Costs

We love it when experts on Pakistan, Afghanistan and Osama bin Laden get so excited about health reform that they spend their weekends reading 89-page policy papers. But that's what New Yorker writer and New America Foundation President Steve Coll did with Finance Committee chairman Max Baucus's white paper on health reform. It's a blueprint for legislation that will make sure that all Americans have health insurance while taming costs and improving quality. Coll wrote in his New Yorker Think Tank blog:

Health care is usually deemed more or less recession proof. Maybe not this time, according to a recent Chicago Tribune article that analyzed several Moody’s Investor Service reports on sectors including hospitals, medical devices and insurance companies. Bottom line: Moody's revised the health care industry’s 12- to 18-month outlook from "stable" to "negative."

Speaking of the auto bailout (well, we weren't, but everyone else seems to be...)

It's a cliché by now to talk about how carmakers spend more on health care than they do on steel, but clichés stick around for a reason. What's happening now in Michigan is not just another blow to our manufacturing sector but another crisis for our whole economy. And our overpriced, inefficient health care system is a big component.

CNN just took a look at the health care element to the Big Three crisis, and quoted New America health policy director Len Nichols on the costs, in particular, of retiree health care. U.S. carmakers used to have a bigger share of the market, and they had more workers than retirees. Now, they have foreign competitors with lower health care costs, and they have more retirees than workers (two times as many retirees in some cases)

GM is now paying about $1,500 per vehicle for health care, and two-thirds of that is for retirees.

PS As you know, this isn't a new topic. Here's a look back at what Health Populi had to say last year, and Huffington Post in 2006...

Our New America health policy colleagues Elizabeth Carpenter and Sarah Axeen in an op-ed in the Philadelphia Inquirer build on their recent paper on The Cost of Doing Nothing (report here, blog summary here) and explain why we can't recover from the economic crash if we allow people to get crushed by health costs.

Some of the Philly piece naturally focuses on Pennsylvania, where health costs have been a factor in the loss of 207,000 manufacturing jobs since 2001. But their overall message applies to the nation as a whole.

In the face of historic job losses and the worst financial crisis in 80 years, why did health care remain a salient issue in the final weeks of a tough campaign? The answer is simple: When people are worried about their jobs, they are nervous about the security of their health coverage. And when people are trying to figure out how they are going to pay their bills, they are concerned about being able to afford medical care.

Another reminder of the way the economic crisis is adversely affecting our nation's health. More people appear to be skimping on their prescription drugs because they can't afford them.

In the first eight months of 2008, the number of prescriptions dispensed in the United States was slightly lower than the comparable months of 2007, reversing a decade-long trend, according to a recent analysis of data from IMS Health, a research firm that tracks prescriptions.

Cost may not be the only factor. Headlines about safety concerns of a few drugs, and the over-the-counter availability of some former prescription medications may play a role, according to a New York Times story on the trend. But doctors and other experts say consumer belt-tightening is a big factor in the prescription downturn, as is the higher co-payments that insured consumers face. And these figures reach only through August, before the recent weakening of the economy and the banking crisis.

"People are having to choose between gas, meals and medication," said Dr. James King, the chairman of the American Academy of Family Physicians. A family practitioner in rural Tennessee, Dr. King said he's seen some of his own patients stop taking their medications or skip doses to stretch out a prescription.

Last year, the Washington Post profiled ten area residents and asked them to rate their own experiences with various forms of health insurance. The average grade: just over a B minus. A year later, the Post checked in with some of those profiled to see how things had changed. The resulting updates, as well as the original profiles, provide a striking survey of the state of health insurance in America.

Here are some of common themes that stood out to us from the series:

We see a lot of gloom and doom out there about how the Wall Street bailout won't leave any money left over for health reform (or anything else for that matter). We have often pointed out that the question shouldn't be whether we can afford health reform, but whether we can afford NOT to do health reform given its impact on federal and state budgets, the manufacturing sector's ability to compete globally, and ordinary people's pocketbooks up and down "Main Street" (to use the term of choice this week).

Jane Sarasohn-Kahn over at Health Populi makes similar arguments. Each one percent increase in unemployment, means one million more uninsured (and another million on Medicaid and SCHIP). State tax revenue is falling, while medical bills are growing. ERs are swamped. Ordinary people are delaying care—even necessary care. You can read her full post but her bottom line for health reform: "The lesson from financial markets is not to put off to 2012 what we can and should do in 2008."(We think she means 2009 but you get the point.)

In more than 50 years in Congress, House Energy and Commerce Chairman John Dingell has seen it all in health care. He can even remember when President Truman tried to get the job done. But Dingell doesn't just look back—here's some of what the self-described "stubborn and optimistic" Michigan Democrat told a Washington policy center about the convergence of interests that make the future of health reform look a little brighter.

"I am starting to see light at the end of this dark road I've been traveling," said Dingell. The spiraling cost of health care, he said, has caught the attention of people and groups who used to oppose insuring everyone. Health reform, he said at an event yesterday at the Center for American Progress, used to be a moral issue. Now it's a moral and economic one, with a greater diversity of business and health industry leaders backing comprehensive reform. Because they need it.