Anna in the combox on my last post points out that I glossed over the importance of routine care as a cost-savings measure. She shares a specific example of a family member’s costly (and potentially deadly) health problem that could have been caught and treated earlier via routine care. WSJ this morning has an article about the large number of clients health insurers are losing to layoffs.
–> Given the cost of privately-obtained insurance, and given that an unemployed person will naturally put off lower-priority expenses, the layoffs *will* mean people skip on routine care that could have saved much time and distress.
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What’s the solution? I don’t know. It’s really tempting to, say, add some kind of health care aid as part of unemployment compensation. It seems pretty simple – in addition to that paltry sum of unemployment payments, you get a packet of health-care stamps or some such thing.
Objections?
Doing so creates an incentive to not return to employment unless it provides a better package than the unemployment package. The way our unemployment system works now, we assume that you were pretty pulled together before you were laid off — you kept yourself healthy, you are up-to-date on your physical, you have some emergency savings, you weren’t living above your means. Unemployment payments are, in my state anyway, a little something extra to tide you over while you scramble for a new job, any job.
Most Americans, it turns out, aren’t actually living this way. Americans are, on average, in poor health, they haven’t got savings, they are in the habit of using credit all the time. Not poor Americans, *all* Americans. Conservatives have a well-trained stinginess-reflex that recoils at the thought of aiding and abetting these bad habits. Liberals, on the other hand, might recognize the need for change, but observe that you won’t have much chance for self-improvement if you’ve just dropped dead.
My intuition is that the solution lies in the middle. It is reasonable to set up some mechanism for providing routine preventative care and emergency health care to people whose situation falls outside the norm. Whether due to temporary unemployment or some tragic longterm problem. We should think about how to do so efficiently. (Health care stamps? Clinics? Private Charities? Insurance vouchers? School nurses? So many possibilities.)
And then, separately, we need to be working on addressing the myriad problems that are making our health care crisis so much more onerous than it ought to be.