An Avalanche Starts Quietly

Unemployment is up as full-time workers lose their jobs. Unreported unemployment involves workers who, a year ago, had full time jobs but now may be only working two-thirds or half time. And then there are the unemployed who used to make do by occasional agency or contract work but no longer can find any meaningful income. According to the Morningstar video I watched this morning, "Unpacking the Unemployment Numbers," we are not yet at the bottom of our national financial crisis. So what does all of this have to do with our health care system?

Those who are unemployed usually lose their health insurance (while they may have Cobra guarantees of the capacity to extend their former employment health insurance, without income they cannot afford expensive monthly payments). Minor illnesses don't require medical care. Major illnesses, injuries, and pregnancy require expensive professional services. State Medicaid programs are broke and dysfunctional. Lower employment means lower contributions to the Medicare fund which, a year ago, was predicted to be in precarious condition in 2019.

The only bright spot in the nation's employment picture is health care. However, not-for-profit institutions (many of which have no access to the financial market in this depression and if they did, would have to pay high rates of interest) do not have the capacity to subsidize health care for all of America. For-profit, investor-owned institutions are structured to generate profits, not losses. In short, we are in a period of diminishing gross domestic product coupled with stable or increasing demand for health services.

Expect your newspapers and television reports to headline health care inflation since the denominator (gross domestic product) will be smaller and the numerator (total health care costs) will be flat or increased. Listen for dire predictions of Medicare insolvency as the Medicare tax yields less revenue and the aging population requires increasing services. Watch and listen for politicians proclaiming doom and gloom for a national health care system based on erroneous analyses. It's quiet now, but it's coming.