To improve health and cut costs, UnitedHealth spending $150 million on affordable housing

Having affordable housing is linked to better health outcomes so insurance company UnitedHealth is spending some money on affordable housing units:

The firm is taking an unusual step for an insurance company –investing $150 million to build low-income housing in a dozen states…

UnitedHealth’s big push into housing isn’t charity. The company derives benefits from it, too, including tax credits.

But Kate Rubin, vice president of social responsibility for UnitedHealth Group, says the real payoff is longer term.

“Studies show that without stable homes people are sick more often,” says Rubin. “There’s more undiagnosed illness and people are more likely to seek care in emergency rooms.”

That’s expensive for insurance companies, for patients and for the rest of us, who pay the price in higher premiums and taxes.

It will be interesting to see how many units UnitedHealth is able to construct for that kind of money. It seems like the biggest payoff would be if they are able to have sufficient economies of scale, enough units to see significant long-term returns.

This also hints at the need for affordable housing more broadly in the United States and the inability of others to construct it. Public housing in the United States is limited and has had a variety of issues for decades. Lower levels of government, whether states or metropolitan regions, or local government, have had either a hard time finding the right mix of regulation and incentives or haven’t paid any real attention to affordable housing. If few organizations are stepping up to provide or prompt public housing, perhaps insurance companies are a good bet.

Sociological study: American individualism limits support for national health care

A new sociological study argues that the American cultural values of individualism and choice are behind the lack of support for national health care:

American obsession with individual rights and choice are killing any chance of a universal solution on health care, according to an analysis in the authoritative trade publication “Current Sociology” which argues that Europe’s health care is the model the U.S. should follow…

Other “western nations,” he said, are smarter on the issue because they have an all-for-one approach and aren’t obsessed with choice and individualism. “These countries have more communitarian- and solidarity-based value systems, their populations are much more willing to live with what Americans would see as an unfair system, in other words, one that sets limits on medical care for those with coverage,” said Blank…

“The U.S. is the prototype of an individualistic society. Although individual rights are emphasized in all western countries, in the US rights have been elevated to a status of supremacy over collective interests. Moreover, by rights Americans mean negative rights, and, as a result, they are hesitant to sacrifice perceived individual needs for the common good. Thus, there is no guaranteed universal coverage, but also no limits on what healthcare individuals can buy if they can afford it. This cultural tenet goes a long way to explain why the US expends so much more of its GDP on healthcare than other developed countries without providing universal access.”

My translation: who wants to tell individuals that they can’t get certain kinds of health care? Of course, not everyone has these options now but Americans like the idea that people could have these options. I assume opponents of European style health care would not call these traits individualism (which often has negative connotations) but rather people interested in liberty and freedom.

This also reminds me of research from scholars like Barry Schwartz (see The Paradox of Choice) that suggests having more choice can actually have negative consequences. Faced with too many options, some people can be paralyzed and feel worse after they make a choice compared to people choosing among more limited options. I hear tons of radio commercials for hospitals and medical centers for serious and not so serious conditions – do these all really lead to better medical outcomes in the long run?

At this point, it looks like there is some time to still debate the different value systems behind different health care proposals. I wonder, however, if there will be a turning point soon where economics or other factors (Supreme Court decisions?) will force the end of such ideological debates.

Sociologist argues carers need more support

In the high-stakes discussions taking place in a number of countries, a British sociologist argues countries should support one group more: carers.

Some 6.4 million people in the UK care for sick, disabled or frail friends and relatives – and they’re often punished for doing so. Many of them pay a “triple penalty”: damage to their health; a poorer financial situation; and restrictions in everyday life. The intrinsic unfairness of this situation is made all the more remarkable by the fact their work and effort saves the public purse £119bn a year – more than the whole budget of the NHS. But in the current climate of public sector cuts, how can we make their lives better without costing the earth, and support those who wish to care without giving up paid work?…

Our report New Approaches to Supporting Carers’ Health and Well-being: evidence from the National Carers’ Strategy Demonstrator Sites Programme highlights ideas that work to help carers stay well and healthy, to get a short break or chance to meet their own needs. For carers struggling to make ends meet, small investments in gym memberships, laptops or short holidays make a real difference, yet cost only a fraction of what needs to be spent if their care breaks down or cannot be sustained.

Special health and wellbeing checks spotted many physical and mental conditions, including diabetes, depression and cancer, which – as carers often put their own needs second to those of others – were previously undiagnosed. When GPs or hospitals work together with social services and voluntary agencies in their area, support for carers can really improve at a comparatively small cost…

Circle researchers have consistently made the case for better carer support. Our work has informed policy developments under both Labour and coalition governments. Unsupported, carers risk exhaustion, isolation and stress – yet when valued and offered flexible services, many see caring as among the most rewarding and important things they have ever done.

In the debates over health care costs in the United States, I haven’t heard much about carers. I wonder if some might argue that these caring duties shouldn’t be rewarded by the government but rather are familial or relational duties. But, if health care costs are a public problem, might it not make sense to invest here?

I wonder how millennials feel about this. Frankly, it probably hasn’t entered their minds much.

If sociologists have some interest in concepts like the sick role, do we have notable scholarly works addressing the role of carers?

New Urbanists explain side effects of sprawl

Two New Urbanists, Andres Duany and Jeff Speck, argue that sprawl contributes to two more issues that some might not think of: climate change and rising health-care costs (obesity and car crashes).

h/t The Infrastructurist