45.7 million people in America do not have health insurance. 16 million people are under-insured and do not have adequate protection. $768 is the amount an average family of four falls short in having to pay for health care premiums each year with an annual minimum wage salary. $8,233 is how much the American government spends on health care for each person every year.
Health care is widely discussed and debated all over the world, but for good reason. I will admit that health care issues were not always at the forefront of my mind. However, when I saw the numbers and realized what could be improved upon, that is when I knew that caring about health care was in everyone’s best interest. One day I will go to the doctor for something - my annual check-up if I am diligent - and realize that something that I had not appreciated entirely before is actually essential. “I do not need any medical work done, so what do I care?” The next thought that I had was, “Should I care?”
Do a simple Google search for any news story related to health care and the word reform is sure to follow. In general, health care reform is just means to change health policy with the hopes to improve the quality of the system in place. Reform is synonymous with change, but it also has the connotation that the change will be for the greater good to make something better or fix a problem. In order to develop a solution, the problem needs to be identified, so let us reexamine the numbers.
45.7 Million
The entire populations of Texas and New York combined do not reach 45.7 million people (45.5 million to be exact). Imagine the entire nation has health care except for two of the United States’ largest states. Two states would have to fend for themselves, hoping no citizen got sick or needed to go to a doctor for any reason so as not to come out of pocket for medical treatment. That is the reality. Just because all of the people are not populated in just two areas where they would be more visible, does not mean they are invisible.
16 Million
16 million is no small number. The country of Chile has approximately 16 million people living in it. Chile certainly has healthcare provided by their government, but could you imagine an entire country that size, with that many people not having adequate health care? 16 million people would have to find the best help with what they could afford, if anything at all. In the United States, that is the reality. There are 16 million people that do not have access to adequate doctors, physicians, or the help they need. By the numbers, the United States has an entire country within it that does not have access to proper health coverage. Just because people have some form of health care insurance does not mean they are insured from high bills, debt or even will receive care at all. Simply because the 16 million people are not clustered in one country does not mean they do not exist.
$768
In a Gallup Pole conducted in November 2012, it was estimated that an average American was expected to spend $800 on holiday gifts. We rarely think about the money we spend once it is gone, unless we could not afford whatever it is we were buying to begin with. The moment you realize you have gone past your monthly budget is when reality starts to set in and you try to figure out how you can recoup. Could you imagine never having any money to buy anything other than the bare essentials of life, and even still not having enough money for that? 3.8 million people in the United States must deal with this every year. This is the reality. Health insurance premiums exceed their yearly income by about $800, when no other spending factors are included. The cost of health care is escalating, which burdens families and businesses. 47% of Americans claimed that they needed, but delayed getting health care because of cost. Many people simply cannot afford the cost, so they remain uninsured. $768 over the course of a year does not sound like a lot, but when you do not have it, sacrifices have to be made. Is health care something that can be sacrificed?
$8,233
The poverty threshold for America is approximately $11,000 and 15 percent of the country’s incomes fall below that number. Health care consumes about 17 percent of the GDP and yet 15 percent of the nation is barely getting by, let alone being able to attain proper health care. America spends $480 billion in excess in comparison to other OECD countries where everyone is covered, so there is a divide between what works and what does not. Over $8,000 is paid per person in the nation for care, yet everyone still is not covered. People in the U.S. literally cannot afford to get sick, yet other countries are spending less and gaining more. America has the number one healthcare in the world, but at what cost? The cost of $8,000 is not the only bill worth paying attention to, especially when everyone at the table is not being fed, or just spent their entire paycheck on an insufficient meal.
This is the reality of our health care situation. Changing the context may put a different perspective on the issue, but it does not change the severity and complexity of it. Simplicity and transparency in the system are reforms worth mentioning, but information visibility also means there needs to be a visible problem. When we do not think of all the 46 million people gathered in two states, or an entire country the size of Chile, or how much we waste each December on gifts that are just re-gifted to someone else the next year, we often forget about the importance of health care and the reality of the problems. Or is it that we do not care at all?
This article first appeared on The TIBCO Blog and has been lightly edited.
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Lifehacker
I wade cautiously into this topic. It is charged emotionally, politically and socially; however all three elements tend to slide towards one end of the spectrum or another. Neither side is without compassion. To characterize otherwise belies the importance of what is truly at stake. I gain no office, nor political favor and risk isolating myself on an island surrounded by derision of all types. How is that for a pre-amble?
