THE SOCIAL COSTS OF DANGEROUS PRODUCTS:
AN EMPIRICAL INVESTIGATION
METHODOLOGY FOR EXTENDED COSTS
I.
Introduction
In most studies that estimate the costs associated with dangerous products, the range of costs
considered are direct costs only – and usually costs to the company that produces the hazard.
This paper, on the costs of dangerous products, looks at the medical and productivity costs of the
victim, but it looks at many other costs as well. It reviews a range of out-of-pocket costs to the
victim not usually considered. It includes the many costs to the family unit and to other
individuals in the family of the victim. It considers costs to employers of family members and
also costs to federal, state, and local governments. The impact of one disabled or sick individual,
or the impact of one fatality, can affect many people and many organizations. These costs may
be as high or higher than the traditionally measured costs of most studies.
II.
General Method
Scenarios were developed based on examples and circumstances in the literature. Family
members of victims lose employment, housing, and opportunities to pursue education. As a
result they may need help and support for far more than their medical bills. Society incurs far
more burdens than simply lost work time of the injured party. Three scenarios were developed
for each of 3 case studies in the paper: Ford/Firestone rollovers, Baycol, and three-wheeled
ATVs. The scenarios developed were higher, medium, and lower levels of family impact. In all,
9 scenarios are incorporated into the paper. Clearly the monetary impact would differ if the
scenarios were different. The scenarios were developed to be as realistic as possible and every
time an assumption was made, an effort was made to be conservative. In addition, the monetary
impact would have been different if the sources were different. In each case, an effort was made
to have the most credible and recent source possible. In most cases government or peerreviewed journals were used. In a few cases this was not possible. All sources are clearly listed.
III.
Specific Method
Research on costs of a range of family impacts was broad-based. Tables were developed to
capture major costs associated with dangerous products. Table 1, on extended costs to
individuals and families, illustrates the most frequent sources used, based on the most common
family impacts of dangerous products. Table 2 focuses on costs to the private sector and Table 3
lists costs to the public sector.
All costs were converted to 2007 constant dollars according to the inflation calculator on the web
site of the U.S. Bureau of Labor Statistics.
Present value was calculated using a 3 percent discount rate. This, of course, can significantly
reduce the calculated costs of dangerous products, because the impacts may span several
decades.
P. 1
TABLE 1
EXTENDED COST TO INDIVIDUAL AND FAMILY
COST IN DOLLARS
•
ADULT DAY CARE:
$61/day, national average, 2007. 1
•
ALCOHOL RELATED ILLNESS:
ASSISTED LIVING:
$10,660 2
•
•
$2969/month, or $35,628/year, 2007. 3
BANKRUPTCY:
ƒ
50% bankruptcies in families related to medical
events.
ƒ
More likely to lose health insurance
ƒ
40% lost phone service
ƒ
20% went without food
ƒ
50% went without doctor/dentist
ƒ
40% went without prescription medicine
ƒ
The long-run impacts of having to file for
bankruptcy include: Turned down for job,
mortgage, car loan, apartment rental
ƒ
“…homeowners who filed for bankruptcy
between 1991 and 1994 are about 28 percent
more likely to lose their houses within the four
years after bankruptcy filing compared to similar
homeowners without a bankruptcy record.” 4
ƒ
“The incidence of bankruptcy 5 years post injury
was 3.5%...Better rehabilitation, workforce
reintegration, and disability programs might
reduce bankruptcy post injury.”5
1
Metlife Mature Market Institute and Life Plans, Inc., The MetLife Market Survey of Adult Day Services
& Home Care Costs, September 2007, http://www.metlife.com/WPSAssets/18746211091190810760
V1F2007ADSHCC Study.pdf, retrieved March 7, 2008.
2
Siegel, Michael cited in National Alliance to End Homelessness, “The Cost of Homelessness,”
http://www.endhomelessness.org/section/tools/tenyearplan/cost, retrieved February 11, 2008.
3
Metlife Mature Market Institute, “Private and Semi-Private Nursing Home Room Rates Increase 3% in
2007 Assisted Living Rates Remain Steady, According to MetLife Market Survey,” Mature Market
News, October 2007, http://www.metlife.com/WPSAssets/40608978001193759945V1FNursing
HomeAsstLiving2007L.pdf, retrieved March 7, 2008.
