I just listened to a fantastic talk that Mark Smith of the California Healthcare Foundation gave last month at a conference sponsored by the Center for Health Policy and the Center for Primary Care and Outcomes Research at Stanford University. Here's an excerpt:
It’s increasingly dysfunctional actually to talk about people in binary fashion as insured or uninsured because there are people with insurance who are going bankrupt.... On the other hand, there are people who are uninsured who are now able to access certain services for less out-of-pocket than people who are insured.
It is not clear to me why we pay Aetna $20, so they can pay Medco $15, so they can pay CVS $10, so CVS can collect their $5 copay from us for something we could have just bought at Wal-Mart for $4 in the first place....
Yet our debate in the public space is how can we get everybody into these traditional insurance products...at an increasingly unaffordable rate.