Public health could be the next casualty of the recession, according to a Thomson Reuters survey (PDF) indicating that patients are postponing healthcare procedures.
The study, “The Current Recession and Healthcare Consumers,” was based on a telephone survey of 12,000 households conducted from February 11 to March 15. It found that 20 percent of respondents postponed or cancelled care last year. Nearly a quarter of those who called off care cited cost as the primary reason.
That’s an increase of 15.9 percent in cancellations or postponements from 2006, according to the survey.
Employer-sponsored health insurance dropped 4.4 percent in the year leading up to the survey, a decrease that may explain the significant drop-off in care, said Thomson Reuter chief survey officer and study author Gary Pickens.
One in five respondents said they would have difficulty paying for insurance over the next three months.
That comes as no surprise to Alan Sager, a professor of health policy and management at the Boston University School of Public Health, who told MassDevice that the survey results confirm other reports that the number of uninsured people in the U.S. is growing at a rapid clip.
“It’s always a combination of the economy and rising healthcare costs,” Sager said, citing a report indicating that the number uninsured Americans rose from 46 million in early 2007 to 52 million earlier this year. “We haven’t had a drop in the economy this bad since healthcare costs became so high.”
Whether the trend of people cutting back on healthcare affects public health is hard to predict, he said.
“Much depends on whether the care that’s eliminated is care that’s less useful,” Sager explained. “During the 1970s, when people had to pay more out of their pockets, they used less care. They were indiscriminate in the care they eliminated [and were] just as likely to cut back on care that was useful as care that was not useful.”
Unlike past recessions, in which the healthcare sector buffered poor economic conditions, there are signs that this recession is hitting that industry too.
“Healthcare has never had a bigger share of the economy,” Sager said, noting that it accounted for roughly 16 percent of the economy when the recession began and looks to account for close to 18 percent this year. “There are some mild signals that healthcare won’t be as strong a buffer this time. On the other hand, Medicaid’s ability to act counter-cyclically has been enhanced by the [American Recovery and Reinvestment Act], which has made more federal dollars available to be used by state Medicaid programs.”
Sager said the fix may lie in improving the efficiency of the healthcare system.
“Every other wealthy country covers everyone, essentially, spends on average about half what we do per person and enjoys better health outcomes across the board — even though people in most of those countries smoke and drink more than we do,” he said. “Probaably half of what we spend on healthcare in this country is wasted. If we went from 50 percent waste to 40 percent waste on a healthcare spending basis, saving 10 percent of current spending would be a quarter trillion dollars, which is more than enough to cover everyone who’s uninsured and also provide dental and mental health coverage [for everyone]. We have more than enough money to provide care for those who needs it.”