4
Long, C., Colgate College, conference paper, “Negative Effects of Personal Bankruptcy for
Homeowners: Lost Homes and Reduced Credit Access,” July 2005.
5
Hollingworth, W., Relyea-Chew, A, et al., “The Risk of Bankruptcy Before and After Brain or Spinal
Cord Injury: A Glimpse of the Iceberg’s Tip,” Medical Care, APHA, 45(8), August 2007.
P. 2
TABLE 1
EXTENDED COST TO INDIVIDUAL AND FAMILY
COST IN DOLLARS
•
•
•
6
DEPRESSION . – Untreated, depression is costly.
Those with depression use two to four times more
health care than people without mental illness. 7
EMERGENCY AND AMBULANCE SERVICES – at the
time of the initial accident; for service demands due
to paralysis and associated breathing and other
problems
FAMILY CARETAKERS
ƒ
Cost of becoming a caretaker
An individual provides approximately $10,400 a year
in unpaid care (based on $9.63 per hour for 20 hours
a week). In addition, family and friends who are
caregivers spend an estimated $2400 per year for
groceries, medicine, and other out of-pocket cash
outlays.
ƒ
Caregiver Risk
Older care-giving spouses, who report strain from
care-giving, suffer a 63% higher mortality rate than
older spouses not involved in care-giving. 9
Depression among caregivers is a serious risk factor
for coronary heart disease, cancer and diabetes.
ƒ
ƒ
ƒ
ƒ
ƒ
Accident: $8800, 2003
Emergency Room Visit median: $560;
average: $299, 2003
Ambulance $350-1000, 2003 8
$10,400/year
$2,400/year 10
6
Cannuscio, C.C. et al., “Reverberations of family illness: A longitudinal assessment of informal
caregiving and mental health status in the nurses’ health study,” American Journal of Public Health,
92, 2002, http://www.ajph.org/cgi/reprint/92/8/1305? ck=nck, retrieved March 10, 2008 and National
Institute of Mental Health, Older adults: Depression and suicide facts, Publication no. 01-4953,
Rockville, M, 2001, http://www.nimh.nih.gov/health/publications/older-adults-depression-and-suicidefacts.shtml, retrieved March 10, 2008.
7
Goff, V. V., “Depression: A decade of progress, more to do,” Issue Brief No. 786, National Health
Policy Forum, George Washington University, 2002 in Gray, Leslie, “Caregiver Depression: A
Growing Mental Health Concern,” Policy Brief Family Caregiver Alliance, September 2003.
8
U.S. Department of Health and Human Services, Machlin, S. R., Expenses for a Hospital Emergency
Room Visit, 2003. Statistical Brief #111, January 2006, Agency for Healthcare Research and Quality
(AHRQ),
Rockville,
MD,
http://www.meps.ahrq.gov/mepsweb/data_files/publications/st111/
stat111.pdf, retrieved March 9, 2008.
9
Schultz, R. and Beach, S. “Caregiving as a risk factor for mortality: The caregiver health effects study,
Journal
of
the
American
Medical
Association,
282,
1999,
http://jama.amaassn.org/cgi/reprint/282/23/2215.pdf, retrieved March 10, 2008.
10
Mary Jo Gibson & Ari N. Houser, Valuing the Invaluable: A New Look at the Economic Value of
Family Caregiving, Issue Brief, AARP Public Policy Institute, June 2007 (indicating the value of
informal care-giving as $10,400 per year), http://assets.aarp.org/rgcenter/ il/ib82_caregiving.pdf,
retrieved December 2007.
P. 3
TABLE 1
EXTENDED COST TO INDIVIDUAL AND FAMILY
COST IN DOLLARS
•
HOME HEALTH AIDE:
$19/hour, national average, 2007 11
•
HOMEMAKER/COMPANION:
$18/hour, national average, 2007 12
•
LIFE-TIME EARNINGS
ƒ
Cost to a child of becoming a high school dropout
Adults who do not finish high school earn 65
percent of what people who have high school
degrees earn.
