Good piece on health care/insurance

[Guest guest]

I thought this was a well done piece on the insurance/health care

problems in this country...

Ellen

Post-Dispatch Op-Ed: Health care must be viewed as an economic issue

Professor D. McBride

St. Louis Post-Dispatch

09/02/2008

Economic issues — rising unemployment, falling home prices, high gas

prices and more — are weighing heavily on people's minds this year. So

is health care, which also is an economic issue.

One of voters' greatest fears is losing health insurance. Nationwide,

about 47 million people do not have health insurance; in Missouri,

about 772,000 people are uninsured. The increase in the number of

people without health insurance can be traced in part to the sluggish

economy. When people lose jobs, they lose the health insurance their

employer had provided, and in Missouri almost 17,000 jobs have been

lost since November.

But just keeping one's job doesn't guarantee keeping health insurance.

The upwardly spiraling insurance costs have led some employers to drop

it or to shift a greater share of the cost to employees who can ill

afford it.

Health insurance premiums have doubled in the past eight years,

outpacing by a substantial margin the 20 percent rise in inflation

over the same period. In that time, the percentage of firms offering

health insurance to their employees has fallen from 69 percent to 60

percent nationwide.

Directly or indirectly, rising health insurance premiums cut into

workers' take-home pay. While health insurance premiums have doubled

since 2000, wages have increased only 24 percent. Some of the money

employers used for those insurance premiums might have been available

for pay increases.

Changes in government policies and practices also have made it more

difficult to get health insurance coverage, especially in Missouri.

In 2005, Gov. Matt Blunt, supported by the majority in the state

Legislature, changed eligibility criteria for Medicaid, which left

more than 100,000 low-income people without health coverage and

another 300,000 with reduced services. Although the effort was

characterized as necessary to balance the state's budget, it actually

was short-sighted from an economic perspective.

To understand this, consider what would happen if the Medicaid cuts

were restored. It would require roughly $265 million in state dollars

to do so. However, because the federal government shares the cost of

Medicaid, spending $265 million in state money would bring in an

additional $430 million in federal dollars. By the time all that

Medicaid spending cycled through the economy, it would generate an

increase of $890 million in economic activity in the state each year —

accounting for more than 11,500 additional jobs and more than $400

million in additional state wages.

This projection demonstrates how closely linked the health care and

economic systems are. Since the 2005 policy changes were enacted, the

state has turned away more than $1.6 billion in federal matching

dollars. These are funds that could have gone to health providers and,

in some case, for treating the uninsured.

At Missouri's hospitals, the cost of uncompensated health care — care

for which no payment is received — increased by 38 percent and $162

million in the first two years after the Medicaid cutbacks. This

actually underestimates the total economic burden of the Medicaid

cutbacks because it does not account completely for the revenues lost

by clinics, physicians and other safety-net providers.

Our health care system probably will not improve without intervention

and a public-private effort to solve the problem. Employers and health

providers now seem sufficiently concerned about the issues — and

convinced of our inability to survive current trends — to be willing

to work with state and federal policymakers to put together packages

of reforms that can address long-term affordability and access problems.

We know what needs to be done, and there is a long list of viable

private-public alternatives that might prove acceptable across the

political spectrum. Among them: expanding the children's health

insurance program and Medicaid, programs to improve care for chronic

health conditions, consumer choice and high-deductible insurance plans

and insurance reforms to reduce premiums.

What we have yet to find, however, is the political will to proceed

and the determination to succeed. Those will come once we understand

that everyone has a stake in the solution and that our economic

problems are connected to our health care problems. The voters seem to

understand that already. Our leaders need to catch up.

D. McBride is a health economist and a professor at Washington

University's Brown School of Social Work

Link is: http://www.jaynixon.com/news/?id=0124

--------------------------------------------------------------------------------

One site keeps you connected to all your email: AOL Mail, Gmail, and

Mail. Try it now.