Will the Economic Meltdown Undermine Interest in Health Care Reform?

By Niko Karvounis, Health Beat. Posted October 6, 2008.

This post originally appeared on Health Beat.

Writing on The Health Care Blog, D.C. insider Bob Laszewski puts the chances of health care reform -- at least in the form envisioned by the presidential candidates and ambitious activists -- at about zero in the wake of Wall Street's meltdown. It's easy to see why Laszewski is so pessimistic:

"On top of the $500 billion deficit [that the government faces] in 2009 ... and the cost of the Freddie and Fannie bailout ... the Congress is now being told it must take on a total of almost $1 trillion in government long-term costs to try to turn the financial system around."

That's a problem. McCain claims his reform plan will cost $10 billion; Senator Obama says his will cost $65 billion. Both are no doubt low-ball estimates. Obama's plan, for example, is more likely to cost $86 billion in 2009 and $160 billion in 2013, after it's expanded, according to the Urban Institute. Given these numbers, Laszewski says that the candidates have to "get...real" about how they're "really going to deal with health care reform in the face of all of these challenges."

In an upcoming post, Maggie will dig deeper into just how health care reformers can and should 'get real' in post-meltdown America. But instead of talking about what reformers should do, I want to discuss another important question we have to pose in the upcoming age of austerity: will the public even care about health care reform anymore, now that the economy has gone south?

On September 30, the Partnership to Fight Chronic Disease (PFCD) held a conference call with reporters. On the call were Ken Thorpe, PFCD's Executive Director, and former U.S. Secretary of Health and Human Service Tommy Thompson. Though I've never been a fan of Thompson, he had some interesting things to say.

Thompson opened by laying out the numbers behind U.S. health care expenditures, noting that "16 percent of the [U.S.] gross national product goes into healthcare [every year], and [that proportion is] on its way to 21 percent." He also pointed out that "we're spending $2.4 trillion, on the way to $4.6 trillion, and 75 to 80 percent of that cost is over chronic illnesses" like cardiovascular disease, strokes, cancer, diabetes, and obesity.

While these statistics are hardly new to health care wonks, they're worth reconsidering in light of Congress' bailout plan. Seventy-five percent of $2.4 trillion is $1.8 trillion -- meaning that, annually, chronic diseases cost us almost three times as much as the current bailout bill. The nation's total health care bill is the equivalent of passing a bailout, saving Bear Sterns, nationalizing Fannie and Freddie, and propping up AIG twice every year.

If nothing else, the Wall Street implosion puts the sheer scale of America's health care woes in perspective. As such, Thompson and Thorpe agree that the economic meltdown is a powerful wake-up call to the American public. During the call, Thompson said that he thinks that citizens are "absolutely frustrated with Congress and Washington avoiding problems," and are thus likely to begin demanding action on long-term crises like health care. The need for reform "is hung around the neck of Democrats, Republicans, George Bush and everybody else, and Wall Street," he said, and the American public wants to "find an answer." Thorpe agreed, saying that outrage surrounding the economic crisis has "stirred a bee's nest" of dissatisfaction that will "elevate the interest and desire to do something on healthcare reform in 2009."

In other words, our economic crisis highlights the danger of senseless spending and lays bare the catastrophic danger that comes with ignoring the rumbling of a financial crisis. As Thompson and Thorpe see it, voters are deciding that they're mad as hell -- and health care is another area triggering their wrath.

Dr. David Kibbe of the American Academy of Family Physicians agrees. Also writing on The Health Care Blog, Kibbe argues that Americans' feelings of betrayal over Wall Street's greed will spill over into health care. Kibbe notes: "[A]ny sentient observer of this [economic] trickery on such a massive and systematic scale will start to ask questions about who else among our highest paid and most trusted professionals might be lying to us about the well being we place in their hands.   Who else [besides financiers,] they will ask, is making money off our trust in them? Who else, they will ask, is skimming money off the top of an inflated and ultimately doomed -- because unsustainable -- market for complex services? Where is the next bubble that privatizes profits but socializes risk?"

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Niko Karvounis is a Program Officer with The Century Foundation in New York City, where he works on issues of socioeconomic inequality and health care. He is a regular contributor to Health Beat, the Foundation’s health care blog.

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