ƒ
ƒ
$8,161/year 13
ƒ
$513,520 over 40 years, undiscounted
$12,858/year 14
Cost to a child of not going to college
Those with a high school degree have median
annual earnings 36 percent below those with a
Bachelor’s degree. In 1996, this meant a salary
of $23,317 per year vs. $36,155.
ƒ
11
Metlife Mature Market Institute and LifePlans, Inc., The MetLife Market Survey of Adult Day Services
& Home Care Costs, September 2007, http://www.metlife.com/WPSAssets/18746211091190810760
V1F2007ADSHCCStudy.pdf, retrieved March 7, 2008.
12
Metlife Mature Market Institute and LifePlans, Inc., The MetLife Market Survey of Adult Day Services
& Home Care Costs, September 2007, http://www.metlife.com/WPSAssets/18746211091190810760
V1F2007ADSHCCStudy.pdf, retrieved March 7, 2008.
13
U.S. Department of Labor, Bureau of Labor Statistics, in Occupational Outlook Quarterly, October 23,
1998, http://www.bls.gov/opub/ooq/ooqhome.htm and Organisation for Economic Co-operation and
Development
(OECD),
“Education
at
a
Glance
2006,”
(2006),
available
at
http://www.oecd.org/dataoecd/51/20/37392850.pdf. The average graduate earns $23,317 and high
school dropouts on average earn 65 percent less than this amount. The difference is calculated as:
$23,317 - (0.65x$23,317) = $8,161 per year.
14
U.S. Department of Labor, Bureau of Labor Statistics, in Occupational Outlook Quarterly, October 23,
1998, http://www.bls.gov/opub/ooq/ooqhome.htm. [$36,155-$23,317].
P. 4
TABLE 1
EXTENDED COST TO INDIVIDUAL AND FAMILY
COST IN DOLLARS
•
LOSS OF HOME
$108,000 17
ƒ
If one owns a home valued at $200,000 and has
(54.0% average equity on ones home)
$100,000 equity in it when foreclosure begins,
there is $108,000 of wealth lost to the family,
which must then come up with a first month, last
month, and security deposit in order to rent a
place to live.
ƒ
One-quarter of those surveyed by The Access
Project, said housing problems resulted from
medical debt. 15 Over 10% said they were unable
to qualify for a mortgage, over 10% said they
were unable to pay their rent or mortgage, over
6% said their rental application was rejected and
over 5% said they were forced to move. Seventy
percent were likely to have a housing problem if
sued for medical debt and nearly 40% were likely
to have a housing problem if contact by a
collection agency for medical debt.
ƒ
Homelessness can be the result of a disability.
According to the National Coalition for the
Homeless, “a serious illness or disability can start
a downward spiral into homelessness, beginning
with a lost job, depletion of savings to pay for
care, and eventual eviction.” 16
15
Rakavina, M., Executive Director, The Access Project, Boston, Massachusetts, “Hearing on Working
Families in Financial Crisis” Medical Debt and Bankruptcy,” Testimony submitted to the House
Committee on the Judiciary, Subcommittee on Commercial and Administrative Law, July 17, 2007.
16
National Coalition for the Homeless, “Why are People Homeless?” NCH Fact Sheet #1, June 2007,
http://www.nationalhomeless.org, retrieved February 2008.
17
Average equity in one’s home 2007, 54.0%. See Alan Greenspan & James Kennedy, SOURCES AND
USES OF EQUITY EXTRACTED FROM HOMES 27 (Federal Reserve Board, Finance and Economics
Discussion Series No. 2007-20, 2007), available at
http://www.federalreserve.gov/pubs/feds/2007/200720/200720pap.pdf.
