Rick Newman

The Trouble With Healthcare Reform, In Numbers

By Rick Newman

Posted: July 22, 2009

It will be just like getting a complex diagnosis from the doctor: As President Obama and other political leaders intensify their battle over healthcare reform, they're going to bombard bewildered Americans with jargon about insurance exchanges, play-or-pay rules, and various formulas for tax credits, penalty fees, and income eligibility.

Anybody who’s ever filled out an insurance claim knows how complicated the healthcare system is. The reforms Obama is pushing will make it more so, at least for awhile. But there’s one fundamental problem that’s easy to understand: cost. The price of healthcare is rising faster than just about anything else in our economy, placing an unsustainable burden on individuals, companies, and even the federal government. That’s the main reason one-sixth of the American population—about 50 million people—don’t have health insurance. And when they seek care, it tends to be the most expensive kind—at the emergency room—which raises costs for everybody else even more.

[See what Obama must do before Stimulus II.]

Congressional Democrats’ first draft of a reform plan illustrates the cost problem: The plan would extend coverage to about 37 million uninsured Americans—but cost more than $1 trillion over 10 years. That scheme has landed with a thud, so newer versions of the plan will probably emerge, with a lower price tag. Still, the major battle over coming months will be over who pays for the healthcare we consume. Here are some stats that flesh out the problem:

Total U.S. healthcare spending: $2.1 trillion

Projected annual increase in spending through 2017: 7 percent

Projected overall inflation rate: 1.2 percent (through 2015)

Healthcare spending as a percentage of all economic activity: 16.3 percent

Projected in 2017: 19.5 percent

[See 6 small steps toward a more normal economy.]

Percentage of Americans covered by employer-provided plans: 61 percent

By government plans: 16 percent

By private plans: 5 percent

Uninsured: 17 percent (about 50 million Americans)

Percentage of large firms offering health coverage: 99 percent

Percentage of small firms: 59 percent (down from 68 percent in 2000)

Industries with the highest health coverage rates: government, manufacturing, transportation, communication, utilities

Industries with the lowest coverage rates: retail, service, health care

Percentage of uninsured who live in a household where nobody works: 19 percent

Who live in a household with only a part-time worker: 12 percent

Who live in a household with one or more full-time workers: 69 percent

[See 11 places with a worse economy than ours.]

Average amount of personal income spent on health care: 6 percent

On housing: 39 percent

On transportation: 20 percent

On food: 14 percent

On clothing: 4 percent

Healthcare spending as a percentage of income, for those earning less than $20,000 per year: 15.5 percent

For those earning between $55,000 and $70,000: 5.1 percent

For those earning more than $70,000: 3 percent

Average increase in employer-based health insurance premiums since 1999: 120 percent

Average increase in wages since then: 29 percent

Proportion of personal bankruptcies related to illness or medical bills: 62.1 percent

Increase since 2001 in the proportion of personal bankruptcies caused by medical problems: 50 percent.

Sources: Randcompare.org; Congressional Budget Office; American Enterprise Institute; Urban Institute; National Coalition on Health Care; Kaiser Family Foundation; American Journal of Medicine

Health Care Reform

Either way, if the reform passes or doesn't, I(we) as a working middle class person will pay. I(we) will pay for the millions of uninsured coming on board through taxes, I(we) will pay for higher private insurer premiums if it doesn't pass. Nothing really changes.

In my state, Massachusetts, they tried to adopt the revolutionary comprehensive care tiered insurance plan. All it did was take the block sum free care pool money that went directly to health care providers(hospitals, clinics, etc.)who used it for the uninsured and also to balance their internal financial affairs to stay in the black and moved it to the insurance companies who then dicker and dole out just what, when, where, how or if they are going to cover any of the costs incurred by the patients. Result: Health care facilities are losing more money and moving into the red as reimbursement shrivels. As long as politicians and insurance companies are in each other's pockets don't expect healthcare to work for the masses. There are always going to be people; the chronically unemployed, the system riders, frequent flyers, etc. who just will not pay for healthcare. In our ER they come in for aspirin and pregnancy tests. As long is there is no review process for individuals and families who are evading paying into the system, they will exploit it.And again, I(we) will pay. Soon enough many will begin to go John Galt...but that's a topic for another day.

suzanne of MA @ Sep 16, 2009 14:51:01 PM

Wish it were that easy

To Collins of OR--I have worked in health care and I am sorry to say that many people become sick through no fault of their own, just bad luck, bad genes, or bad environment. There are others who contribute to their illnesses through bad self-care or not following the doctors' orders. A recent survey found that only about 5% of Americans are following advice not to smoke, to drink only in moderation, to exercise 30 min 5 days a week, to keep a normal weight, and to eat 5 servings of fruits and vegetables a day. I have decided that it is best to withhold judgment.

I would be very happy to see us become a healthier society, and in fact I hope a change in attitudes will be one consequence of our shared "footing the bill."

SusanRN of AL @ Sep 15, 2009 23:30:55 PM

A Nurse Looks at Health Care

As a regular volunteer in a free clinic, I have plenty of experience with the uninsured. As a self-employed person paying all my health insurance costs directly, my deductible is so high that, except for a major catastrophe, my family is basically uninsured. There is no good way out of these problems until we can reduce the cost of US medical care.

Almost no one seems to recognize that one major cause of these soaring costs is our own "sue crazy" culture. Until we start charging the cost of ridiculous suits to the person and lawyer who filed them and have torte reform to limit the astronomical amounts currently awarded, changing the health insurance system will not change the huge cost of medical care at the root of the problem. This is a hugely uphill and largely unaddressed problem, since most of our legislators are lawyers! A large part of their campaign funds come from other lawyers. An obstetrician can basically work three days out of the week simply to pay his malpractice insurance. Any doctor is likely to order expensive and probably unneeded tests "just in case" he might get sued later. These things hit all of us hard in the pocket book. They are bankrupting the whole system. Let's do something constructive about it NOW!

Why does New York City have more lawyers than the entire nation of Japan? Because "we the people" are willing to keep them busy.

Diane of NC @ Sep 09, 2009 22:55:05 PM

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Rick Newman

Rick Newman

The global economy is mysterious, even scary. Chief Business Correspondent Rick Newman connects the dots. In addition to his writing for U.S. News, Rick is the co-author of two books: Firefight: Inside the Battle to Save the Pentagon on 9/11, and Bury Us Upside Down: The Misty Pilots and the Secret Battle for the Ho Chi Minh Trail.

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