Insurers are doing
just fine. So are most large providers, but the industry is seeing increased consolidation because smaller, rural providers can't keep up with burdensome and costly administration and compliance. That's obviously bad for access to care.
Medicare has potential solvency issues, but the "current' version of Medicare and the future version of Medicare look very different in how they pay providers. HHS has
set a goal (PDF) of tying 30 percent of Medicare fee-for-service payments to quality or value through alternative payment models by 2016 and 50 percent by 2018. HHS has also set a goal of tying 85 percent of all Medicare fee-for-service to quality or value by 2016 and 90 percent by 2018. They're not meeting these goals -- which are very aggressive -- but their intent is clear. Value will almost entirely supplant fee-for-service in the near term.
Providers are only required to provide
emergency care for uninsured patients to remain complaint with EMTALA. The effects of uncompensated care on provider costs are generally overstated, and in any case most providers freely write off those costs to meet their charity care requirements.
If you want to understand what's really driving costs, go read the article I poasted. The one part that becoming outdated in #6, because contract negotiations with insurers are moving away from guaranteed fee schedule increased towards payment for value, just like Medicare.
The most expensive 1% of patients in this country account for 28% of all healthcare costs. The most most expensive 5% of patients account for 50% of all healthcare costs. The
data behind those numbers is 10 years old, but it's still incredible.