New study: Jobs crisis promotes rationing of care

Tue Dec 13, 2011

by National Nurses Movement

A new NPR/Kaiser Family Foundation survey released today documented again the direct link between the economic crisis – you know the one Nobel Laureate Paul Krugman now says we ought to start calling a Depression – and families undermining their health.

Of 1,500 U.S. adults polled, half of whom have been without jobs for more than a year or work part-time while looking for full-time work, the study found that three-fourths of those unemployed or underemployed say they or a family member have delayed medical care because of the cost.
Let that sink in a minute – 75 percent of those in American families who have been discarded in the economic meltdown are self-rationing needed medical care.

Among the key findings:

  • 46 percent skipped recommended medical treatment or a diagnostic test
  • 40 percent did not fill needed prescription
  • 63 percent postponed dental care or checkups
  • 43 percent had problems paying medical bills
  • 33 percent said their mental health has gotten much worse or somewhat worse as a result of their employment status

This is not a surprise to nurses. Months ago National Nurses United identified broad declines in health and living standards for substantial segments of the U.S. population as a direct consequence of low wages, unemployment, hunger, substandard housing and prohibitive medical bills. Among them:

Heart ailments in younger patients, especially in men in their 40s; hypertension; pancreatitis, typically an adult disease now increasingly found in children due to high fat diets linked to low incomes; a range of "gut" disorders, such as colitis; increased obesity linked to poverty; manifold mental illnesses, including anxiety disorders, in youth populations; and higher asthma rates with reports surfacing of deaths as a result of the delays tied to poverty or insurance obstacles.

    The economic pandemic is global, of course. But somehow the impact on health is worse in the U.S. That’s what a Commonwealth Fund study last month showed. It compared 11 of the world’s richest nations, and found that sicker adults in the U.S. took top honors for having healthcare cost and access problems.
    More than one-fourth could not pay medical bills over the past year, compared to just 1 percent to 14 percent in the other countries. Further, 42 percent of U.S. adults said they had put off visiting a doctor, filling a prescription or getting other recommended care, twice the rate for most of the other nations.
    What’s the difference? Those other countries have some form of a national healthcare system or single payer system, such as our Medicare program that so many U.S. politicians on both sides of the aisle are itching to cut.

    Some of their counterparts abroad are equally shortsighted, such as the conservative Cameron government in the UK, now pushing major cuts in their crown jewel National Health System. The last thing British patients need is for politicians to be emulating the U.S. model and pushing toward a more broken healthcare system with its great race to the bottom.

    Every day nurses see the living embodiment of the patients and families behind the statistics listed in the NPR/Kaiser survey, one reason that U.S. nurses have long advocated a more humane healthcare system not based on ability to pay, but one that guarantees healthcare for all in a single payer system, such as expanding and adequately funding Medicare to cover everyone.

    That’s been a fundamental plank of NNU’s call for a Main Street Contract for America, which also calls for good jobs with dignity for everyone, which along with guaranteed healthcare is the only effective solution to the deplorable numbers found in both the NPR/Kaiser survey and the Commonwealth Study.

    NNU has also been stepping up the campaign for a major funding mechanism with a tax on Wall Street, the very banks and financial firms which tore that giant hole in our economy by gambling with people’s mortgages, pensions, and other reckless financial misdeeds.

    The nurses’ proposal a small financial transaction tax of just 50 cents on every $100 of trades of stocks, bonds, derivatives, and other major trades (exempting normal consumer activity) could raise up to $350 billion every year to help reframe our economy, heal America, and end the shame of people sacrificing their health and lives due to the cost.