commentary

(United Press International)

October 11, 2005

Health Costs of Katrina

by Dana P. Goldman and Mark A. Schuster

Hurricanes Katrina and Rita took a devastating toll on their victims, tragically killing and injuring some and leaving many not only homeless but jobless — deprived of paychecks and employer-sponsored health insurance. Suddenly unable to pay their medical bills, these people — like many others who were poor and lacked health insurance before the hurricanes — now face a health care crisis.

As these Americans struggle to cope with the terrible impact of the two hurricanes, our government has the opportunity to make it possible for them to get the care they need.

With an estimated $200 billion in federal aid expected for recovery efforts from Katrina and additional funds for Rita recovery, federal assistance needs to be used to help meet the needs of survivors who can't pay for health care on their own.

Members of Congress and most federal employees need look no further than their own health insurance program to find a model to help the victims of Katrina and Rita. The Federal Employees Health Benefits Program provides insurance coverage to 8 million current and former federal employees and their families.

The federal program has been around for more than four decades and is well regarded for providing excellent access to physicians, health plans and rural health care. All federal workers — regardless of geographic location — have access to at least 12 health insurance plans, including several nationwide plans.

Congress can help storm survivors by creating a health insurance voucher program to serve individuals and families displaced by Katrina and Rita. The voucher could pay the full cost of enrolling in a reasonable health plan in each family's geographic region.

Vouchers are highly portable and would allow survivors, regardless of where they may choose to relocate, to seek care from health care providers. The vouchers could also cover the cost of a comprehensive physical and mental health assessment.

By issuing vouchers, the government could use storm recovery funds to pay for victims' health care, rather than placing further financial burden on the already-strained public health systems of communities that have taken in storm survivors. The idea of disaster assistance delivered by private health plans is also ideologically appealing to many in both political parties, so passage by Congress is feasible.

Who would be eligible? It does not make sense to place onerous restrictions that require lengthy paperwork on this insurance program. Many victims have little or no documentation to prove their residency or economic status. Streamlined enrollment forms would resemble the forms the Federal Emergency Management Agency already uses to determine who gets disaster assistance.

Vouchers should be offered to anyone who was forced to evacuate his or her home and lacks access to other health insurance. The vouchers could be good for a limited time period, such as for a year of coverage.

Congress could reconsider the program a year later, depending on needs at that time. We estimate such a program would cost less than $2 billion for victims of Katrina, with a smaller amount of additional funds for victims of the less-powerful Rita. Dollar for dollar, this investment could have a greater impact on saving lives and improving people's health than other proposed recovery efforts.

The economic toll from Katrina and Rita is staggering. But the damage goes well beyond property and income. If America doesn't provide needed health insurance to those now without coverage, the health consequences of the two hurricanes will only continue to grow — and become more painful and expensive.

One of the primary roles of government is to serve as the insurer of last resort. We should remember that storm recovery is not just about rebuilding roads and walls and roofs. It's also about rebuilding lives.

Outside View © 2005 United Press International


Dana P. Goldman, PhD, is director of health economics and Mark A. Schuster, MD, PhD, directs maternal, child and adolescent health at the RAND Corporation, a nonprofit research organization. Dr. Schuster is also professor of pediatrics and public health at UCLA.

This commentary originally appeared in United Press International on October 11, 2005. Commentary gives RAND researchers a platform to convey insights based on their professional expertise and often on their peer-reviewed research and analysis.