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Return on Investment

November 23, 2004 By Charley on the MTA

Looks like Mitt tried to get out in front of the health care issue, with the support of some small business groups. I haven’t yet seen his plan, but I’ll be looking at it in the context of the report by the Urban Institute for the Blue Cross Blue Shield Foundation. The BCBSF report has a manageable executive summary, with these critical paragraphs:

Expanding coverage to the uninsured in Massachusetts would result in economic
and social benefits due to improved health of $1.2 billion to $1.7 billion. Thesebenefits are based on estimates of the effect of the lack of health insurance onhealth, including lower mortality and morbidity and lower wages and productivity.We relied on work conducted by the Institute of Medicine (IOM) that estimatedthe value of a year of healthy life as well as the number of years the uninsuredwould lack coverage. The IOM estimated the annual discounted present value oflost health up to age 65 due to lack of insurance ranged from $1,645 to $3,280per uninsured person. Applying the midpoint of this range to the two estimatesof the number of uninsured in Massachusetts results in an estimate of the total value in improved health from covering the uninsured in the range of $1.2 billion to $1.7 billion.

These estimates of economic and social benefits, i.e., the value of better health, including the higher wages and productivity that the newly insured would experience
if fully insured, exceed the incremental cost of expanding coverage by a ratioof about 3:1. The many other benefits that would come from universal coverageare difficult to quantify. They include reduced financial uncertainty and depletionof assets such as bankruptcy; improved workplace productivity and higher taxpayments; improvement in the quality and availability of personal health services,particularly emergency room care; reduced pressure on the public health system;and lower costs of other public programs such as Medicare and state and federaldisability programs.

So there’s a significant upfront investment, with a big monetary and moral payoff in the future — i.e. healthier people create more economic value, and it’s just the right thing to do.

Is the Governor willing to make this big step, or is he too timid? I know how I’m betting… More on this later.

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