Health-care cure for the economy

PEOPLE who suffer from chronic diseases are still vulnerable to temporary maladies.

A bad accident or the flu can create a crisis for someone with heart disease or diabetes. People sometimes discover chronic illnesses only when acute problems make them evident. And sometimes it's impossible to deal with a medical crisis without addressing the underlying chronic problems.

And what's true for our health is also true for health care in the U.S., which suffers from many chronic ills. The current economic crisis is showing us how bad they are. That's why an economic-recovery bill that includes initial steps toward health-care reform is now before Congress.

One chronic problem is the rising cost of care, growing two to three times faster than inflation. Businesses, governments and individuals face premium increases of up to 10 percent a year.

The recession has aggravated this chronic problem, creating an acute crisis. Businesses are closing because health-care costs have become unmanageable. Others are cutting back on insurance, leaving employees with higher premiums or, in some cases, dropping coverage altogether.

A second chronic problem is that private insurance often fails us. People with insurance find that the care recommended by their doctor isn't covered. Co-pays and deductibles are so high, and lifetime limits so low, that even the insured suffer when they become ill.

The recession has exacerbated this chronic problem, too, creating another crisis. Insurers under economic pressure deny more claims, making it harder for people to get care. The burden of co-pays and deductibles and lifetime limits becomes more evident when family budgets are tight.

The third chronic problem is that more than 45 million Americans don't have insurance at all. Most can't afford it because their pay is low or because insurers charge high premiums for those who are older or have an existing medical condition. That hurts all of us as 12 percent of our insurance premiums cover the cost of health care for the uninsured.

The recession has worsened this problem, creating an acute crisis here, too. As workers lose jobs, they lose insurance. With every increase in the unemployment rate, thousands of Pennsylvanians lose insurance. While COBRA lets those laid-off workers with insurance continue coverage, the cost is often impossibly high. Private insurance is unaffordable for older workers and those with medical problems.

WE CAN'T restore prosperity in the long term if we don't solve our chronic health problems. We've had an economy driven by staggering debt, the false hopes generated by the housing boom and luxury consumption by the rich. We have to create a different economy, based on a rising standard of living for everyone in America.

But we can't create such an economy when wages are stagnant because the income generated by increased productivity is eaten up by rising health-care costs. Nor will we create new jobs when businesses can't compete in a global market because of impossibly costly insurance.

Four important measures that begin to address our health care problems have been, at one time or another, part of the economic stimulus bill before Congress.

They would:

* Increase the federal contribution to Medicaid. This will bring almost $1.5 billion to Pennsylvania. These funds will help the state deal with a critical budget shortfall without cutting Medical Assistance.

* Cover 60 percent of the cost of COBRA payments for workers who've lost their jobs, thus their work-related health insurance.

* Let workers who've lost their jobs get health care under Medicaid, even if they are above the usual income limits.

* Provide funds for health information technology and research in comparative effectiveness of medical treatments, critical to controlling health-care costs in the future.

Even if these provisions stay in the recovery bill, as they should, it will still be only the first step in dealing with our chronic health-care problems. Our representatives and Sens. Specter and Casey need to support it. *

Marc Stier is the Pennsylvania state director of Health Care for America Now, www.healthcareforamericanow.org.