The "hidden tax" on premiums to help defray indigent-care costs went up $95 last year compared to an average expense of $922 in 2005, according to the study commissioned by Families USA, a liberal consumer health-care group based in Washington, D.C.
A single insured person paid an extra $368 last year to help cover indigent care costs, up from $341 three years prior.
"As more people join the ranks of the uninsured, the hidden health tax is growing," said Ron Pollack, executive director of Families USA. "Due to the economic downturn, more and more people are losing their jobs and their health-care coverage. As a result, it is likely that the hidden health-care tax for 2009, which is not yet known, will be considerably higher than the $1,017 experienced in 2008."
The study was based on data collected from Milliman Inc., a global actuarial and consulting firm and analyzed by officials at the Department of Health Policy and Management at Emory University.
The $1,017 annual expense incurred by insured families is for those with group or commercial coverage.
"This is the first number I've seen on it," said Gary Pickel, executive vice president of the insurance firm Nichols and Associates in Naples. "It is widely known that is what is going on. I've just never heard a number before."
Because group coverage in Florida costs more than elsewhere in the nation, Florida families could pay more than the $1,017 reported in the study, Pickel said.
"There's a huge difference in the cost structure in Florida compared to, like Michigan," he said. "They come down here to establish a business and (health insurance) costs are at least double compared to what they paid up there."
The $1,017 figure is probably on target but could be higher in Florida because of the state's high uninsured rate, said Randy Kammer, vice president of regulatory affairs and public policy for Blue Cross and Blue Shield of Florida.
"This is the kind of stuff we have been looking at a long time, the cost-shifting, and (the report) doesn't show that Medicare and Medicaid pay significantly less to providers and that increases the cost shifting," she said.
The realities of cost-shifting and how hospitals bemoan how much indigent care they provide -- and therefore need to shift some of the cost to the insurers during contract negotiations -- validates that everybody needs to have coverage, she said.
At the same time, there would be a considerable impact on cost-shifting if the government comes in and sets rates and more employers get out of sponsoring insurance coverage for their employees, she said.
The nonprofit Florida CHAIN, an advocacy group, said the increasing hidden tax to the insured to compensate for the uninsured is proof the current health-care system is insufficient and hurting families and businesses,
"All of Florida's families, the insured and the uninsured, need genuine health-care reform and eliminating this hidden health tax is part of that reform," said Lisa Grossman, interim executive director of Florida CHAIN.
The study also found that more than one third, or 37 percent, of medical care provided to the uninsured is paid by them out of pocket, but another 26 percent of it is paid by charities and government programs.
The remaining $42 billion in uncompensated care rendered in 2008 is what gets "cost-shifted" to the health-care bills of the insured people.
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