P. 5
TABLE 1
EXTENDED COST TO INDIVIDUAL AND FAMILY
COST IN DOLLARS
•
•
MENTAL HEALTH SERVICES:
ƒ
$202,575/year for an inpatient bed 18
ƒ
$106.08 average per hour for therapy,
2004. 19
NURSING HOME:
Institutionalization
The costs of early institutionalization have burdens
$213/day, or $77,745 for a private room;
beyond the family – extending to taxpayers. Most
$189/day, or $68,985 for a semi-private
families pay 1/3 of nursing home costs, but most is
room, 2007. 21
paid by publicly funded programs, with Medicare and
Medicaid, for example, paying 58% of nursing home
costs. 20
18
State of Washington ($555/day); State of Washington, Washington State Department of Community,
Trade and Economic Development, Housing Division, Olympia (360-725-2930), Ten-Year Homeless
Plan, July 2006, http://cted.wa.gov/_CTED/ documents/ID_3356_Publications.doc, retrieved February
2008.
19
Brown, E., Jr. and Beauregard, K., Regional Differences in Total and Out-of-Pocket Expenditures for
Selected Types of Office-Based Visits, 2004, Statistical Brief #157, January 2007, Agency for
Healthcare Research and Quality (AHRQ), Rockville, Md., http://www.meps.ahrq.gov/
mepsweb/data_files/publications/st157/stat157.pdf, retrieved March 9, 2008.
20
Kaiser Family Foundation, Medicaid’s role in long-term care, Kaiser Commission on Medicaid Facts,
Washington, DC, 2001 in Schultz, R. and Beach, S. “Caregiving as a risk factor for mortality: The
caregiver health effects study,” Journal of the American Medical Association, 282, 1999,
http://jama.ama-assn.org/cgi/reprint/282/ 23/2215.pdf, retrieved March 10, 2008.
Cannuscio, C.C. et al., “Reverberations of family illness: A longitudinal assessment of informal
caregiving and mental health status in the nurses’ health study,” American Journal of Public Health,
92, 2002, http://www.ajph.org/cgi/reprint/92/8/ 1305?ck=nck, retrieved March 10, 2008 and National
Institute of Mental Health, Older adults: Depression and suicide facts, Publication no. 01-4953,
Rockville, MD, 2001, http://www.nimh.nih.gov/health/publications/older-adults-depression-andsuicide-facts.shtml, retrieved March 10, 2008.
21
Metlife Mature Market Institute, “Private and Semi-Private Nursing Home Room Rates Increase 3% in
2007 Assisted Living Rates Remain Steady, According to MetLife Market Survey,” Mature Market
News,
October
2007,
http://www.metlife.com/WPSAssets/40608978001193759945V1F
NursingHomeAsstLiving2007L.pdf, retrieved March 7, 2008.
P. 6
TABLE 1
EXTENDED COST TO INDIVIDUAL AND FAMILY
COST IN DOLLARS
•
SOCIAL SECURITY:
An individual who earned average hourly
earnings and retired in 2007 at age 66,
would receive $324 per month less if
he/she spent the last 20 years without
income, caretaking for a disabled family
member. If they lived until 80, this would
represent, at $3,888 per year, a loss of
Social Security income of $54,432. 22 (See
Table A, footnote 7 for other scenarios.)
•
STRESS
The average number of days of the job, for
workers who must take time off for stress,
anxiety, or a related disorder, is 20 days. 23
•
SUBSTANCE ABUSE:
•
•
22
$8360 if in treatment
$14,740 if not in treatment 24
$22,667 for non-hospital residential
care
$3767 for outpatient methadone
treatment
$3347 for outpatient non-methadone
treatment 25
Loss in Social Security, with no promotions lost, from years totally or partly out of the workforce.
Table A
Social
Security
Monthly Social
Security
Monthly
Payment: Retire end of 2007, Payment: Retire end of 2007,
age 62, begin working 1964
age 66, begin working 1964
35 years working full time
$1167
$1556
Last 10 years earning ½ time
$1157
$1542
Last 10 years not earning
$1146
$1528
Last 20 years earning ½ time
$1046
$1394
Last 20 years not earning
$924
$1232
23
U.S. Department of Labor, Bureau of Labor Statistics, reported in National Institute for Occupational
Safety
and
Health,
“Stress…
At
Work,”
Publication
No.
99-101,
1999.
Http://www.cdc.gov/niosh/stresswk.html, retrieved February 11, 2008.
24
For California. National Alliance to End Homelessness, “The Cost of Homelessness,”
http://www.endhomelessness.org/section/tools/tenyearplan/cost, retrieved February 11, 2008.
