Imagine a restaurant in which the maitre d' asked each patron to show a credit card before being seated. Those with a card would be seated, served and then given a bill for the cost of their meal. Those without a credit card would be fed for free.

How long would it take for the paying customers to figure out that they were paying not just for the cost of their own food, but also indirectly for the free food served to others?...

The fictional practice of this fictional restaurant is the real-life policy of real-life hospitals, medical clinics and doctor's offices. When patients come in, they're asked for an insurance card. If they have one, their medical services are paid for. If they don't, the provider often ends up giving medical services for free.

In the end, it's the people with the insurance cards who pay for all of it.

In an important new study released last month, the nonpartisan New America Foundation put a price tag on what the average insured Californian pays to underwrite the medical care provided to the state's 6.5 million uninsured.

"When medical bills go unpaid, many healthcare providers shift the cost onto those who can pay — those with health insurance," the report says. "The cost-shifting amounts to a hidden tax levied by providers on behalf of those who cannot pay.... This results in an approximate 10 percent increase in health insurance premiums for Californians. More specifically, the average California family with health insurance will pay an additional $1,186 in premiums for 2006."

It's noteworthy that Gov. Arnold Schwarz-enegger chose to highlight the release of the report with an appearance at a Los Angeles hospital, where he spoke pointedly about the burden of this "hidden tax" on California businesses and individuals.

With the governor having already identified healthcare reform as his top priority for the Legislature in 2007 and scheduled to release his own specific proposals next week, this notion of a hidden tax could become the economic underpinning for a plan to provide universal, or near-universal, health insurance...

It's not yet clear whether Schwarzenegger is prepared to go that far, but if he chooses to, the Republican governor could use the hidden-tax argument to make a strong case that such a mandate would be a good thing for most California businesses...

The New America Foundation study nicely sums up the issue:

"It is too easy for the 80 percent of Californians with insurance to dismiss the uninsured as an issue that does not affect them. Many businesses that offer insurance today have this same belief. However, as this analysis shows, the cost of the uninsured is shared across those who purchase private insurance in a way that hides the true costs. Covering the uninsured is a matter of self-interest for all Californians."

For the complete article, please visit the Ventura County Star website.