Universal Coverage: A Revenue Windfall?
The New York Times, October 24th, 2009
Arthur Ullian is president of the National Council on Spinal Cord
Injury and co-author of two studies in the Proceedings of the National
Academy of Sciences on the economics of health care. In a forthcoming
analysis, Mr. Ullian, the demographer Kenneth G. Manton of Duke
University, the statistician Dennis Tolley of Brigham Young University
and others conclude that expanded access to health care will generate
revenue and savings for the federal government that are not accounted
for in official cost estimates. Mr. Ullian spoke with the freelance
writer Anne Underwood.
Q.
You and your co-authors say that over the long term, improved
health care will actually contribute billions of dollars to the
Treasury, even without the taxes and service cuts that Congress is
considering in various legislative proposals. How is that possible?
A.
There are offsetting dollar gains that Congress and the Congressional Budget Office aren’t taking into account.
Q.
But the C.B.O. projects costs of around $800 billion over 10
years for the Senate Finance Committee bill, and so far that’s the
cheapest of the proposals.
A.
The projections are an enormous percent of G.D.P., and they’re not
sustainable, which is what everyone is yelling about. But that’s
because no one is taking into account the health improvements that will
result from covering millions of the uninsured.
Q.
How does that help?
A.
There are two parts to this theory. The first relates to the
expansion of the labor force. We know from the National Long Term Care
Survey that as a result of improvements in health care, active life
expectancy in the United States has been increasing. In 1982, 74
percent of those aged 65 and older were healthy. By 2004, that had gone
up to 81 percent. Projections for 2014 are between 84 and 85 percent.
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