25
1997 estimated cost per enrolled client per day for substance abuse treatment were $62.10 for
nonhospital residential care, $10.32 for outpatient methadone treatment, and $9.17 per outpatient
nonmethadone treatment. U.S. Department of Health and Human Services, The ADSS Cost Study:
P. 7
TABLE 1
EXTENDED COST TO INDIVIDUAL AND FAMILY
COST IN DOLLARS
TRAUMATIC BRAIN INJURY
ƒ
ƒ
Many TBIs go undiagnosed, but still can have serious health and economic impacts. “In many instances, no
link is made between the blow to the head the person sustained and subsequent physical, cognitive,
behavioral or emotional sequelae. TBI has been called the ‘silent’ or ‘hidden’ epidemic because many
individuals are not identified by the health care system and their neurological, neuropsychological and
neurobehavioral symptoms and functional difficulties are attributed to etiologies other than brain injury ...
headaches, sleep problems, fatigue, blurred vision, dizziness, loss of hearing, and in a small percentage of
cases, seizure disorders… changes in cognitive, behavioral and emotional functioning… increased
irritability, depression or anxiety…impulsive behavior, reduced frustration tolerance, lack of empathy,
emotional liability apathy or aggression.” 26
Co-occurring Psychiatric Diagnoses, accompanying TBI: 27
Disorder
Major depression
Substance abuse
Post-traumatic stress disorder
Other anxiety disorders
ƒ
ƒ
ƒ
% Incidence
14-77%
5-28%
3-27%
3-28%
“individuals who have experienced a loss of consciousness are four times more likely to attempt suicide than
those who have not. Additionally, Simpson and Tate reported that co-morbid depression and substance
abuse in individuals with TBI increased the risk of suicide twenty-one times.” 28
“Only 42% of couples were able to sustain their relationship for more than 5 years after injury.” [TBI] 29
“A mild brain injury frequently causes cognitive and behavioral impairments or deficits that are not obvious,
but result in life altering changes. These impairments may be short term or last throughout the person’s
life….Adults with traumatic brain injury who can walk, talk, and look ‘normal’ are refused services, even
though they cannot maintain themselves in the community without help. Cognitively impaired people
frequently lack executive skills…have difficulty functioning independently… Results in a growing number
of Texans with traumatic brain injury whose only service delivery system is a homeless shelter, a prison or a
Costs
of
Substance
Abuse
Treatment
in
the
Specialty
Sector,
http://www.oas.samhsa.gov/ADSS/ADSSCostStudy.pdf, retrieved February 2008.
July
2003,
26
Ashman, T., Gordon, W., Cantor, J., and Hibbard, M, “Neurobehavioral Consequences of Traumatic
Brain Injury,” The Mount Sinai Journal of Medicine, Vol. 73, No. 7, November 2006.
27
Ashman, T., Gordon, W., Cantor, J., and Hibbard, M, “Neurobehavioral Consequences of Traumatic
Brain Injury,” The Mount Sinai Journal of Medicine, Vol. 73, No. 7, November 2006.
28
Ashman, T., Gordon, W., Cantor, J., and Hibbard, M, “Neurobehavioral Consequences of Traumatic
Brain Injury,” The Mount Sinai Journal of Medicine, Vol. 73, No. 7, November 2006.
29
Kreutzer, J., “Consequences of Traumatic Brain Injury for the Family,” at NIH Consensus
Development Conference on Rehabilitation of Persons with Traumatic Brain Injury, Bethesda,
Maryland, October 1998.
P. 8
TABLE 1
EXTENDED COST TO INDIVIDUAL AND FAMILY
COST IN DOLLARS
state institution, thereby costing Texas more for their care than it would have been had these individuals
received the necessary rehabilitation and community based services.” 30
ƒ
Results of Kentucky Traumatic Brain Injury Prevalence Study: 31
o
24% reported increased memory problems after the injury
o
21% experienced increased depression after the injury
o
23% experienced increased anxiety after the injury
o
6% reported increased substance abuse problems
o
5% needed substance abuse counseling
o
23% needed personal care assistance
o
30% needed mental health services
o
26% needed specialized equipment
o
40% needed physical, occupational, or speech therapy
o
11% needed vocational training
o
22% needed residential treatment or rehabilitation
o
3% needed environmental modifications
o
32% were reported needing professional service following this injury
o
45% reported losing a job or school placement (but 84% were eventually able to return to work or
school)
15% of professional services were paid by Medicaid and Medicare and 19% out of pocket by the injured party
(60% was paid by private insurance).
