Galesburgers for Health Care Reform Regular people working to make a reform a reality…

on fivethirtyeight.com
(a very pop­ular site for polit­ical commentary)

Imagine what the Amer­ican Trucking Asso­ci­a­tion would say if the inter­state highway system was a jumble of uncon­nected, poorly paved roads, every mile of which was nonethe­less tolled at exor­bi­tant rates. Think what the Amer­ican Tele­mar­keting Asso­ci­a­tion would do if half the calls their employees dialed every day were abruptly dis­con­nected because of faulty, unre­li­able tele­phonic infra­struc­ture. And how quickly would the Direct Mar­keting Asso­ci­a­tion, which relies on the U.S Postal Ser­vice, mobi­lize on Capitol Hill if mil­lions of their mail pieces each day never arrived at their intended addresses?

In my Bal­ti­more Sun column today, I ask the $7 tril­lion dollar ques­tion few seem to be asking, no less answering:

In October 2007, the Milken Insti­tute pub­lished “An Unhealthy America: The Eco­nomic Burden of Chronic Dis­ease,” a report ana­lyzing the long-term eco­nomic costs of leaving unchecked just seven mal­adies: cancer, heart dis­ease, hyper­ten­sion, mental dis­or­ders, dia­betes, pul­monary con­di­tions and stroke. Com­paring a sce­nario of “rea­son­able improve­ments in treat­ment and behavior” with a “busi­ness as usual” base­line, the report esti­mated that cumu­la­tive sav­ings in health care expen­di­tures over two decades, from 2003 to 2023, could total $1.6 tril­lion. That’s $80 bil­lion saved per year — no small sum.

But those sav­ings are dwarfed by the costs to the Amer­ican economy caused by an unhealthy work force. “Chron­i­cally ill workers take sick days, reducing the supply of labor — and, in the process, the GDP,” the report’s exec­u­tive sum­mary explains. “When they do show up to avoid losing wages, they per­form far below par — a cir­cum­stance known as ‘pre­sen­teeism,’ in con­trast to absenteeism.”

Milken’s esti­mated cumu­la­tive loss to America’s GDP of doing nothing during the same period? Almost $7 trillion.

We wouldn’t tol­erate $7 tril­lion sort of inef­fi­ciency and loss if it resulted from a tax increase or pro­posed busi­ness reg­u­la­tion. Wouldn’t Grover Norquist and his gang be screaming tire­lessly, per­haps with cause? Yet as a nation we sit back pas­sively and allow our cap­i­talist economy to be hob­bled by solv­able prob­lems affecting the most impor­tant infra­struc­tural input of all: the labors of the Amer­ican work­force. What’s amazing is that Amer­ican workers today work longer hours and are more pro­duc­tive than ear­lier gen­er­a­tions of workers–despite our health problems.

When the gov­ern­ment does or doesn’t do some­thing that is bad for Amer­ican cap­i­talism, rel­e­vant busi­ness inter­ests step to the fore to cor­rect the problem. “The busi­ness of America is busi­ness,” is the famous mis­quote from Ronald Reagan’s favorite pres­i­dent, Cal Coolidge. So why hasn’t cor­po­rate America stepped forward–long before Barack Obama even arrived on the national scene–to com­plain about the busi­ness inef­fi­cien­cies of an unhealthy citizenry?

But the tougher, more polit­ical ques­tion I want to ask is this: Why hasn’t the pres­i­dent framed his calls for health care reform–either in subtle or more direct, forceful ways–in terms of Amer­ican eco­nomic per­for­mance and pro­duc­tivity? Wouldn’t that put a lot of his con­ser­v­a­tive critics back on their heels? Wouldn’t it rally more cor­po­rate inter­ests and trade asso­ci­a­tions to his side?

I can’t find any polls to bol­ster my suspicions–typical national polls ask Amer­i­cans whether they sup­port reform leg­is­la­tion or whether they approve of the government’s han­dling of the health reform issue–but I sus­pect that too many Amer­i­cans con­ceive of health care reform as a purely fiscal issue, a matter of taxing and spending. Worse, a sig­nif­i­cant subset of them surely view reform in terms like those recently invoked by Mike Huck­abee: that is, as some stealthy, redis­trib­u­tive grab, just another big-government Demo­c­ratic ini­tia­tive to take money from their pock­et­books for an enti­tle­ment pro­gram to help the poor, indi­gent or other unde­serving types.

Now, it’s true that reform will cover more people who don’t have the means to insure them­selves. But whether they’re poor or middle class, the unin­sured or merely under­in­sured also go by another name: the Amer­ican work­force. And the less we think about them as patients, and the more we think about them as workers essen­tial to Amer­ican pro­duc­tivity, the easier it is going to be polit­i­cally to fix what ails us. And instead of a national con­ver­sa­tion about how we can’t afford health care reform, the president’s oft-stated macro point that we can’t afford not to reform the system would be a lot easier to make.

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the­center: www.thecenteringalesburg.org
drearth: www.onehuman.org
word­ner­dau­thor: http://www.onehuman.org/books.html