expect. I would have preferred the primary estimates to be in terms of social cost.  And I would have liked a discussion of how mandates and minimum benefit requirements distort the price of health insurance and limit competition.  Read Shikha Dalmia.  Nonetheless this remains is one of the best papers on health care economics to be had. Gruber also poses an interesting philosophical question for the paternalists: would you rather be uninsured in today's America or obese?  And if you, like I, answer "uninsured," why not first direct paternalistic interventions toward obesity?  And I'm not talking about subsidies to olive oil, I mean real mandates.  After all, they will lower health care costs, no?