•
VOCATIONAL REHABILITATION:
•
•
$5,577/person, with orthopedic
disability 32
$2923, vocational rehabilitation
average, 2003 33
30
U.S. Department of Health and Human Services, HRSA, Maternal and Child Health Bureau, State
Traumatic Brain Injury Grants, “The Texas Traumatic Brain Injury Advisory Council Presents A
Summary of Gaps in Services in the Texas Health and Human Service Delivery System,” March 1999.
31
University of Kentucky, Center on Drug and Alcohol Research, “Kentucky Traumatic Brain Injury
Prevalence Study,” CDAR Technical Report No. 2004-01, January 2004.
32
2003 average for those with orthopedic disability, University of Massachusetts-Boston,
http://www.statedata.info/datanotes/datanote.php?article_id=167.
33
University of Massachusetts, Boston, http://www.statedata.info/datanotes/Datanote.php?article_id
=167. Private vocational rehabilitation can cost as much as $5000/month or more.
P. 9
TABLE 2
COSTS TO PRIVATE SECTOR
COST IN DOLLARS
TO EMPLOYER OF VICTIM
• Lost productivity for victim who continues
working, temporary replacement and then
reduced ability to maintain job performance
• Lost productivity to hire and train new person
$22,000 34
For a manager, 150% of salary 35
TO THE EMPLOYER OF CARETAKER
•
Lost productivity due to caretaking
$3600/year
•
Lost productivity due to depression
$3600/year 36
TO LOCAL UTILITY COMPANIES
• Requests for help with utility payments – gas,
electricity, water
TO PRIVATE HEALTH INSURANCE COMPANIES
• More illness as a result of stress, victim and
family members
$312/month average for assistance
with heating costs 37
34
National Highway Traffic Safety Administration (NHTSA) for serious auto accident, The Economic
Impact of Motor Vehicle Crashes, 2000, May 2002, By L. Blincoe, A. Seay, E. Zaloshnja, T..Miller,
E. Romano, S.Luchter, R.Spicer, NHTSA Technical Report DOT HS 809 446, http://wwwnrd.nhtsa.dot.gov/Pubs/809446.PDF, retrieved February 2007.
35
Bliss & Associates Inc., “The Business Cost and Impact of Employee Turnover,”
http://www.blissassociates.com/html/articles/employee_turnover01.html, retrieved March 9, 2008.
36
Walter F. Steward, Judith A. Ricci, Elsbeth Chee, Steven R. Hahn, David Morganstein, Cost of Lost
Productive Work Time Among US Workers with Depression, 289 J. AM. MEDICAL ASSOC. 3135
(2003).
37
For heating assistance only. A 2003 study by the U.S Department of Health and Human Services
found that average household benefits, through the Low Income Home Energy Assistance Program
(LIHEAP), for heating costs was $312. About 48 percent of households that received assistance had at
least one person with a disability. U.S. Department of Health and Human Services, Executive
Summary – Low Income Home Energy Assistance Report to Congress for FY 2003, August 2003,
http://www.acf.hhs.gov/programs/ocs/liheap/publications/execsum.html, retrieved February 11, 2008.
P. 10
TABLE 3
COST TO PUBLIC SECTOR
COST IN DOLLARS
•
EMERGENCY SHELTER BED
$8067/year
•
FOOD STAMPS
$480-1668/person 2000 39
•
JOB TRAINING
$3800-$4700/person 40
•
MEDICAID
ƒ
•
MEDICAID PRESCRIPTION
38
$2215 per year, 2006 41
ƒ
$204.95 per month, or $2459 per year,
blended cost FY03 42
ƒ
Disabled individuals on Medicaid cost
approximately $12,855 per year (16% of
the Medicaid population), 2003 43
ƒ
$13,303, 2003, for permanently and
totally disabled persons 44
$866.85/year FY03 45
38
When funded through the Department of Housing and Urban Development’s Emergency Shelter
Grants program, is approximately $8,067; U.S. Department of Housing and Urban Development,
Office of Policy Development and Research, Evaluation of the Emergency Shelter Grants Program,
Volume 1: Findings, September 1994, as reported in National Alliance to End Homelessness, “The
Cost of Homelessness,” http://www.endhomelessness.org/section/tools/tenyearplan/cost, retrieved
February 11, 2008.
