Today is Christmas, and although millions of people across the country rejoice with friends and family, there may be some eerie undertones spreading through the masses.
The stock market crashed. Big time. The Dow Jones Industrial Average took a nosedive 653 points. Experts state U.S. markets across the board took historical losses, dating back to the Great Depression in some comparisons. This feeling of unease is inflamed by a vicious federal government shutdown that delays paychecks and shuts down important government services.
If the United States slides down the dark road into a recession, what do we really lose in terms of our healthcare? It's an interesting question because the conversation usually centers around how rising healthcare costs can ultimately lead to a recession. My proposed question puts that to the side and looks at the structural integrity of American healthcare. Let's dig in by evaluating some of the effects of The Great Recession.
Healthcare employment
There was something unique in the air from the years of 2007-2009: my country and I were both going through an awkward phase. I was around 11-13 years old, so...yeah. And the U.S. had an exploding unemployment rate--up to 10%. The Bureau of Labor Statistics reports that "healthcare employment expanded, increasing by 852,000 jobs, or 6.6 percent." Indeed, the United States gained healthcare jobs during The Great Recession. In fact, from 2001-2014, healthcare jobs increased by 31.6%, and when you compare that number to all-sector job growth, that accounts for 56.1% of national growth!
Insurance coverage
Get ready to change your mood. Over five million Americans became uninsured during the recession. Healthaffairs.org states that while all demographics were affected, White Americans experienced most of the growth in uninsured individuals, while Blacks and Hispanics "experienced large drops in employer-sponsored insurance coverage but had greater increases in Medicaid and CHIP coverage because they had lower incomes." Inversely to its timed necessity, public mental health agencies also saw their services drastically cut across multiple states. After almost a full decade of improvements to mental health services, these funding cuts were nothing short of disappointing.
The American and His/Her Healthcare Decisions
Even after only one semester of medical school, I have heard a lot about empowering the patient. But what happens when healthcare providers cannot empower patients because they simply never come in? They cannot afford care or think they cannot afford treatment. We saw that in The Great Recession. A paper out of The Stanford Center reports that there were significant increases in Americans forgoing dental care, prescription medications, and eyeglasses.
Let's make this clear: an increasing number of Americans foregoing healthcare poses a major threat to public health. No doubt. However, statistical analyses repeatedly show that "health does not decline in any precipitous way when the economy does," and using the indicators utilized in the Stanford study, "most Americans did not have immediate negative health impacts." These results also do not suggest that health affairs run optimally or even close to so during a financial crisis, but they should provide solace to the Americans who are targeted when a politician predicts a healthcare apocalypse when their legislation is not passed.
The Wrap Up
I am not a healthcare advisor nor am I an economic expert. What I can say is that I know data over rhetoric when I see it. If the next recession--whenever it is--is anything near how terrible The Great Recession was, we will certainly face setbacks. We will undoubtedly cut funding in healthcare sectors that make us cringe. Healthcare costs will get more expensive--that's okay. I'll take that over many terrible alternatives that directly affect the average American's health.
So, what does healthcare really lose if we enter a recession? A temporary severe distrust in the system, I suppose. A fear to listen to the paramedic who strongly suggests you are experiencing an MI instead of heartburn. A fear that an operation will leave you financially disadvantaged (even more so than usual). At the end of the day, health outcomes supersede costs. Settled.
For the country as a whole, we will be alright.
Sources:
Burgard, Sarah. “Health, Mental Health, and the Great Recession.” Health, Mental Health, and the Great Recession, Oct. 2012. DeCambre, Mark. “The Stock Market Just Booked Its Ugliest Christmas Eve Plunge - Ever.” MarketWatch, MarketWatch, 24 Dec. 2018, www.marketwatch.com/story/the-sp-500-is-on-the-verge-of-tumbling-by-the-most-it-has-ever-fallen-on-christmas-eve-2018-12-24. “Healthcare Jobs and the Great Recession : Monthly Labor Review.” U.S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, 1 June 2018, www.bls.gov/opub/mlr/2018/article/healthcare-jobs-and-the-great-recession.htm. Holahan, John. “The 2007–09 Recession And Health Insurance Coverage.” The Physician Payments Sunshine Act, www.healthaffairs.org/doi/10.1377/hlthaff.2010.1003.
Ezra Guttmann is a medical student at the Touro College of Osteopathic Medicine. There is no medical advice on this website.
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