Health care now comprises about one-sixth of the U.S. economy. Given the aging of the population, that portion is likely to grow. Therefore, making major changes in the system that delivers and funds health care requires especially careful analysis, not a rush to judgment.
True, this issue has been discussed for decades, especially since the advent of Medicare. Prior to that, the federal role was perceived primarily as battling communicable diseases such as yellow fever and smallpox. Medicare and the subsequent addition of Medicaid, the federal/state program to provide health care to low-income families, greatly increased the government’s involvement.
That involvement escalated in recent years as healthcare costs rose faster than the general inflation rate. Many employers reduced or eliminated employee benefits. Even though most Americans still have health insurance and — polls show — like it, many others lack it. Still others have some form of health insurance but complain that their coverage is inadequate or too costly.
The growing pool of the uninsured has increased the clamor for “reform.” Moreover, unlike some previous reform efforts, the current push has support from formerly resistant entities such as major employers eager to reduce the cost of benefits, elements in the pharmaceutical industry, and providers chafing under managed care’s cost-containment policies and extensive red tape.
Much of the debate has been driven by raw data on the number of “uninsured,” but those data can be misleading. For some people, the lack of coverage is only temporary, occurring briefly when they’re between jobs. Others — especially healthy young people — may well make a conscious choice to avoid the expense. They may reasonably calculate that other forms of insurance — worker’s comp for job-related injuries, automobile insurance for vehicle-related injuries — will cover most of the types of medical attention they’re most likely to need.
Health-conscious younger people also may resent subsidizing care for folks who make unhealthy choices (i.e. smokers, drug abusers, the morbidly obese, the sexually promiscuous) and for older adults, who are more likely to suffer from chronic illnesses requiring costly long-term care. Many of the uninsured also know that a lack of health insurance won’t necessarily deny them access to care, albeit care at the expense of the insured and other “paying patients.”
This study, prepared by Arduin, Laffer & Moore Econometrics, indicates that Florida is especially vulnerable to the adverse effects of the healthcare proposals promoted by the White House and advancing in Congress. Given the magnitude of the changes being proposed — and given their potential effects on our daily life as well as the economy — the legislation now moving through Congress arguably violates a basic tenet of good medical practice: “First, do no harm.”
Read the Backgrounder here.