Morrison Memo: Debate over insurance reform is healthy

The contentious debate over health insurance isn’t unique to Congress, it’s occurring on a daily basis all across the nation and in Arizona:

To the worker with no health-care benefits: “Should I pay the light bill or go the doctor’s to check on this nagging cough?”

To the unemployed worker: “Should I continue to pay COBRA or apply that dollar amount to my late house payment?”

To the union worker: “Should I consider striking or just be happy to have a job with benefits and accept the fact I have to pay more for my health insurance?”

Too many Americans are living without health insurance.

How many? Estimates vary, but the Census Bureau’s annual report released in September puts the figure at 46.3 million Americans in 2008. The actual number is likely higher since it does not include the hundreds of thousands of layoffs this year that resulted in loss of employer-provided insurance.

Arizona has one of the highest levels of residents without health insurance – almost 20%, or one in five residents, as noted in the 2009 report, Truth and Consequences: Gambling, Shifting and Hoping in Arizona Health Care.

By and large it’s not the very poor doing without insurance, since many are eligible for Arizona Health Care Cost Containment System (AHCCCS) coverage, Arizona’s version of Medicaid. No, it’s your working-class neighbor – if not yourself – who’s living without coverage. Eight out of 10 Arizonans without insurance are in households where one or more members works at least part time, according to the Truth and Consequences report, prepared by Morrison Institute for Public Policy. And as more full-time employees get laid off, along with the disappearance of dependable paychecks so go their employer-provided health care coverage.

The high cost of COBRA (Consolidated Omnibus Budget Reconciliation Act) prevents many unemployed Arizonans from purchasing the federal government’s stop-gap insurance program, which was never intended to provide long-term coverage.

In Arizona, where average unemployment insurance benefits are $937 a month, the average family COBRA premium is $1,084 – or 116% of UI income, according to a 2009 study by Families USA, a national organization for health care consumers.

In response to the worst recession of our time, the federal stimulus package reduces the COBRA premium for recently unemployed workers so they pay just 35 percent of the usual amount – but only for up to 9 months, at which time COBRA can again charge 102 percent of the premium the employee and employer collectively were playing for insurance.

With their inherent and colossal complexities, health care reform and cost containment are two issues we’ve ignored for too long, and understandably may be a bitter pill for some to swallow all at once. But a fiery debate in the Senate to find the right prescription for the ailing nation is preferred to the daily debate too many Americans face: Groceries or health care.

Report Reveals the High Cost of Arizonans Living Without Health

“I have a lot of friends who don’t have it (health insurance). I think they’re dealing with it like I am: Hoping we don’t get sick.”
Those are the words of Josh, 47, who suffers from hypertension and unemployment.
His story and many others are told in Truth and Consequences: Gambling, Shifting, and Hoping in Arizona Health Care, a new report by Morrison Institute for Public Policy, St. Luke’s Health Initiatives, and the L. William Seidman Research Institute at the W.P. Carey School of Business.
The report, released today, examines the true costs of so many Arizonans – almost one in five – living without health insurance.
“Health care is expensive, but the costs of poor health can be enormous,” said Arizona State University economist Kent Hill, who contributed to the report.
Treatment costs alone for chronic disease in Arizona are estimated to be $4.2 billion, or 2.3% of the gross state product. By 2023, projected costs for major chronic diseases are $99 billion, of which more than $25 billion could be avoidable.
But without health insurance, the personal stories of so many Arizonans will continue to paint a gloomy picture of lost dollars, lost potential, and lost opportunity:
· “At a public health clinic, you have to go wait in line. I try to avoid going because of cost.”
· “What if I got hurt? What’s going to happen to daughter?”
· “It’s very frustrating. Especially when you know you’re sick but you can’t get anything done about it.”
Truth and Consequences seeks to change that portrait by presenting recommendations to Arizona’s policymakers that could help the state fare better in the future so that Arizona can stop taking risks on residents’ health and health care.
Read the full report at http://morrisoninstitute.asu.edu

Arizona's second-class status for behavioral health care

Some of Arizonans’ most common and destructive illnesses—those of the brain—are failing to receive adequate treatment due to a combination of modern governmental gridlock and a centuries-old philosophythat separates the mind from the body.
That is among the findings of a new publication by Morrison Institute for Public Policy at Arizona State University.
"Arizona’s Mind-Body Problem: Mental Health Systems and Choices" is the latest issue in the Institute’s Forum 411 policy briefing series.
The eight-page report looks at why mental health care has been relegated to second-class status, resulting in markedly fewer benefits for Arizonans with private insurance and a public system that has long has been criticized as underfunded, understaffed, and highly uneven in its quality of care.
How severe is the gridlock?
Arizona’s system, which spends more than $1 billion annually, has been embroiled in a major class-action lawsuit for 28 years.
National studies have repeatedly shown that mental disorders, from phobias and panic attacks to schizophrenia, are widespread throughout the population, inflict suffering on millions of individuals and their families, and cost society billions in lost production.
Most people still shrink from the stigma of acknowledging mental problems, and most health care providers still labor under the false premise — refuted by the U.S. Surgeon General and other authorities — that problems of the mind should be dealt with separately from problems of the body.
Arizona’s Mind-Body Problem offers a range of policy choices, ranging from combating the stigma of mental illness to merging the public system with Arizona Health Care Cost Containment System (Arizona's version of Medicaid).
To read the full version of Arizona’s Mind-Body Problem, go to http://morrisoninstitute.asu.edu/
This Forum 411 on mental health is scheduled to be presented on June 17 to the Arizona Senate Committee on Healthcare and Medical Liability Reform.
Sponsored by Westcor, Forum 411 is a quarterly briefing series offering policy, business, and community leaders information on Arizona’s critical issues.
Morrison Institute is an independent and non-partisan public policy research organization based at Arizona State University as part of the College of Public Programs. The Institute is located in downtown Phoenix.