39
U.S. Department of Agriculture, “Food Stamp
fsp/applicant_recipients/BEN.HTM, retrieved May 1, 2008.
40
U.S. Government in Boston Globe, Davis Bushnell, “Retraining funds higher but more seen needed,”
September 2004, http://www.boston.com/jobs/globe/articles/091904_retrain.html.
41
Social Security Administration, “Medicaid,” http://www.socialsecurity.gov/policy/docs/statcomps/
supplement/2006/medicaid.pdf, retrieved March 10, 2008.
42
State of Texas, “Healthcare Costs in Health and Human Services Programs,” Presentation to Senate
Finance Committee, October 24, 2001, http://www.hhsc.state.tx.us/news/presentations/Healthcare
Costs_102401.pdf, retrieved March 2008.
43
Social Security Administration, Office of Policy Data, Annual Statistical Supplement, 2006, June
2007, http://www.socialsecurity.gov/policy/docs/statcomps/supplement/ 2006, retrieved March 2008.
44
Social Security Administration, Office of Policy Data, Annual Statistical Supplement, 2006, June
2007, http://www.socialsecurity.gov/policy/docs/statcomps/supplement/ 2006/medicaid.pdf, retrieved
March 2008.
45
State of Texas, “Healthcare Costs in Health and Human Services Programs,” Presentation to Senate
Finance
Committee,
October
24,
2001,
http://www.hhsc.state.tx.us/news/presentations/
HealthcareCosts_102401.pdf, retrieved March 2008.
Program,”
http://www.fns.usda.gov/
P. 11
TABLE 3
COST TO PUBLIC SECTOR
•
MEDICAID NURSING FACILITY SERVICE
COST IN DOLLARS
$23,882/year, 2003 46
•
MEDICARE
$14,000-$134,000/year 47
•
NEED FOR SUBSIDY/PUBLIC HOUSING
$451/month for occupied subsidized units 48
•
PRISON
ƒ
ƒ
$23,876 average annual per prisoner
operating costs 49
The typical cost of a prison bed in a state
or federal prison is $20,000 per year. 50
The average cost per year per person in
an average county jail (in Washington
state) is $17,485, or $47.90 per day. In a
Washington State prison it is $32,000, or
$87.67 a day. 51
46
Social Security Administration, Office of Policy Data, Annual Statistical Supplement to the Social
Security Bulletin, 2006, June 2007, http://www.socialsecurity.gov/policy/docs/statcomps/
supplement/2006/supplement06.pdf, retrieved March 2008.
47
Many sites on Medicare web page.
48
U.S. Department of Housing and Urban Development (HUD), 1998, http://www.hud
user.org/publications/pdf/economic.pdf; the average operating cost of a single room occupancy for
Section 8 housing is $298 per month, or $3570 per year. In addition 47% of sponsors also provided
such support services as health exams, substance abuse counseling, job counseling and literacy
training.
National Coalition for the Homeless, “Section 8/Single Room Occupancy (SRO),”
http://www.nationalhomeless.org/publications/facts/federal.html, retrieved February 11, 2008.
49
Costs ranged from $13,009 in Louisiana to $44,860 in Rhode Island in 2005. The capital expenses per
bed for medium security were approximately $65,000. The Pew Center on the States, “One in 100:
Behind
Bars
in
America
2008,”
http://www.pewcenteronthestates.org/uploadedFiles/
One%20in%20100.pdf, retrieved March 5, 2008.
