Health care’s post-recession toll

According to the Congressional Budget Office, the rate of unemployment has been above 8 percent since February 2009, making this stretch of high unemployment the longest since the Great Depression. The CBO expects it to remain there until 2014.

Health care, long considered immune from economic cycles, have felt this deeply. About 10 million lost employer health insurance between December 2007 and June 2009. About 40 percent of Americans had trouble paying medical bills in 2010. More than half of patients delayed care because of cost in 2011. Even 1 out of 4 insured households had problems with medical debt. All of this has contributed to a slower rise in medical inflation.

Hospitals have felt this downturn deeply as well. According to the American Hospital Association, 90 percent say charitable giving is down and do not expect it to recover until 2014. Two out of 3 have delayed capital projects and 1 out of 4 have cut services.

The question is whether the slowdown is structural or cyclical. Health-care spending generally rises when the economy improves. However, there is evidence that the rapid rise in high-deductible health plans is becoming a factor. Those with high-deductible plans are 3-4 times more likely to delay care. About half of that foregone care is considered an “unmet need.” Self-diagnosis is becoming increasingly common in U.S. households.