When the electioneering bandwagons roll back into the barn and our new leaders assume their duties – regardless of the party in power – health care remains as the immense force on the nation’s political horizon.
With a growing, aging U.S. population living longer and a health care system struggling under a century of temporary programmatic fixes, there are no magic wand solutions.
In April, the Peter G. Peterson Foundation explained why the growth of health care costs is a certainty because of the growth of Medicare: “The number of Medicare enrollees is expected to increase from 60 million in 2018 to 75 million by 2028. That expansion in enrollment is expected to significantly increase the cost of Medicare over time. In fact, the Congressional Budget Office projects that Medicare spending will double over the next 30 years relative to the size of the economy — growing from 3 percent of GDP in 2019 to 6 percent by 2049.”
Since 2011, every single day, more than 10,000 Baby Boomers reached age 65 – and that growth will continue each day until the end of 2030. All 78 million Boomers in the U.S. are legally entitled to Social Security and Medicare.
American population growth and our entitlements are only one concern. Health care prices are a significant piece of the healthcare puzzle as well.
Johns Hopkins Bloomberg School of Public Health researchers published in the journal Health Affairs in 2019 that “that the U.S. remains an outlier in terms of per capita health care spending, which was $9,892 in 2016. That amount was about 25 percent higher than second-place Switzerland’s $7,919. It was also 108 percent higher than Canada’s $4,753 and 145 percent higher than the Organization for Economic Cooperation and Development (OECD) median of $4,033. And it was more than double the $4,559 the U.S. spent per capita on health care in 2000—the year whose data the researchers analyzed for a 2003 study.”
But population growth, entitlements, and health care prices don’t tell the whole story, either. Health care management is an incredibly volatile.
Relying on data from the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey Household Component (MEPS-HC), researchers found that just 5 percent of the population accounted for over half (50.1 percent) of total healthcare spending in 2017.
What does that mean? Gerald F. Kominski, director of UCLA’s Center for Health Policy Research, told journalist John Donovan that so-called “super-users” in two categories significantly drive up the overall cost of health care delivery.
The first group comprises those who develop an acute illness like an emergency appendectomy or suffer an accident that requires hospitalization and acute care. Still, those illnesses or accidents are basically once-in-a-lifetime occurrences.
But the second group – those with chronic diseases like cancer, diabetes, and heart disease – who need regular physician, hospital, and emergency room care, expensive medicines, and treatment – really consume health care expenses.
Experts say systemic changes in health care management could stave off much of the ER, hospital care, and interventional treatments if those patients had better management of their treatments.
The availability of health care in rural locales is a problem with which Mississippians are all too familiar. Poor people in places with Hill-Burton hospitals - where the percentages of either private pay or government-reimbursed care are severely impacted - put those facilities’ future at dire risk.
Bottom line? The future is more patients scrambling for fewer resources in a health care system, not particularly equipped to handle the influx.
Those are bipartisan challenges that will
hit us all close to home. Social Security, Medicare, Hill-burton,
Medicaid, the Affordable Care Act, none of those fixes have fixed the
American health care system. The next shift of government
leaders – federal, state, and local - have one long row to hoe on this
single issue
Sid Salter is a syndicated columnist. Contact him at sidsalter@sidsalter.com.
16 comments:
After all of the gum banging and tongue wagging, don't believe anything will change much if at all.
Sid, you omitted the two greatest negative impacts on our health care system.
The first was when both parties, in an effort to make it appear that we had reduced " welfare", eliminated welfare to the Aged and Disabled and made them eligible for Social Security payments without having paid into the system. To raid Social Security funds even more, Medicaid was created to move all welfare medical costs for the aged and disabled and then added medical costs for family and children.
In this move, they campaign on reducing both welfare and taxes. Stealing our Social Security payments and reducing what those would be were their " slight of hand".
Then, when a lame duck Congress was lobbied by the health insurance providers that fear the incoming Clinton's advertised health care move would hurt their profits, Congress gave them all they wanted. Congress made sure they were no longer have to report key budget figures on costs and profits and coverage decisions to OMB or GAO. This was expanded to the insurance industry in general before the ducks waddled out.
With the exception of USAA ( which originally was only for military officers and their families, but now includes enlisted and who is owned by those insured) most Americans only have coverage and costs on ALL insurance that is as good or bad as their State Insurance Commissioners negotiate on their behalf.
USAA , which I have, has far lower rates than ANY other insurance company, and still I get checks from them on their profits ( I can apply those checks to payments if I wish).
It begs the question, how can they profit enough to pay all their " customers" a rather nice check every year? Now they were limited to life, auto and only could over catastrophic health insurance.
