November 19, 2005
Return on Community Investment
Len Stewart of Cape Cod Works has a must-read post on how we must look at any health care reform: It's an investment in our community, which will bear real and tangible economic as well as moral benefits. Quoting Dave Rogoff, Director of Hillsborough County Health and Social Services:
When there is agreement that access to health care makes financial sense, however, cooperation towarding funding solutions develops regardless if it is determined to be a right, a privilege, or something else entirely. [my emphasis]
Luckily, it makes abundant financial sense. The Blue Cross Blue Shield Foundation determined that under its own plans,
Achieving universal coverage under the Roadmap plans would require between $700 million and $900 million in new government spending, some of which would be federal. While universal coverage would require modest additional state spending, the Commonwealth would also gain an estimated $1.5 billion a year from the direct economic and social benefits of improved health as well as other positive effects on the state’s economy. [my emphasis]
Now, that was under the "Roadmap to Coverage" plan; Neither the House nor the Senate is talking about spending 700-900 million new dollars. But the principle is clear: It's an investment, with the reasonable expectation of a significant return. If we're healthier, we're more productive; we miss less work; we earn more money; we spend more money; we create jobs; and so forth.
And not coincidentally, we're probably all a heck of lot happier.
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we miss less work
I've been thinking about this one a good bit, and while it seems obvious to be true, I can't help but wonder just how true it is.
One the one hand, with health care -- including preemptive care -- people are far less likely to get long-term sick before retirement. How much less likely? I have no idea.
On the other hand, it would seem like people would miss more days or half-days of work going to the doctor, since now they're insured.
Furthermore, most white collar jobs mix sick and vacation days, so being sick less often results in more vacations, but does it really result in more work days, more income, and hence more spending and tax revenue? It wouldn't seem that way in the case of white collar work.
So, my question: where's the evidence that if MA suddenly had health care for all that the productivity -- measured in SDP, total income, etc -- would go up?
Posted by: stomv | Nov 20, 2005 7:57:00 AM
stomv, you might try the Roadmap to Coverage reports that I just linked above (should have done it last night). It seems intuitively obvious to me -- sure, you miss 1/2 days of work, but you get medicines for illnesses, antibiotics, etc.
Also you should really read Uninsured in America to see how lack of health insurance creates a downward spiral in earning power.
Posted by: Charley on the MTA | Nov 20, 2005 8:42:39 AM
Excuse me, but let's have a reality-based conversation on this.
currently, in Mass., we spend about $1 BILLION ber week on healthcare; there is enough money in "the system" already to provide comprehensive coverage to everyone. it is public knowledge that 39 cents of EVERY healthcare dollar spent in this state is diverted away from care and spent on administration, marketing, etc...
in 2001, when the economic analysis on healthcare spending was done for the legislature, this 39% figure totaled $16 Billion dollars (for source, see Resources section of our website at www.DefendHealth.org for the 12/02 LECG Report on Universal Healthcare Financing and Delivery prepared for the Mass. Legislature).
so, the challenge is how to get the legislature to develop the chutzpah to require that non-healthcare expenditures be capped at, say, 10% (even charlie baker agrees this is a doable, even generous figure). if three-quarters of the 39 cents of every health care dollar that is currently NOT spent on care is re-directed to providing universal comprehensive coverage, we would have at least $12 Billion additional dollars to spend on covering everbody.
small businesses should be lining up for this type of reform, and i think they would be if we had any political leadership putting out a high profile vision to accomplish it (and the "Gold Standard" single payer bill already is in the legislature, SB 755, see www.MassCare.org).
the senior researcher for the Roadmap to Coverage reoport commissioned by BCBS of MA (john houlihan, i believe it is) stated that their research and final report did not include looking at single payer reform because reform approach was not asked for by BCBS (or put another way, because BCBS did not want this looked at or included in the final report--now whay could that be?...)
and btw, there is a national project for universal healthcare reform called "Everybody In Nobody Out" which started 7 years ago. and there is a related project that folks might want to check out as well--here are their websites.
www.EverybodyInNobodyOut.org and www. RightToHealthCare.org
lastly, right here in our own backyard a group of concerned citizen's have lauched a historic campaign to secure the right to affordable, equitabley financed and comprehensive health insurance coverage. we need your help. rushika fernadapuole, md, co-author of "uniinsured in america" is among this group. if you share this vision and want to help make it a reality, please endorse the campaign at www.HealthCareForMass.org.
Posted by: Ann (at DefendHealth) | Nov 20, 2005 3:11:19 PM
So let me get this straight. The largest health insurance agency in the state says that insuring everyone is a good thing? Isn't that a bit of a conflict of interest?
Posted by: Ken | Nov 21, 2005 7:15:19 PM
Good question, Ken. My sense is that the BCBS *Foundation* is a reasonably well- and transparently-run organization, which includes a lot of folks that would be considered "progressive."
Now, it's true that they didn't consider single-payer, and it might not be realistic for an insurer's foundation to consider it, for exactly the reason you cite. So yeah, because of the inherent conflict of interest there is a limit to the questions that the foundation might consider. Within those constraints, I think their research is considered pretty sound, but it's also reasonable to notice the elephant in the living room. :)
With that, Ann's thoughts, especially regarding the enormous administrative waste in the insurance system, are well-taken.
Posted by: Charley on the MTA | Nov 21, 2005 10:25:13 PM
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