Archive for March 23rd, 2011

So American Health Care is Even More Costly than We Thought…

admin March 23rd, 2011

Not-unexpected but useful news item that got buried behind Tokyo’s contaminated water story - apparently Americans aren’t spending 8K a year on health care costs, they are actually spending 10K a year on health care costs.  Is this the time for one of those choruses of “We’re number one!”

These “hidden” costs of health care — like taking time off to care for elderly parents — add up to $363 billion, according to a report from the Deloitte Center for Health Solutions, a research group.

hat amounts to $1,355 per consumer, on top of the $8,000 the government says people spend on doctor fees and hospital care.

“We’re surprised that this number came in so high. It’s significant,” said Paul Keckley, executive director with the group.

The out-of-pocket costs that the government tallies usually include only insurance-related costs like premiums, deductibles, and co-payments.

Keckley said the study is the first to estimate how much consumers dish out on health care related goods and services not covered by private or government insurance.

These include: ambulance services, alternative medicines, nutritional products and vitamins, weight-loss centers and supervisory care of elderly family members.

“These costs can add up to billions of dollars, even eclipsing housing as a household expense,” said Keckley.

The study found that more than half of those costs were the cost of caregiving in lost wages.  This is a number we can only expect to see rise radically.  Many states have already cut aide and home health care support, assisted living kicks you out as soon as your income runs out, disability housing and services for the disabled are among the first convenient targets when budgets get tight, and the state funded nursing homes are both closing and becoming increasingly dire.  Add to that an aging population, and the outcomes are predictable.  The only alternative is for people to do caregiving at home - and at considerable cost in both wages and personal terms.  For those unlucky enough to have no one to take care of them, the outcomes are worse.

This is something I know something about - I worked for many years in elder care and hospices, then cared for Eric’s grandparents in our home, and eventually I will be my oldest son’s caregiver, since he is unlikely to ever live independently.  We are also guardians for our disabled niece whose mother is a generation older than I and who will also probably never live independently.  Giving care is something I expect to be doing for a long time.  I’m very comfortable with that part of my life, but I don’t claim it will be easy or that the costs will be easy to bear.

The hard reality is that a lot of people will have to come out of the workforce in order to do the work of caring for children, the disabled and the elderly.  The good/bad news is that a lot of people are coming out of the workforce, of course, but their obligation is to look for work full time - which pretty much precludes taking care of Grandma, your brother who is a war amputee or any children who need it.

Apparently many economists were surprised by the high cost of caregiving, of transporting the ill too and fro, of all the attempts to find alternatives and to soften side effects that go will illness and disability, aging and ordinary childhood health costs.  Anyone who lives them is not.  The reason these are surprising to some people is that they are “housewifized” out of existance - our society doesn’t recognize the value of caregiving except when it is professionalized and industrialized.  It erases domestic and family support, implies they are valueless and best undertaken in professional settings.  Then, when the money isn’t there or the professional settings are unhealthy, we pretend that this is not “real” work.

The shifting of nearly everyone into the industrial, formal economy resulted in the radical impoverishing of the informal economy - an impoverishment that must be reversed if outcomes are to be better than worst.