Don't Let the Economy Endanger Your Health

Hard times aren’t just causing Americans to cut back on shopping, vacations, and other pleasurable activities. One of life’s essentials-—adequate medical care—is being affected, too. A startling new survey from the American Heart Association (AHA) finds that 57% of people say that the economy has affected their ability to take care of their health. The impact appears to be greatest on young adults, women, and people with low incomes. But even one-third of those surveyed who earn more than $75,000 a year say that they are feeling squeezed.

People Are Forgoing Lifesaving Care

Among the changes in behavior: 10% have stopped or diminished their use of medicines to lower cholesterol, manage asthma, or treat other chronic conditions. Meanwhile, 13% skipped their flu shots last year, and 18% are opting to forgo potentially life-saving exams such as mammograms.

“People under financial stress don’t take care of themselves as well,” says Dr. Timothy Gardner, a cardiac surgeon and president of the AHA. “If they end up neglecting medication or skipping dental cleanings, they’re adding to their health risks.”

Pressure on families’ medical budgets has been building for decades. In 1970, U.S. spending on health care amounted to 7% of national output. By last year, it was 17%. In fact, 2008’s health outlays of $2.4 trillion exceeded our spending on housing or food. A large proportion of the total reflects our frequent use of advanced specialty care, in which American medicine leads the world. But according to the World Health Organization, our country ranks behind 30 others in promoting the simple preventive care, good nutrition, and exercise that enable people to live longer. Average life expectancy in the United States is about 78 years, according to the National Center for Health Statistics. In Japan, it is 83 years; even Costa Rica does slightly better.

Prevention Must Be a Priority

U.S. health care needs to shift its focus away from treating illnesses and problems and move toward prevention instead, declares Kathleen Sebelius, Secretary of Health and Human Services. “We cannot achieve our ultimate goal—a healthier nation—unless we shift away from a sick-care system,” she said at a Senate hearing earlier this spring. “We pay for emergencies, not the care that prevents them, with little emphasis on the responsibility each of us has in keeping ourselves and our families well.”

Some smart employers, health plans, and medical providers are experimenting with ways to save people’s health dollars or use them more effectively. Their goal is to make it easier, even in a recession, for families to receive the care they need.

In Bethesda, Md., Jill Berger is making preventive measures, such as mammograms and childhood immunizations, free for nearly 160,000 people. Berger oversees benefits at Marriott International, the hotel chain. In 2006, she reconfigured most of the company’s health plans to eliminate the $10 or $20 co-payments associated with such procedures.

The result: a 20% increase in the number of employees or their dependents receiving regular preventive care. Marriott has analyzed the effects of such changes and discovered that extra money spent on pre-emptive efforts usually pays off in the form of reduced hospitalizations later on. “We had to do it,” Berger says. “It helps our employees in their lives and helps them be more productive at work.”

Dr. Lonny Reisman, chief medical officer at the health insurer Aetna, says 20% of employers have retooled their health benefits so that people receive concrete incentives to follow through on preventive care. In some cases, patients who have already had one heart attack are provided with free cholesterol-lowering medicine in order to reduce their chances of suffering a second attack. “ All you need to do is treat 50 people who might not have been on the right medication,” Dr. Reisman says, “and you’ve prevented one heart attack. That’s a powerful reason to do this.”