Do people with private insurance pay for care for the uninsured through "cost shifting?"

Maybe not. See ObamaCare and the Truth About 'Cost Shifting': There's simply no evidence to support the claim that the insured bear the costs of caring for the uninsured in today's WSJ. Excerpts:

"The centerpiece of the court battle over ObamaCare's constitutionality is the law's mandate that most U.S. residents obtain health insurance. To justify the mandate, the administration and Congress have asserted that people with private insurance pay for care for the uninsured through "cost shifting"—higher prices charged by doctors and hospitals to recover losses from uncompensated care.

The government argues that the Constitution permits Congress to require that people get insurance in order to reduce the extent of this "hidden tax." Although courts have disagreed about the constitutionality of the mandate and the new law as a whole, all courts have accepted the premise that the hidden tax is significant.

But how strong is the evidence for this proposition? Our review of the research has found that there is no credible evidence of a cost shift of any substantial consequence, either within state boundaries or across state lines. Moreover, the new law will likely generate more cost shifting—the opposite of what its supporters would have us believe.

There are, surprisingly, few peer-reviewed studies of the magnitude of alleged cost shifting at the national level. A study conducted by George Mason University Prof. Jack Hadley and John Holahan, Teresa Coughlin and Dawn Miller of the Urban Institute, and published in the journal Health Affairs in 2008, found that so-called cost shifting raises private health insurance premiums by a negligible amount. The study's authors conclude: "Private insurance premiums are at most 1.7 percent higher because of the shifting of the costs of the uninsured to private insurance." For the typical insurance plan, this amounts to approximately $80 per year."

"Moreover, the economics of markets for health services suggests that any cost shifting that may occur is unlikely to affect interstate commerce. Because markets for doctor and hospital services are local—not national—the impact of cost shifting will be borne where it occurs, not across state lines.

The bad news for the new law's supporters (and for individuals with private insurance) doesn't stop there. If anything, the likely impact of the law will be to increase, not decrease, cost shifting. According to the Congressional Budget Office, around half of the people who are expected to become newly insured under the new law will be enrolled in Medicaid. But Medicaid payments to doctors and hospitals are so low that the program creates a cost shift of its own. In fact, a long line of academic research shows that low rates of Medicaid reimbursement translate into higher prices for the privately insured."

The articel was by By JOHN F. COGAN, R. GLENN HUBBARD AND DANIEL KESSLER.

Mr. Cogan is a senior fellow at the Hoover Institution and professor of public policy at Stanford University. Mr. Hubbard, dean of Columbia Business School, was chairman of the Council of Economic Advisers under President George W. Bush. Mr. Kessler is a professor of business and law at Stanford University and a senior fellow at the Hoover Institution. The second edition of their book "Healthy, Wealthy, and Wise: Five Steps to a Better Health Care System" was just published by the AEI Press/Hoover Institution.