Ezra Klein points us to a study appearing in The New England Journal of Medicine indicating that Medicare costs are lower for people who had health insurance before enrolling in Medicare. It underscores the fact that in order to address the long term fiscal imbalance, we need to address health care in America. More evidence for the importance of health coverage comes from a study in The New England Journal of Medicine this month, which tracks what happens when the previously uninsured become eligible for Medicare. It turns out that they -- surprise! -- need a whole lot more care than their demographically similar, but previously insured, brethren! They have conditions that need to be treated and managed, exhibit higher rates of hospitalization and doctor's visits, and generally cost a whole bunch more money than those who've been availing themselves of the health care system for years. As the NEJM dryly concludes, "The costs of expanding health insurance coverage for uninsured adults before they reach the age of 65 years may be partially offset by subsequent reductions in health care use and spending for these adults after the age of 65." Add in what they cost the system in catastrophic health incidents before they become eligible for Medicare, and it begins to look like keeping the uninsured population uninsured is a much better deal for the insurers than it is for taxpayers, hospitals, or just about anyone else.