America desperately needs affordable, universal health care. Americans pay more for health care than any other developed nation. One of out of every five dollars spent in our economy is spent on health care. Even with this much money being spent, we are last among developed countries in terms of human health.
Could things get much worse?
Yes. Our country now stands at a dangerous crossroad. The Republican American Health Care Act (AHCA) has been withdrawn. President Donald Trump and House Speaker Paul Ryan now threaten to allow, or even enable, the collapse of the Affordable Care Act (ACA, commonly known as Obamacare). This will only increase healthcare costs even more for America and Americans.
This three-part series searches for answers to America's continued failure at providing affordable and effective health care.
Our failed insurance business model is driving healthcare costs higher
An insurance business model that can raise prices with little consumer recourse is the first-tier explanation of why our health care is so expensive. Examples of how this system is failing consumers include:
- Use of highly complex rate structures and contracts to limit the consumers' ability to understand prices, gain price transparency and challenge price hikes
- The power of insurance companies to serve as their own arbitrator after they deny a claim
- Price discrimination between demographically similar consumers through the use of artificial insurance pools built around whether a person works for a big company, a small company or is self-employed
- Little or no performance link between consumer payment and medical service results
The bottom line is that our current insurance business model charges higher prices because it can.
Extreme American behaviors are driving healthcare costs to record levels
While our insurance model charges us more for health care, our lifestyles and behaviors are the underlying reason why it remains so expensive. These seven data points define how our lifestyles and actions are driving healthcare costs to record levels:
- We are in a national weight crisis. Fifty percent of Americans are either overweight or obese. This weight crisis is driving a costly national diabetes and heart disease epidemic.
- Gun deaths are comparable to vehicle deaths. Gun violence kills over 33,000 Americans annually. The good news is that gun violence is not growing. The horrible news is that every day 30 people die from gun violence and 200 are injured.
- Over 50,000 Americans die annually from drug overdoses. Drug abuse is now an epidemic. Drug overdose deaths have grown three times higher in just 15 years.
- The rate of increase in vehicle accident deaths is at a 50-year high. Annually, over 38,000 Americans are killed, and an additional 4.4 million seriously injured, in vehicle accidents.
- America’s infant mortality rate compares to Serbia and Bosnia. America’s infant mortality rate is approximately three times higher than Japan’s.
- End-of-life costs. Approximately a third of all Medicare expenditures occur during the last six months of life because only Oregon and Washington empower the individual with end of life decision-making.
- White middle class economic depression. Our white middle class, in economic distress from factory and middle management job losses, is self-medicating their pain through drug/alcohol abuse and suicide.
Healthcare costs will continue to soar until Americans come together on these public policy issues.
The American bottom line on healthcare costs
The path to affordable healthcare requires two key steps.
The first is to replace the current insurance business model with one that protects consumers against price gouging and pricing discrimination.
The second is for Americans to adopt healthy behaviors. None of us want to be told what to do. None of us want our rights diminished. But with liberty comes responsibility. Until Americans take responsibility for their health, and healthcare costs, the cost for healthcare will continue to soar. Americans coming together on public policy that protects their health is an absolute requirement if we are going to achieve lower healthcare costs.
Obviously, both steps one and two are easier said than done.
The next two articles in this series will outline what America, and Americans, can do to gain affordable health care.
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