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You can’t square a circle: Healthcare and the economy

Healthcare and the economy are inextricably linked. Simply put, by taking care of healthcare we can positively impact the economy (and vice versa). But yet despite these being inseparable, we sometimes fall guilty of separating out healthcare and the economy – we see these as two separate issues when they are not.

In a Robert Wood Johnson Foundation (RWJF) issue brief on the economy:

“In the United States, the economy shapes the complex interactions among employment, health coverage, and costs, as well as financial access to care and health outcomes.”

Like most systems it is important to recognize what can be done on any one component but to recognize that there is a dynamic interaction between all components. Said differently, we must understand how to change healthcare while simultaneously understanding how to change the economy but recognizing that these two issues impact on each other.

In an piece published in the Economist on why health reform is so challenging (but needed):

“What is needed is a change in the structure of health-care systems so that competitive pressures push them in a more useful direction, enhancing the power of purchasers and increasing competition in the supply of medical care. The traditional argument has been that health care is too important to leave to the market. The opposite holds true: it is too important not to be exposed to the market.”

Again, back to the dynamic systems interaction – from RWJF:

“In economic downturns, few employers drop health coverage or restrict employee eligibility. More commonly, they reduce costs by changing benefits and cost-sharing provisions. Employees in low-wage jobs, those working in small firms, and those in certain industries have been far more likely than others to have been uninsured when they lost their jobs, but this recession is affecting a broader swath of the workforce.”

When the economy hits that downturn, like we are witnessing right now, someone somewhere will have to adapt to “afford” healthcare. Employers put more of the cost of healthcare on employees when the economy is not as robust. In a survey conducted by the Kaiser Family Foundation, it was found that “forty percent of employers surveyed said they are likely to increase the amount their workers pay out of pocket for doctor visits.” They continued that “almost as many [employers] said they are likely to raise annual deductibles and the amount workers pay for prescription drugs. Nine percent said they plan to tighten eligibility for health benefits; 8 percent said they plan to drop coverage entirely.”

You can see that critical decision points are made about healthcare based on the economy.

Why does this matter and why is today’s post addressing this issue? Well, as we all begin to weigh the upcoming election, it is important to recognize that solutions around healthcare will not be able to be separated from those made about the economy. Maybe this is common sense, but political arguments sometimes artificially separate these two issues in attempt to “get the point across.”

We cannot “square a circle” and we cannot address healthcare without considering a multitude of factors, including the economy.