Cratchet, you're fired!

The holiday season is upon us. For many, the lights are not quite so bright as in years past. Parents wrap gifts for the kids, emotions contained amidst a continuous flood of depressing economic news heaped upon them by the media. 401K statements, which were once greeted with anticipatory grins as envelopes were torn open are now things to be avoided. Bad news can wait another day.

Setting aside the blatant financial incompetence demonstrated by banking and investment professionals, my concern as it relates to caregivers and those in our charge has to do more with health care and, most importantly, health insurance. In a nutshell, it stands to reason that we're going to see a sharp increase in the number of families unable to find and/or afford health insurance.

America is undergoing a "job cleansing" of nearly unprecedented proportions. In November alone, non-farm payroll employment fell by 533,000. That followed similar large drops of 403,000 in September and 320,000 in October. In just three month, the US job market shed more than 1.2 MILLION jobs. The unemployed now number 10.3 million... nearly 3 million more than in December '07.

Just wait until the December figures are released. As bad as they are sure to be, January will be worse. Lots of companies seem to wait until right before New Years to announce layoffs.

As stated earlier, my concern in the midst of this crisis is the availability and affordability of private health insurance. Front and center during much of the recent presidential campaign, health insurance seemed to fall back on the list of national priorities once the economy began to crumble. But out-of-sight, out-of-mind isn't going to keep this problem under wraps for long. As people lose their jobs, many will be offered the opportunity to continue their health insurance benefits via COBRA. Some will elect to pay for COBRA coverage, but many will not. COBRA is normally quite expensive, much more than the share of any health coverage the employee normally would have to pay. And, for many, much more than they can afford when making the adjustment to surviving on their unemployment check.

My guess is that many of the newly unemployed are going to find themselves venturing into the murky waters of private insurance. What they find will shock any of them who, like so many, have some sort of pre-existing condition such as MS. In many cases, a caregiver will learn that while he or she may very well be eligible for health insurance cost-wise on par with what they may have paid while employed, they will be shocked to find that no such welcome mat is rolled out for their partner. Indeed, in the few states that mandate insurance be made available to everyone, there are little, if any restrictions on the conditions attached to that insurance nor on the rates charged.

There's not much that can be done to prevent the pain that our economy is preparing to inflict on the uninsured and soon-to-be-uninsured. But we can learn from this and take steps to make sure that it does not happen in the future. One way to do this is to begin the systematic uncoupling of health insurance from employment status.