Can’t We Do Better?

48 million Americans, according to the Census Bureau, had no health insurance in 2012.  We can and must do better.  Take a look at this Chicago Tribune piece for all the details.  Yes, the number of uninsured went down last year from 48.6 to 48.0 million and the percentage of uninsured went down from 15.7% to 15.4% but this change is happening way too slow.  With the Health Insurance Exchanges going live soon, perhaps this will improve the situation but it seems the energy is not really there yet to create dramatic change.

This lack of healthcare coverage is a major drag on the pharmaceutical industry as this group of 48 million definitely will not be purchasing brand name pharmaceuticals at a cost of thousands of dollars a year.  It just won’t happen.  The key point to consider is who are the uninsured?  Keep in mind they are not the poorest of the poor as those patients will be eligible for Medicaid.  It seems to be the people living on the edge of poverty and perhaps those who work at jobs without insurance who have the greatest chance of being uninsured.  There is even 8% of people with family incomes over $75,000 who are not insured.  Why is that?

So much debate over the last year has been around the role the government plays in healthcare and how this hurts the free market forces.  Even before the passage of the Affordable Care Act, the role of government was extremely significant with Medicare and Medicaid covering between 30-40% of those insured.  In addition, and this is critical, government provides a further boost through their tax support of corporations that provide insurance for their employees.  In so many ways, government already ran and will continue to dominate healthcare policy in our country.  The concern is not about that but rather the lack of a “free market” opportunity for individuals who want to buy their own insurance.  The health insurance exchanges run by government and those run by private industry should help rectify this situation.

Having everyone insured is not just a feel good thing we should strive for but rather a driver for fiscal stability in our economy.  In the vaccine world there is the herd immunity concept that might provide a model for the health insurance world.  The concept is that the more people who are vaccinated, the less chance a disease will have to break through the barrier and that the overall success against a disease is actually higher than the number of folks vaccinated.  Having people uninsured hurts everyone in the system as it drives up costs for the insured.  Making sure everyone is covered and having the opportunity to get medical care before their problems get too advanced helps avoid the catastrophic costs that impede the progress of healthcare economics in our country.

Selfishly the pharmaceutical industry wins when more people are insured and have access to medications.  The earlier this intervention happens the better for the industry as drugs provide tremendous value preventing disease and minimizing the progression and the costs associated with no treatment.  This is a win for everyone and the industry should do everything possible to promote coverage for everyone.

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