The U.S. healthcare system is the best in the world. Our patients, eh, not so much. We are a country of blessings. Our poor make the middle class of other countries look poor. We have acces to as much food ( so much we turn our food into fuel for our cars) as we want, entertainment as we want and leisure as we want (although I know I could use more on-demand series at my fingertips).
Don’t hate the story. Appreciate what we’ve accomplished. Every person in the entire history of life wants to live in our time; save the self-hating few that belittle our accomplishments while rolling in its fruit. Occupy my ass. Only in America, right. God bless us everyone.
But this blog and any honest conversation about healthcare in the U.S. needs to look at the building blocks to all of the numbers spewed by either side of the aisle. The U.S. spends $8k per person. The avg. poor family is $800 short on premiums v. their total income?
Both of those numbers, irrespective of their conflagration are based upon a cost. When I insure a 14 year old Taurus with liability only I expect to pay less than my neighbor with full coverage, no deductible on his/her Bentley. I am not entirely sure how to even spell the latter. But I instinctively know there is a difference in the cost and repair of the two.
So what drives cost? Not insurance companies; they only measure the risk and play the odds. They are the bookie that takes the over under and hope to cover the spread. Pre-existing conditions? A place kicker that can’t hit the uprights from more than 32 yards out is no different than a person who can’t regulate their own behavior. Genetic predisposition - hey, in spite of 6 years of football from 12 -18 I wasn’t going to be fast enough with short legs to keep up with my class mates let alone play in college or the pros; get over it. I am not 6’3″ and model handsome, either.
Oh, but this is a life. True. And people live in other countries with worse healthcare and lower costs. That doesn’t seem possible or ‘fair’. Which brings us back to cost.
Hospitals waste $800B a year collectively in materials management labor. That’s more than Obama-care per year. Why do they waste that much? Because they operate like every other subsidized industry. Eisenhower or some great President warned of the Military Industrial Complex. The same should have been warned of the Healthcare Industrial Complex. Only the HIC is backed by the feel-goody-two-shoes that fret over the plight of the poor while the former is backed by the feel-goody-boots-on-the-ground people who want protection from foreign threats. Same people, same flag; just slightly different anthems.
So to tackle the healthcare issue you have to speak honestly about cost. And never, ever, ever put the Federal Govt. in charge of anything you want to cost less, provide better service or meet your expectations. Protect me…yeah, I suspect their command and control is much better than my own ill-conceived, emotionally-charged and unsupported abilities to defend even my own house (although I just started digging a mote).
Vilify the insurance companies; complain about the population of Texas, New York or even Chile not having adequate protection and believing the U.S. Govt. is the answer…come on! Intellectual honesty must be a requirement to jump into this debate. Without looking at the costs we will all buy $500 hammers just like the Military Industrial Complex that others vilify. At least the MIC ended the Cold War and the horrible effects of communism…oh wait…they probably have ‘free’ healthcare.
Steve, caution on this topic is a learned skill, no doubt. Working in healthcare for the past year, I’ve heard from many an honest doctor, nurse, administrator, IT professional and others that our healthcare is not the best in the world. In fact, studies show that we have rapidly rising cost and outcomes that aren’t in line with many other developed countries. I think we tell ourselves we’re the best in the world but that’s a considerable amount of chest thumping and not backed up by fact.
As far as the insurance companies go…it is much more than risk models that drive them. They drive the per-visit cost down for each patient to the point that doctors are incented to operate ‘patient mills’ for the economic model to work. I have a doctor who is now in a concierge program and he laid out the math for me. He seems very credible. The insurance companies, prior to reform, did everything in their power to also insure only the healthy patients and make it very difficult for anyone with a pre-existing condition, be it their own fault or not at all, to get coverage. Profitability was never higher as the employer and employee costs skyrocketed.
For me to be happy about what we’ve accomplished, we need to see health care as a fundamental human right. It is no different than safety or security. The fact that the US is the only wealthy country that doesn’t treat healthcare this way is an accident of history, not a blessing. I think we’ve been kidding ourselves that this isn’t an enormous human dignity problem…mostly because those making that argument aren’t in the 47 million.