50
Slevin, Peter, “Life After Prison: Lack of Services Has High Price,” in Washington Post, April 24,
2000 as reported in National Alliance to End Homelessness, “The Cost of Homelessness,”
http://www.endhomelessness.org/section/tools/tenyear plan/cost, retrieved February 11, 2008.
51
State of Washington, Washington State Department of Community, Trade and Economic
Development, Housing Division, Olympia (360-725-2930), “Ten-Year Homeless Plan,” July 2006,
http://cted.wa.gov/_CTED/documents/ID_3356_ Publications.doc, retrieved February 2008.
P. 12
TABLE 3
COST TO PUBLIC SECTOR
•
SCHIP (CHILDREN’S HEALTH)
•
SOCIAL SECURITY DISABILITY
INSURANCE
•
SPECIAL EDUCATION SERVICES
•
TANF (TEMPORARY ASSISTANCE FOR
NEEDY FAMILIES)
COST IN DOLLARS
ƒ
FY2003 average $1,178 52
ƒ
From $42/month per child age 11-18,
male, south Delaware to $418/month for
child less than 1 year in Kansas, 1999 53
ƒ
$938/ per month, or $11,256/year,
average for disabled workers, 2005 54
ƒ
$978/month for disabled workers,
$258/month for spouses of disabled
workers and 290 average monthly
benefit for children of disabled workers
for 2006 55
$9369 above average student cost of
$7,552 56
$397/month average family 2004 57
52
State of Mississippi, A Limited Analysis of the State Children’s Health Insurance Program (SCHIP),
Performance Audit Report #91, March 29, 2005, http://www.osa.state.ms.us/documents/performance/
Schip.pdf, retrieved March 2008, [Mississippi FY2003 average was $1648]
53
National Conference of State Legislatures, “SCHIP: Money Matters,”
http://www.ncsl.org/programs/health/moneymat.htm, retrieved March 4, 2008.
54
Social Security Administration, Office of Policy Data, Annual Statistical Supplement, 2006, June 2007,
http://www.socialsecurity.gov/policy/docs/statcomps/supplement/ 2006/oasdi.pdf, retrieved March
2008.
55
Social Security Administration, Fast Facts & Figures About Social Security, SSA Publication No. 1311785, September 2007, http://www.socialsecurity.gov/policy/docs/chartbooks/fast_facts/2007/fast_
facts07.pdf, retrieved March 2008.
56
National Education Association (NEA), “Special Education and the Individuals with Disabilities
Education Act” http://www.nea.org/specialed/index.html, retrieved March 9, 2008.
57
Social Security Administration, Annual Statistical Supplement, 2005, Public Assistance, “Temporary
Assistance
for
Needy
Families/AFDC
and
Emergency
Assistance
(9.G),”
http://www.ssa.gov/policy/docs/statcomps/supplement/2005/9g.pdf, retrieved March 6, 2008.
January
2000,
P. 13
TABLE 3
COST TO PUBLIC SECTOR
•
UNEMPLOYMENT INSURANCE
•
VETERANS’ BENEFITS
•
WORKERS COMPENSATION
COST IN DOLLARS
Approx $25-500/week with $400/year
Administrative cost in 2004 58
$266.60 average weekly benefit, for 15.3
weeks, 2006. 59
$911 non-service-connected disability,
maximum per individual; $1801 with one
dependent in need of aid and attendance,
2006 60
$351-1173/week 61
58
Five state web sites: IL, OR, RI, MD, AZ. Feibelman, A., “Defining the Social Insurance Function of
Consumer Bankruptcy,” American Bankruptcy Institute Law Review, Vol. 13, 2005,
http://papers.ssrn.com/sol3/papers.cfm?abstract_id= 708583#PaperDownload, retrieved March 7,
2008.
59
Social Security Administration, Office of Policy Data, Annual Statistical Supplement, 2006, June
2007, http://www.socialsecurity.gov/policy/docs/statcomps/supplement/ 2006, retrieved March 2008.
60
Non-service-connected disability is for wartime veterans with limited means. Social Security
Administration, Office of Policy Data, Annual Statistical Supplement, 2006, June 2007,
http://www.socialsecurity.gov/policy/docs/statcomps/supplement/ 2006, retrieved March 2008.
61
Range of state web sites.
P. 14
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