Perspective

The Checkup Is in the Mail? Soliciting Letter Carriers to Help Deliver Health Care

(KHN illustration)

Two of America鈥檚 toughest problems can be tempered with one solution.

The baby boom generation is graying, creating an ever-larger population of older people, many isolated, whose needs the nation is ill equipped to meet or even monitor.

Meanwhile, the U.S. Postal Service has gone , in part as digital communications have replaced snail mail. This year it has requested two rate increases for stamps and other services, bringing the price of a first-class stamp to 58 cents. It is running an aggressive TV ad campaign, presumably to build support for Congress to step in with some kind of rescue.

So here鈥檚 a potential win-win solution: Have letter carriers spend less time delivering mail, much of which now involves fliers and solicitations. Instead, include in their responsibilities 鈥 鈥渢he swift completion of their appointed rounds鈥 鈥 home visits and basic health checks on the growing population of frail and elderly.

This may sound out-of-the-box, but it鈥檚 , like France and Japan. Indeed, the idea that the USPS could get more involved in home health services 鈥 to fill a need and earn money 鈥 was in March.

So far, other solutions to fill the need for home health care have proved elusive. President Joe Biden proposed to improve services for the homebound elderly, a feature that Congress didn鈥檛 retain. But Democrats鈥 congressional reconciliation budget resolution, currently under debate, could allot money to the cause.

Meanwhile tens of millions of older Americans 鈥 the 鈥渙ld old鈥 鈥 are not so sick that they need a hospital but are unable to live safely at home without help. In Maine, the state with the oldest population, an estimated of needed and approved home care is not provided every week because of a dearth of workers. That, for example, leaves patients with early dementia fending for themselves at great risk. People who need help preparing medicine or meals can be missing both.

Postal workers are already on virtually every block of America six days a week. They are 鈥減eople people,鈥 as the recent TV ads portray, often beloved by their customers.

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Yes, letter carriers are already busy, in part because of the volume of package deliveries, which jumped during the pandemic. But what about scrapping the idea of everyday delivery? That too by the agency鈥檚 inspector general, a decade ago. Mail could be delivered just a few times a week, say, every other day. And on the off days, presto 鈥 we get a new on-the-ground home health workforce.

They could do home visits, to redress an epidemic of loneliness among older homebound Americans and check on whether a customer has an adequate supply of food and medicines. With a bit of retraining, they could check and record blood pressure, test blood sugar levels in people with diabetes and even administer pills.

Letter carriers already effectively serve as informal watchdogs, noticing if an older client hasn鈥檛 picked up mail, for example. In some parts of the country, that function is formalized under a voluntary program called , in which the Postal Service notifies a participating service agency, noted Brian Renfroe, executive vice president of the National Association of Letter Carriers.

But the USPS could be paid, by the government or by individuals, for this and other valuable services.

In France, since 2017, to La Poste 鈥 about 20 euros or $24 鈥 to have home check-ins for an older relative. The service, called Watch Over My Parents, offers one to six visits per week, and the postal worker reports the resident鈥檚 condition to the client each time.

Japan launched through a public-private partnership in 2017, to underwrite paid, monthly, half-hour visits (a friendly chat and health check) with members of the aging at-home population.

The post office鈥檚 essential functions 鈥 like delivering the federal government鈥檚 $1,200 pandemic relief checks, mail-in ballots and prescription medicines 鈥 are too important to lose. And USPS finances have improved recently, in part because of package deliveries and a $10 billion loan through the 2020 American Recovery and Reinvestment Act.

But when was the last time you ran to the mailbox to hear from a friend, check the news, or collect a bank statement or bill? It just makes sense financially and socially for the agency to evolve to meet the nation鈥檚 current needs.

Of course, this alone will not close the USPS鈥 $160 billion budget gap, the bulk of which resulted from a government mandate . Without that, the USPS would have been in the black (often just barely) for about half of the years since 2006 鈥 though, overall, it was nearly $10 billion in debt

Solving that requirement will take congressional intervention; changes will also be needed in a law that currently requires six-day-a-week delivery and generally precludes the USPS from offering 鈥渘onpostal鈥 products. Bipartisan legislation introduced in the Senate this year seeks to to help the USPS earn money from services of 鈥渆nhanced value to the public鈥 (like selling hunting and fishing licenses).

Today, the postal service delivers vast amounts of 鈥渏unk mail,鈥 also called direct mail. Companies spend about , the industry says. But much of it ends up unread and unopened in the trash or recycling bin, an environmental nightmare.

Why not instead redeploy some of the U.S. Postal Service鈥檚 vast supply of human resources to deliver a service our aging population 鈥 and our country 鈥 desperately needs?

Related Topics

AgingPublic HealthU.S. Congress

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