A Collection of Problems with the US Health Care System

Health Care Statistics

Healthcare is one of the top social and economic problems facing Americans today. The rising cost of medical care and health insurance is impacting the livelihood of many Americans in one way or another. The inability to pay for necessary medical care is no longer a problem affecting only the uninsured, but is increasingly becoming a problem for those with health insurance as well.

  • In 2012, nearly half (46%) of adults ages 19 to 64, or an estimated 85 million people, did not have health insurance for the full year (30%, or 55 million) or were underinsured and unprotected from high out-of-pocket costs (16%, or 30 million). (Source: Commonwealth Fund Biennial Health Insurance Survey 2012)
  • The amount people pay for health insurance increased 30 percent from 2001 to 2005, while income for the same period of time only increased 3 percent. (Source: Robert Wood Johnson Foundation)
  • The average annual premiums for single and family health insurance under employer-sponsored coverage was $5,615 and $15,745, respectively, in 2012. (Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2012)
  • Healthcare expenditures in the United States exceed $2 trillion a year. (SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group;) In comparison, the federal budget is $3 trillion a year.

The underinsured are those who have health insurance but still struggle to pay their healthcare bills. Many of them are faced with rising health care premiums, deductibles, and copayments, as well as limits on coverage for various services or other limits and excluded services that can increase out-of-pocket expenses.

The following statistics are from the Commonwealth Fund Biennial Health Insurance Survey of 2012:

  • The number of adults who were underinsured (if insured all year) climbed steadily over the past decade, rising from 16 million (9%) in 2003 to 30 million (16%) in 2012.
  • People in the lowest income levels are affected the most, as 75% of working-age adults with incomes under 133 percent of the poverty level ($14,856 for an individual or $30,657 for a family of four) were underinsured or experienced a time without insurance.
  • 72% of the total number of Americans who were uninsured or poorly insured in 2012 were people with incomes under 250 percent of poverty ($92,200).

To consider an individual underinsured is a somewhat general concept which can vary depending on individual circumstances. The researchers at the Commonwealth Fund, however, define the underinsured as “people who spent 10 percent or more of their income on medical expenses (or 5 percent if they were low income), or people who had deductibles that equaled at least 5 percent of the family annual income.”

As part of the study, researchers found that the underinsured behave a lot like the uninsured when it comes to medical care. That is, they often don’t visit the doctor, don’t fill prescriptions, and don’t undergo preventive checkups and lab tests. Even when they go without preventive care and necessary prescriptions, many of the undersinsured are still unable to cover all their medical expenses.

  • In a study completed by the Commonwealth Fund, in 2012, 41 percent of the adults (2 of 5 adults, or an estimated 75 million people) reported that they had a hard time paying their bills, even with health insurance, and had been contacted by a collection agency or had to change their way of life in an effort to pay their medical bills.
  • Approximately 50 percent of personal bankruptcies are due to medical expenses. (Source: Health Affairs)
  • According to a Kaiser Family Foundation poll, 28 percent of middle income families (annual family income between $30,000 and $75,000) stated that they were currently having a serious problem paying for healthcare or health insurance.

Most Americans would agree that health care reform needs to happen, but the disagreement is on how a new health care system should be structured and funded. What doesn’t work is a health care system administered by profit-driven corporations and health insurance benefits that are primarily tied to employment.

  • Health care benefits are an important factor in either taking a new job or staying with a current job. Approximately 25 percent of employed individuals choose employment based on better health benefits. (Source: Kaiser Family Foundation)
  • Many co-habitating couples are getting married in order to provide their new spouse with access to health care benefits. (Source: Kaiser Family Foundation)
  • Retirees will need an estimated $635,000 (per couple over age 65) to cover healthcare costs in retirement. This amount is estimated to give a retired couple a 90 percent chance of having enough money to pay for their health expenses beyond what Medicare covers. (Source: Employee Benefit Research Institute)

The United States is fast becoming one of the worst health care systems in the world.   Not only are they the only industrialized nation that does not provide some form of universal health care to it’s citizens, they have one of the highest rates for health care expenditures.

  • Health care expenditures in the United States are the highest of any developed country, at 15.3% of GDP.  The country with the next highest spending is Switzerland, at 11.6% of GDP. (Source: Organisation for Economic Co-operation and Development)
  • The United States does not spend health care money efficiently.  An estimated one-third of 2006 health care expenditures, about $700 billion or nearly 5% of GDP, did not improve health outcomes.  (Source: Congressional Budget Office)
  • Prescription prices for drugs still under patent protections (as opposed to generic medications) are about 35% to 55% higher in the United States than they are in other countries. (Source: Congressional Budget Office)

One of the biggest and most costly aspects of health care is the treatment of chronic diseases. It will be hard to make insurance affordable without changing how chronic disease is treated.

  • 75% percent of total health care spending in the United States in 2007 went towards the treatment of chronic diseases, such as diabetes and asthma. (Source: CMS)
  • Approximately half of all chronic diseases are linked to preventable problems including smoking, obesity, and physical inactivity. (Source: CDC)
  • Numerous studies have shown that when patients with chronic diseases focus on their health and get involved in their own care, their health improves and health expenses decrease.

The problems with health care are affecting many Americans: the uninsured and insured, the unemployed and working, children and retirees, single individuals and families. From lack of access to preventative care and the high cost of medical treatment, there are many health care problems facing Americans. By sharing our experiences and problems in regards to health care issues, hopefully we can find a better solution for fixing our health care system.