The Cost of Not Enacting Healthcare Reform

Healthcare reform is back on the front page. There are all kinds of stories about last minute efforts to push through or block the current Senate bill. Most of the stories talk about the millions of dollars being spent by lobby groups trying to protect their turf. The anti-reform groups are clearly outspending the pro groups at this point. Then we have the pressure tactics being applied by President Obama to the Democrats not in the fold to get the House majority he needs. These are countered by threats from the National Republican Congressional Committee to go all out in the upcoming elections against any Democrat who votes with the President.

Nowhere in any of this is there a discussion of the issues driving the debate or ways to improve the current Senate bill to get better healthcare reform legislation passed. In fact, because the way our political system works we are forced to either pass the current Senate bill almost as is or have nothing at all. We need to get back on track to discuss the real issues to advance meaningful reform. Everyone is talking about the cost of passing this legislation. I would like to discuss the cost of doing nothing.

In a recent report by the Robert Wood Johnson Foundation, analysts at the Urban Institute projected changes in coverage patterns and healthcare costs that would occur over the next ten years if no healthcare reform is enacted. They projected three different scenarios from worst to best based on how our unemployment and economy turn around. Here is a summary of their findings:

-Middle income families will be hardest hit. The uninsured rate for this group would increase from the current 19% to as high as 28%, an increase of 7.3 million people.

-More uninsured would come from middle and higher income families. More than half of the uninsured would have incomes of more than 200% of the poverty level.

-The uninsured rate would increase significantly in older adults. For adults ages 45-54 the rate could go from 17% to 24%. For adults ages 55-64 it could go from 15% to 22%.

-The uninsured population will shift to older age groups.

-The uninsured rate will increase for those in better health. This means that premiums will increase for for the insured population since many of the healthy low utilizers will drop out.

All in all this report is not as bad as one might expect. But it does point out that the impact of not acting on some type of healthcare reform goes far beyond those that are currently uninsured. The key point here is that many who consider themselves middle class will be affected, particularly as they get older and are more vulnerable healthwise.

There is probably no stopping the current political process in play and we will end up with the outcome it gives us. Too bad that we stopped addressing the real issues some time ago.

More on this later.

Mark Brodeur