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Health Care: The Impact of Inequality

Infant Mortality, per 1,000 Live Births

Infant Mortality, per 1,000 Live Births

One could hardly find a starker, more grievous example of inequality than the difference between those families with health insurance and those without. Without health insurance, the risk of financial ruin is ever present. Health care policy exemplifies a system in which families can play by all the rules—go to work, spend their money responsibly, provide for their children as best they can—and still be denied the lowest common denominator of economic security. Since 1999, employer-based health insurance premiums have increased by 131 percent,1 and health care debt is now the main cause of personal bankruptcy.2

Absent reform, the number of uninsured people in the United States would balloon to 61 million by 2020, an increase of 14 million over today.3 The vast majority of those without health insurance are families that rely on low-wage work. Low-wage jobs frequently do not come with a health insurance plan; if they do, workers often cannot afford the premiums. In 2008, the average family health insurance policy cost $12,700. That is more than the entire annual earnings of a full-time minimum-wage worker ($10,800).4

A 2007 survey by the Commonwealth Fund found that 48 percent of all low-income households had been uninsured at some point during the previous year.5 Clearly things aren’t getting any easier during a recession. With unemployment rates expected to hover around 10 percent through 2010,6 we would expect to see a lot more people who had health insurance before the recession going without. Because of a lag in data collection, we won’t know the true effects of the recession on health insurance coverage in 2009 until later in 2010.

A common argument by critics of health care reform has been that the United States pays more for health care than other countries because it has the best in the world. But the best care in the world is irrelevant if you can’t afford it. To put U.S. health care in perspective—our country is ranked 50th in the world in life expectancy.7 Every other industrialized country is reducing preventable deaths faster than the United States and for significantly less cost.8 A 2007 report by UNICEF ranked the United States at the bottom of a survey of 21 industrialized countries on all measures of child health. Our infant mortality rate is on par with countries such as Estonia, Poland, and Croatia.9

Footnotes

  1. National Coalition on Health Care (2009), Health Care Facts: Costs. [back]
  2. David U. Himmelstein, Deborah Thorne, Elizabeth Warren, Steffie Woolhandler (June 5, 2009), “Medical Bankruptcy in the United States, 2007: Results of a National Study,” The American Journal of Medicine. [back]
  3. Mary Filardo (2008), Good Buildings, Better Schools: An Economic Stimulus Opportunity With Long-term Benefits, Agenda for a Shared Prosperity, Economic Policy Institute. [back]
  4. National Coalition on Health Care (2009), Facts on Health Care Costs. [back]
  5. Carey et al., op. cit. [back]
  6. Douglas W. Elmendorf (September 24, 2009), The Budget and Economic Outlook, Congressional Budget Office. [back]
  7. Central Intelligence Agency (2009), The World Factbook. [back]
  8. Ellen Nolte and C. Martin McKee (January 2008), “Measuring the Health of Nation: Updating an Earlier Analysis,” Health Affairs 27, no. 1. [back]
  9. UNICEF (2007), Child Poverty in Perspective: An Overview of Child Well-Being in Rich Countries, United Nations Children Fund Report Card #7. [back]

Issues

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