The Coming Age of Unwellness

The lead paragraphs in this article, which appeared yesterday on the Guardian (UK) website, was based on a Reuters report on the latest data on the uninsured from the Centers for Disease Control. It turns out Reuters confused two sets of data; the CDC actually shows a continued rise in the uninsured . . . from 41.1 million in 2005 to 43.6 million in 2006. The Census bureau previously reported the 46.6 million number for 2005, which has since been lowered to 44.8 million. The Census estimate for 2006 will be released in August. It is projected to also show a rise, meaning things are still getting worse. Anyway, the larger point of the story still holds: the U.S. health care crisis will be exacerbated in the coming decade by a rising number of young people in need of health care services because of rising obesity and asthma rates.

Pity poor Michael Moore. With Cannes-sensation “Sicko” set to open amid more press attention than an Angelina Jolie sighting, the federal government’s Centers for Disease Control and Prevention chose this week to release the latest data on the U.S. population without health insurance. It’s down to 43.6 million people in 2006 from 46.6 million the previous year.

Is this a government plot to deflect attention from the core message of his documentary: that America’s profit-driven health insurance system is immoral and needs to be replaced with a national health service along the lines of the western European, Canadian or (let’s admit it, this took chutzpah) Cuban models?

The CDC news isn’t as good as it seems.

Their latest tally of the ranks of the uninsured remains two million persons above 2001, the last time the business cycle peaked. Even on a percentage basis, the numbers are up with the latest survey showing more people – 14.8 percent or one in every seven persons – running the risk of personal bankruptcy and inadequate care because of no insurance than when President Bush took office. While it’s probably not the president’s fault that employers are bailing out of the U.S. job-based health insurance system, it is fair to blame him for a lost decade in dealing with this escalating crisis.

And despite this latest dip in the ranks of the uninsured, the crisis is only going to get worse in the coming decade. According to a new report out today, the health care system faces an unprecedented public health time bomb: the next generation of young people is going to need far more in the way of health care services than previous 20- and 30-something generations.

You’d think that with 77 million baby boomers moving toward retirement where taxpayer-financed Medicare picks up the health care tab, employers would get some breathing room. Younger workers generally require much less health care, which translates into lower insurance costs for those who employ them.

But the study in this week’s Journal of the American Medical Association documents a grim prognosis for the next generation of workers: they are going to be fatter, more asthmatic, and suffering from far more neurological disorders than any previous generation of American young people. And its young people who are most likely to go without health care coverage.

“We’re going to see increased health expenditures for people in their 20s,” said James Perrin, a professor of pediatrics at the Harvard Medical School and lead author of the report. “They’ll be coming to institutions for health care without any means of paying for it.”

How bad is it? About 18 percent of American children and adolescents are now considered obese, up from just five percent in the early 1970s when the baby boomers were entering the workforce. That translates into earlier onset of type 2 diabetes, hypertension and heart disease, chronic conditions that usually require ongoing, often lifelong medical interventions. With obesity already accounting for 10 percent of medical expenses, a doubling of adult rates will add $100 billion a year to health care costs, according to the study.

Childhood asthma persists into adulthood for about a quarter of all persons afflicted with the wheezing disorder. And today, about one in every 11 young persons has asthma, double the rate of the 1980s. Again, that translates into millions of young workers who will need immediate health care assistance as they enter the workforce, even as they lose work days and productivity because of their condition.

Ditto for neurological disorders like attention deficit and autism, which were virtually unheard of in the 1960s and 70s. Perrin and his fellow authors admit that some of the reported rise in these conditions may be associated with diagnostic creep. But whatever the cause, children who need treatments are much more likely to turn into adults who need treatment, and that translates into higher health care costs. “Employees with mental health conditions generate about three times the health care costs of other employees,” the authors noted.

Finally, blacks, Hispanics, Native Americans and low-income whites suffer far higher rates of obesity, asthma and attention deficit disorder compared to their better-off counterparts. These are precisely the groups in society most likely to be without health insurance.

The social factors behind these escalating childhood and adolescent epidemics are well-known: rising income inequality, poor diet, unrestricted television junk food advertising aimed at children and young adults, sedentary lifestyles, rising rates of pre-term and multiple births, environmental exposures – especially for poor, urban children. Universal health care does nothing to solve any of these problems.

We’ve already been told that if the social factors leading to these epidemics go unaddressed, the next generation of Americans may be the first in our history to lead shorter lives. What this latest study points out is that they’re also going to consume a lot more health care all along the way.

Posted by gooznews at June 28, 2007 08:07 AM