Catastrophic health insurance—already endorsed by the President and now on the fast track to approval in Congress—will soon shift the economic burden of huge unexpected medical bills from the elderly to the federal government. But already some members of Congress are complaining that a much more inclusive public health-care plan is needed. Unfortunately, most policymakers forget how much the nation’s health bills have been affected by the fragmentation of the family.
In recent years, an increasing number of young people are postponing marriage until they have had a chance to taste the excitement of the singles scene. But the fern bar and the health spa may turn out to be way stations for singles headed for the hospital—or cemetery. Writing recently in Social Science and Medicine, Drs. Catherine K. Reissman and Naomi Gerstel point out that singles suffer from higher rates of disease, disability, mental neuroses, and mortality—a pattern that holds for both sexes and for every ethnic group.
Divorce brings its own health problems. According to Professor Harold Morowitz of Yale University, “Being divorced and a non-smoker is slightly less dangerous than smoking a pack a day and staying married,” adding facetiously that “if a man’s marriage is driving him to heavy smoking, he has a delicate statistical decision to make.” Divorced and single people also stay in the hospital longer than married people suffering from the same illnesses, and the risk of cancer and heart disease is much higher among the single and divorced than among marrieds. This is not good news at a time when almost half of American marriages end in divorce.
More than half of the mothers of small children now work, but few realize the health risks of day care. A 1984 study in the Journal of the American Medical Association concluded that day-care children are 12 times more likely than children in traditional homes to catch the dangerous disease responsible for most cases of childhood meningitis. The American Academy of Pediatrics (AAP) also recently reported that “outbreaks of gastroenteritis caused by bacteria, viruses, and parasites; . . . hepatitis A; and vaccine-preventable diseases have been documented in day-care groups.” Many observers now predict that rising costs will eventually cause the collapse of Medicare. According to Alexa Stuifbergen of the University of Texas at Austin, “Policymakers are increasingly looking to the family as a hedge against the rising cost of health care services.”
This rediscovery of family responsibility could mark a healthy first step in reshaping public health policy. But unless this move is matched by tax reforms that support the traditional family, the family will be pushed to the end of the line to receive government benefits and pushed to the front of the line to pay for those benefits.