Well, we don't know and can't know because we have no clue how the health insurance companies actually run any more. Blue Cross/ Blue Shield is the hardest to ferret out. Those with BC/BS in Alabama have far more coverage and far less expense. Why is that? Are they healthier? We don't know and can't know why for certain ( see lame duck Congress and Insurance Commissioners).
I can't blame Insurance Commissioners too much as their information is only as good as what the insurance industry chooses to tell them. The means of verification no longer exists.
Even USAA ( who Americans now know exists as they advertise trying to reach all the enlisted people who turned them in) is screwing with the profits as our "investment" checks are getting smaller. They have expanded into banking and investment and with the larger customer base ( sorry but some of them are just happy with a cheaper payment) they will be more and more a for profit corporation rather than the intended goals of serving active duty and veterans at near break even. Now you'd think my " stock" would be worth more when it comes to dividends as it grows, wouldn't you?
We, as a people, know the cost of everything but the value of nothing. And, until we realize that some basic services are needed for a functioning society ( health, education, public utilities) and that a business for profit model doesn't work for everything, politicians will enrich themselves at our expense.
It's time we asked, " Do our politicians live on their salary? Why would they raise millions to have a job that pays thousands? " Our Nation shouldn't be based on a game of winning and losing and who profits but that's what we've let happen. And, it wasn't always this bad. The Scalia ruling that erased any hope of campaign finance control or any meaningful control of lobbying will go down in history as the worst decision ever made.
And most Mississippians are happy to make sure this move to "money isn't just everything, but the only thing" continues.
What really needs to happen never will because of the $$$ involved. The government needs to let the free market compete to drive down the costs associated with care/procedures/meds. Audit and assess costs, but let the market fight it out.
What free market is that 9:31.
Political leaders of each party speak from behind their respective curtains and feed their media 'shuck and jive' gurus tediously worded 'TROOTH' to throw out to the loyal minions.
4 years ago Fox pushed Rand Paul off the stage largely because he assured America that he would audit the Fed and the Pentagon if elected and likewise CNN joined with the DNC to slip Bernie off into oblivion because he also insisted on audits of the Fed and the Pentagon.
There is no FREE MARKET. We have the market that is bought and paid for by that select group of wealthy whose wealth is beyond the comprehension of most Americans.
If you haven't read the comment @9:17 yet let me summarize it for you. It says 'blah, blah, blah, blah blah'.
After the latest stunt by the Republicans, I expect the Dems to start playing hard ball. If they get the presidency, house and senate, there is no reason to treat the right with civility any longer. All norms have been erased over the last 4 years. The dems will end the filibuster and start enacting laws they've always wanted with no reason to even invite the right into the discussion. This is what Moscow Mitch and the right deserve.
The days of expensive healthcare are numbered juat like so many "jobs" due to autonation and Artifical Intelligence.
AI doctors have an overal lower rate of malpractice and significantly better rate of correct diagnosis than biological doctors.
This is vaslty improved when the AI is directly in control of diagnostic imaging equipment as well as in control of the blood and tissue sampling.
You remember all of those articles about how dogs can "small" cancer? A medical diagnosis AI will smell, taste, see, hear, and instantaneously compare to a billion medical records to aid in diagnosis. The actual human doctor will be a relic for scared ludites and his pay will reflect his usefulness.
Doctors already use robotics in surgery and have vastly improved success and shortened healing time.
@10:33
The democrat party can find all the socialist legislation they want in the DPRK, Cuba, Venezuela etc. They keep pushing it here and the right will be forced to go full Pinochet on the leftists.
We have a constitution as the foundation of our republic, and defending it is the duty of every citizen.
Give me liberty of give me death!
Would you believe the cost of healthcare (what insurance companies pay providers for their services) is way less than it was before obamacare?
In most cases 40-50% less. And the cost of private health insurance is 40 - 60% more? UHC made a profit of 6.6 Billion last year, they have set the standard for the industry.
... there is no reason to treat the right with civility any longer.
You're free to bring your incivility to my front door right now. I've got my welcome wagons, plural, packed and ready to greet you.
@12:52, yet another reason to ban civilian ownership of weapons of war and begin red flag confiscations.
Either way, I believe our country is fucked. Blood will most likely be running in the streets. But what the hell, if Covid can't get us maybe Civil War will.
I believe we have us a want to be dictator on this board. That attitude ain't going to work out for you dude.
Ole Chuck warned Mitch. He going to make him his B*t*h.
" When the electioneering bandwagons roll back into the barn"
Cute intro . . . but Sid should have also mentioned "it was a dark and stormy night".
It wouldn't have been on par with a Charles Dickens' opening line, but may have held
a few readers attention for another minute or two.
Sid, again, please start writing more than obvious facts.
A few cute opening sentences does nothing to change the recent criticism of your Column.
Many of us think you are better writer than this.
Actually, if you want the truth, this column got the lowest amount of traffic ever for a Salter column.
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