I know we all know (often from personal experience) that rising health care costs are eating into the financial well being of millions of Americans. However, it’s always nice to have that knowledge validated by government sponsored research:
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WASHINGTON — Health care costs now eat up more than 10 percent of the family income of nearly 50 million Americans under 65, according to a new study by government researchers.
Their estimates, published today in The Journal of the American Medical Association, are based on federal consumer surveys done in 1996 and 2003 that counted all out-of-pocket health care costs.
By 2003, they calculate there were 48.8 million individuals (19.2 percent of the non-elderly population) living in families that spent more than 10 percent of household income on medical care, an increase of 11.7 million people since 1996. […]
Of this group, 18.7 million (7.3 percent of the total population) were in families spending more than 20 percent of family income on medical care.
Among those more likely to face higher-than-average health care costs were low-income individuals, those with individual rather than group coverage, people in the pre-retirement age bracket of 55 to 64, women, people living outside metro areas and people with chronic medical conditions.
“We also noted that high out-of-pocket burdens are associated with delaying or forgoing medical care for financial reasons, behavior that can have severe consequences for those in poor health,” Banthin said.
Sounds like my situation.
Although we have reasonably good group health and dental insurance through my spouse’s employer, my family over the last two years has spent, on average, over $20,000 on out of pocket expenses related to health care. I won’t tell you what percentage of our income that represents, but it is significantly more than 10 percent. And that figure doesn’t include what we pay each month for our health insurance coverage which is automatically deducted from my wife’s paycheck.
My wife, my daughter and I all suffer from chronic medical conditions. I have personally put off needed dental care and cut back on my own doctor visits in order to save money. We’ve even started to eat into our savings to cover some of these expenses. If my wife ever loses her job I don’t know what we would do.
And we’re the lucky ones. I know any number of people in my community who face far greater hardships as a result of health related problems for which they have inadequate insurance. A fact that the government researchers confirmed:
They calculate that 17.1 million people had inadequate financial protection from high out-of-pocket costs in 2003, including 9.3 million who were in private, employment-related plans, 1.3 million with individual coverage and 6.6 million with public coverage.
Health care costs have been rising faster than inflation and the overall economy in the United States for many years. Out-of-pocket payment for health care by patients rose from $162 billion in 1997 to $236 billion in 2004, out of a total national health bill of nearly $2 trillion.
If there is one thing the Democrats in Congress could do this year and the next to expand their newly won majorities in Congress and capture the White House in the 2008, it would be to address the ever expanding burden health care costs place on the 99% of Americans who aren’t ridiculously wealthy. We have privatized our health care system under Republican rule for the benefit of special interests (Insurance and Pharmaceutical companies, for the most part) and the results have been devastating for millions of Americans. Americans like me. Americans like you.
Time to start spending some of that political capital the Democrats won last November on the only special interest that really matters: our families.
Getting good quality healthcare to all Americans will require a total system reform, which is likely why the Dems will tread cautiously in this area that has burnt so many so often. We do not really know systematically what good quality and effectiveness is, the system is often unsafe, we do not know what good value is(cost-benefit). Without first defining these, we cannot provide good access to all because we do not know how many and what type of providers we need, and without first defining good, effective, value care, we cannot control costs.
In a simple comment like this, I cannot get into all of this, but what I do wish to get into are some questions regarding the proposed current conservative market solution to the health care crisis, namely the caveat emptor, Consumer directed Health Care (CDHC).
In a nutshell, the market advocates think consumers shopping around for healthcare will increase quality and lower costs. From my logic and experience, I believe systematically turning over such healthcare decisions to consumers, or caveat emptor care, will do neither. First, think about who can get the the better prices, a large payer or each individual trying to become an MD that day. Furthermore, who can best judge quality of care, my grandmother or some NIH expert??
If large payers can NOW already get 60% off the supposed provider charge (which is the routine reduction now!), I would think that would be the best individual consumers could ever hope to get, so if it is already available with large payers, WHAT EXACTLY IS THE ADVANTAGE PRICE-WISE for the caveat emptor, individual shopping around in healthcare?????
As for assessing quality, I fail to see again why caveat emptor should be the preferred method of judging quality in a supposedly state regulated system. What the heck is the regulation for if consumers have to figure it out on their own?? I would think all quality should be guaranteed by the system through accountability to experts, as that is the point of licensing and state boards,no? Besides, consumers on their own will never overcome the info asymmetry and emotional stress between them and providers, never!!
So back again to the question of lowest price, which I believe is best set (that lowest price) by large payers. The absolute best and fairest example of that would be a monopsony of a single payer negotiation, IMO, However the acceptance of such controls and their longer-term effect on producing better health for all, will depend on properly defining good, quality, effective,and good value care!!
People who believe health care is best provided by an unregulated market are idiots.
People who believe ANYTHING is best provided by an unregulated market are idiots.
Unregulated markets are great if you are the provider, however if you need the product, well, you’re screwed.
10 more studies and maybe they’ll set up a blue-ribbon commission to investigate changes! This was a huge problem a decade ago, and it needs to be one of the major issues of the next election. If an underdog Presidential candidate (like Kucinich) wants to get a big boost, the easiest way IMO is to come up with a comprehensive health care reform plan and make it a signature issue. So far, I don’t feel any rising tide of discussion from politicians and journalists. Will the media even cover this study? The general public is past ready for change, maybe eventually our talking heads will deign to discuss the issue.
it’s probably past time for some direct action, loud demonstrations, riots, etc. While it’s not the answer for everyone, alternative medicine may rescue a number of folks. In my town, acupuncture can be had for $15 a treatment now and herbalists are willing to barter for medicines. We’re going to have to take as much of it into our own hands and show Big Pharma and the medical/industrial complex the door.
numbers they want, but it is costs like these that eat into the average person’s livelihood. And health care costs for those who work for small companies is definitely higher than those who work for big companies. And frankly it just isn’t right.
“And health care costs for those who work for small companies is definitely higher than those who work for big companies.”
I have a friend who works for a public service agency that has to purchase health insurance for the employees. Because they’re so small, it’s like having a bunch of individual policies because the rates go up depending on each individual’s age and medical condition.
Individual policies, especially for those over 50 or 55, are outrageously expensive. We were quoted over $1300 a month for the two of us (no really serious medical problems other than controllable blood pressure but we were closing on 60). Fortunately, I discovered a little known federal law that says once you finish the 18 months of COBRA coverage, you have to be given “community ratings” which can’t take into account age or medical condition by the insurer of last resort – usually Blue Cross / Blue Shield – in your state. By invoking that law, we were able to get the same major medical coverage that would have been over $1300 for slightly over $300. That was over three years ago and we’ve seen double digit increases every year so that the premium is now about $440 a month, but it’s still better than the individual policy. It’s a shame that people aren’t more aware of this provision – it took me several weeks of searching through web sites until I ran across it on the michigan.gov site.
Like your closing line..a lot!