As far as the MIC goes…they didn’t do that for free…I was a Navy officer and even if there was the high profile $900 toilet seat (that was on my aircraft, by the way), the military didn’t operate in luxury and costs are massive.
Chris,
Government procurement policies result in a $900 toilet seat. The military themselves have no luxury. Just as the patient has little today (stay with the poor analogy). The govt contractor that made the toilet seat made a managed profit. I know because I worked for GE Aircraft Engine and executed the procurement policies of the u.s. to sub-vendors.
The hospitals are the contractor and their own financial performance demonstrates a lack of cost/business control. Their profit isn’t managed by anyone but themselves. They tend to overspend and create the results v. cost comparison that is unfavorable to our system v. the world.
The insurance companies have been enforcing behavior changes on Healthcare that lowers cost? At least someone is. They follow the procurement policies set by each of the 50 states as to what they offer and how.
The dark sinister force in this discussion is cost. Healthcare wholesale providers realized the cost plus game was available and their customer didn’t mind so $9 aspirins became acceptable. The story repeats in all of the market segments that are part of the HIC.
Again, I am not advocating rationing care or denying service to anyone. I am advocating that the HIC step up and start to act like a business that is 1/7th our economy and stop acting like the cottage industry from whence it came. I would rather see Walmart open clinics nation wide than let the govt continue to meddle. They can set the rules of how insurance is paid for and what coverage must be included. That needs to be done on a national basis and not state by state. Medical malpractice needs to be limited so that costs go down. Etc.
Done properly I suspect the current Medicaid/Medicare funding at the federal level could be flat year by year. But when does the govt ever manage their budget properly? 71 out of the last 82 years of federal spending have been as a deficit.
I had hoped to be politically neutral in my discussion. Apparently that isn’t possible. Next time I see an opportunity to engage in a thoughtful discussion I will heed my caution and go back to watching Basketball.
Walmart would need to insure their own employees first, no? I don’t trust market forces to manage this by themselves. It is too important and the cost of failure is in lives (it is now, we just don’t acknowledge it). I’m a free market person about most things, but not about health, safety and security. We don’t free market our military, police or fire for good reason.
I don’t live in the US (although have in the past for 4 years) and I see very similar voting patterns and political discussions as to what I perceive to be the case where I live.
To be specific, people seem to make decisions based on mindless political dogma rather than any intelligent questioning. Whichever political side that a person tags themselves, (right wing or left wing, republican or democrat) they appear to have certain points of view as function of ‘what a right/left wing person believes in’, without much/any critical thought as to why, and maybe some more nuanced results.
As a rule this doesn’t particularly bother me, however when it comes to healthcare this disconnected dogmatic political commentary kills/maims people.
What doesn’t help is people who spout what appear to be deliberately obfuscating messages (@Steve C) which cloud the real issue issue amongst a set of unanswered questions and data.
This ISN’T a question of left/right dogma, it is simply a question of HUMANISTIC values, and transcends politics. How anybody in modern western society can be comfortable with a fellow human, citizen of the same country, not having access to basic healthcare is beyond me, I don’t care what political party you vote for.
I wonder how many people (like Steve C apparently) would modify their thinking if faced with a situation where an obviously ill child in the arms of a distressed parent is standing next to them at a hospital and is turned away because the parent couldn’t pay?
I cannot understand why this is even a political decision, there are lots of other things to argue about, basic human healthcare should not be one of them. The right wing dogma driven commentary during the last Obama term was frankly shocking and a disgrace. Put those people in a real human situation that their political perspective creates and let’s see their reaction.. YOUR child is suffering and lack of money means that you, the parent is powerless to help…
Steve C’s comment that ‘the U.S. healthcare system is the best in the world’ would be laughable if it wasn’t so tragic. One can argue about the quality of care actually provided in comparison with other countries, but frankly WHO CARES when the supposed ‘best system’ excludes YOUR FELLOW HUMAN BEINGS from basic healthcare.
Understand that the basis of insurance is humanistic; everybody pays a little so that the few that are in need don’t have to pay for the true cost of their problem. Americans, I implore you, get off your political horses and fix this basic issue. Stop the political bullshit and understand that your stance condemns your fellow humans, depriving them of a what should be a basic right.
