Impact of the Economy on Health Care

Résumé du livre

In the United States, the economy shapes the complex interactions among employment, health coverage, and costs, as well as financial access to care and health outcomes. In economic downturns, few employers drop health coverage or restrict employee eligibility. More commonly, they reduce costs by changing benefits and cost-sharing provisions. Employees in low-wage jobs, those working in small firms, and those in certain industries have been far more likely than others to have been uninsured when they lost their jobs, but this recession is affecting a broader swath of the workforce. Research on the effects of economic cycles on health status is ambiguous. Apart from the current economic downturn, the design and cost of employer-sponsored coverage have also changed over time, and more people are finding work that does not offer health benefits. The recession has kept patients from seeking inpatient and elective services. Physicians and institutional providers are also seeing more patients who cannot pay for their care. Physicians and nurses appear to be re-entering or remaining in the workforce longer than previously planned, and many physicians are establishing new financial arrangements with hospitals and other provider groups to help ensure a steady income. Two dominant structural trends--growth and consolidation--are likely to continue to reshape health care delivery, but reform legislation could significantly affect the speed as well as direction of changes.