The Census Bureau recently reported that the number of people without health insurance in the United States climbed 10 percent between 2008 and 2009, from 46.3 million to 50.7 million, over 15 percent of the nation's total population. This significant increase reflects the state of our economy, increased joblessness among the general public and, even among those with employment, the continued retreat of many employers from providing health care coverage to their workers.
According to the Census Bureau, the percentage of individuals covered through employer-sponsored plans is now at a record low 56 percent. But stay tuned, because over the next couple of years, this figure will rise further and likely not begin to decrease until 2014, when the country makes affordable health insurance available to many more citizens.
Despite these sobering statistics, some still question the merits of our recent health care reform legislation, which finally put in place a safety net for the millions of Americans without health insurance coverage, and for the millions who lose their coverage suddenly, to get it.
Focusing on the economic arguments, reform was and continues to be a no-brainer. First, there is little doubt of the economic costs to employers and the country at large from having a sicker population. Having health insurance is a key predictive factor in whether or not a person stays healthy in the first place.
More uninsured individuals translate into more lost work time and lower productivity for the nation as a whole. We talk in vague terms about "how much" providing health care insurance may cost the country. But what must be remembered is the hundreds of billions of dollars we save by making sure millions more Americans are healthy enough to go to work each day.
For example, a 2003 Commonwealth Fund study concluded that "labor time lost to health reasons" in the United States amounted to more than $250 billion annually. This same survey found that more than 400 million days of work in a single year were lost as a result of worker illness.
Arguments about how much health reform may cost to implement are incomplete when they do not also consider the productivity gains, economic growth and increased standard of living generated over time by having more people working regularly and moving up in their job titles and earnings as a result of the steady employment that comes from being in good health. One of the little known yet most important reasons for our nation's ascension to world economic power over the past 50 years has been the presence of a strong health insurance system to enable American workers to seek care when they need it.
The second valid economic argument justifying expanded health insurance in this country is that the health care sector represents the second largest spending component of our nation's Gross Domestic Product, behind only the military.
According to the Bureau of Labor Statistics, education and health services provide almost one in every five jobs in the United States. The bureau also reported that in 2009 and thus far in 2010, the health care industry has been adding 20,000 new jobs a month across the United States.
Despite our economic meltdown, the health employment sector remains strong, and is a vital ingredient to digging ourselves out of the Great Recession. Nowhere is this seen more clearly at a local level than in the Capital Region, which relies on hospitals, large physician practices, several major insurance plans and countless other health-related businesses to provide tens of thousands of jobs. Without a vibrant health care industry in our area, there would be many more individuals out of work, more houses facing foreclosure, more quickly dropping property values and increased taxes levied on everyone.
When we focus on health insurance's contribution to creating a healthy and productive work force, investment in health reform is a sound investment that will more than pay for itself over time. With our national and local economies in shambles and jobs in short supply, we should embrace any policy that will invigorate the second largest sector of our economy.
Do we need additional health reforms?
Absolutely. These additional reforms must focus on the supply-side problems in our health care industry that include the fragmented and duplicative nature of service delivery, the use of unproven diagnostic and therapeutic approaches that cost too much and the continued problems with customer dissatisfaction and poor quality. It is far from a perfect system, and the underlying business model of "get sick, and then get cared for" must be transformed to one that emphasizes "keep us healthy and prevent illness."
But allowing millions of people to have health insurance at a time when the work force is getting older and sicker and becoming increasingly uninsured is a smart strategic move for our region, state and nation, even if we cannot yet agree on the moral imperative of it all.
Unlike the recent federal stimulus and Wall Street bailout, it will produce a multiplier effect for our economy that will last far longer and help pull us out of this mess for good.
Timothy Hoff, Ph.D., is associate professor of health policy and management at the University at Albany School of Public Health, He is the author of "Practice Under Pressure: Primary Care Physicians and Their Medicine in the Twenty-First Century."
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