I appreciate that it isn’t easy to find an economically viable solution. However at least if you took the basic question off the table and would agree that everybody should have the right, you would focus on providing that right rather than arguing about whether it is a right at all.
If anybody, honestly, disagrees with me that healthcare is a basic right and that a government should provide it, good luck with your self-centred sad little world, one that educated, intelligent and civilised people wouldn’t wish to live.
Final point; just in case you think this is the ranting of a ‘loony lefty’ I am economically right wing, believe in free markets etc. etc., indeed my parents think that I’m too right wing… As I said, this isn’t a political issue, it’s a human one.
Mark;
Recall the wade cautiously statement and island of derision? Cost! If the Federal Govt. wants to provide better access to care they need to encourage hospitals and healthcare providers to be more efficient and accurate. Driving down the cost will allow more service for less cost for everyone. I didn’t suggest that anyone be denied. But until the HIC is able to better manage the business of Healthcare, all citizens suffer.
I’ll put my money where my mouth is and offer any Hospital the software and services necessary to reduce labor and inventory costs on a gain-share basis. Take out the waste, reduce the cost and the benefit to every citizen is obvious.
Thank you all for your comments. As I mentioned before, healthcare issues were not at the forefront of my mind as of late, mainly because I did not know how serious the situation was until recently. This was not a political problem that I saw, but a human dignity problem as stated. When I saw that number 47 million, I did not immediately categorize this in the “to be politicized” file. I thought it was devastating to look at the costs, expenses, prices, and the 47 million people uninsured. America does have privileges and blessings that other countries sadly do not have access to, but healthcare should not be one of the things we sacrifice as a consequence. The chest thumping is going to have to have accountability attached to it. If we want to say we are the best, shouldn’t it be the best for everyone? The context of the conversations are to bring awareness, not to vilify anyone. There is a problem that has been at a standstill. Sometimes changing out perspective will allow us to open up the conversation a little and hopefully offer new solutions.
I’m surprised that healthcare is the issue you would choose to focus on. Economic opportunity should really be the issue. And, the best way to create opportunity is through economic growth. Growth solves the insurance issue as employers are the largest providers of private insurance to American’s. Grow the economy, grow employers, and you increase the number of insurance providers. The market takes care of it’s own. It’s always baffled me that people no longer see that.
America was founded on the premise of the free market, of market economics. But, now it seems that instead of following the principles of the free market, we’ve opted as a society to make government the answer. Government has NEVER been the answer. Government has always lead to $900 toilet seats, and $10,000 hammers. Once you put a governmental solution in place you create a monster. A monster that continues to eat more and more resources because without a market force behind it, the government monster has no reason to be efficient. The monster soon becomes unsustainable just as Medicare and Social Security have become.
One day soon, I hope that more American’s realize that it’s the free and unfettered market that gave them the lifestyle they have now. Not government. Only when we come full circle back to that real truth will we stop voting for more government when in reality less is the answer.
A free and unfettered market is a theory that I’m not sure actually exists, so to say it would solve the problem is conjecture. There are great societies in the world where citizens have healthcare without the debate we have and the economies operate just fine. The Scandinavian countries are a great example, with Germany close behind. Canada now has healthcare and a higher standard of living and life expectancy.
The idea that the free market solves all problems has become a political mantra more than a workable public policy. We were operating a relatively free market for healthcare and with costs skyrocketing and outcomes falling behind other countries that weren’t operating a free market. To me, that’s the evidence that a free market isn’t the solution when it comes to vital services like safety, security and health.
I realize there is a segment of the population and elected officials that took this stance and have been very vocal over the past few years. I think these ideas are on the decline as evidenced in the last election.
Chris, I agree with you that more American’s now believe that more government is the answer. Sadly, just because more people believe that doesn’t make it true any more than believing in Santa Claus has made him real.
I know from my own personal experience that the Affordable Care Act has already increased my insurance premiums 16% (remember by now it was supposed to be saving the average family of four $2500 a year, in reality it has cost the average family $2500 more a year). Many prominent insurance company executives have come out stating that it will likely triple insurance premiums once fully implemented in 2014. Now, I think tripling of insurance premiums is merely alarmist talk. But, I fully believe that we will continue to see dramatic increases in premiums and that the Affordable Care Act will do many things except make insurance affordable.