Identifying the Uninsured

The term uninsured, the Association of American Physicians and Surgeons notes in a 2006 White Paper on Medical Financing is so widely used it is impossible to avoid. The national organization contends the term "self-paying" or "self-insured" is more accurate:

"Many persons have deliberately chosen to risk assets or future earnings rather than buy medical insurance; only a fraction of them intend to steal services from medical facilities and practitioners in the event of illness or accident. Many medical bills of self-insured patients are paid, in whole or in part. Many medical bills of insured individuals are not paid, or are paid at a rate of a few cents on the dollar. Persons with a relatively high deductible are self-insured for amounts less than the deductible and should not be assumed to be "uninsured." Current distortions in terminology reflect the tendency to equate insurance with medical care and to assume that third-party payment is the only, or the only acceptable way to pay medical bills."

The goal of reform should be to maximize access to medical care and minimize cost.

Subsidies should generally flow through patients, not providers. "Most funding," the White Paper states, "should be restricted to the truly needy and should be through taxes borne equally by all, not through hidden charges and preferences, or debts imposed on the next generation. In particular, insurers, hospitals, physicians, or self-paying patients should not be forced to fund government initiatives through cost shifting."

• The uninsured must be identified before meaningful reform is possible in Arkansas.
• State government should not attempt to design a universal insurance package. Instead, consumers should have access to a variety of insurance designs. These might include: broadened Good Samaritan protection for serving patients at greatly reduced charge or no cost; tax credits or deductions for providing uncompensated service; various schedules of deductibles or copayments; and lifetime health insurance provided by private or not-for-profit entities.
• Portable medical savings accounts should be another option.

The Association of American Physicians and Surgeons (http://www.aapsonline.org/) was founded in 1943 to promote private medicine, which holds to the sanctity of the patient-physician relationship. Andrew Schlafly, Esq., and Jane M. Orient, M.D. wrote the White Paper.