Americans do seem to have a more luxurious system—business rather than coach, as it were—but as with business and coach passengers, everyone reaches their destination at the same time.
How is it possible that Americans pay so much and get so little? The money is certainly going somewhere. What is waste to a patient is income to a provider. The industry is not very good at promoting health, but it excels at promoting wealth among health care providers, including some successful private physicians who operate profitable practices.
The industry also delivers vast sums to the owners and executives of pharmaceutical companies, to medical-device manufacturers, to insurers and to large, ever more monopolistic hospitals.
Much of the difference in costs compared with those of other countries comes from vastly higher prices. American doctors get paid almost twice as much as the average doctor in other wealthy countries. The effect on costs is limited because the U. In a private health-insurance system like that in the U. In a single-payer system, more than half of these costs would be eliminated. Last, consolidation of hospitals reduces competition and raises the prices that insurers pay to cover patients; hospitals are more profitable and patients pay more for their health care.
Half of all non-elderly Americans about million people have health insurance through an employer. Employer-provided insurance is typically well liked by those who are covered, although it is not without costs for the employee.
They also pay health-related taxes, and they have to meet co-payments at the time of treatment, as well as deductibles. Yet they are not free to the firm, and they affect how much firms are prepared to pay in wages and how many workers they employ. For an employer, it is not the wage that matters but rather what the firm has to pay to hire the worker, including the costs of health insurance and other benefits. Employees may think they are being given a gift, little realizing that what their employers care about is the total they pay, not to whom they pay it.
Worse still, employers faced with large increases in health premiums may eliminate jobs or outsource work to firms that pay less and provide fewer benefits. Insurance works only when sick and healthy people are pooled together, in America by employment, and in other rich countries by government fiat across the whole population.
Without subsidies for those with low incomes, and without some guarantee that everyone is always in the system, insurance cannot work.
These trends correspond with the ongoing trend of rising premiums, deductibles, and other types of cost sharing in the employer-sponsored insurance market. For many Americans, prescription drugs are another component of their routine care. Three in ten adults ages 50 to 64 report having difficulty affording their prescription medicines 30 percent compared to about one-fourth of those ages 65 and over with Medicare 23 percent and one-fifth of those under the age of 50 21 percent , who take fewer drugs on a regular basis.
This group, adults ages 50 to 64, is not yet eligible for Medicare but is more likely to be taking more prescription medicines than other non-Medicare eligible populations. Beyond the routine costs of health coverage, health care costs also dictate when people decide to seek out care.
About half of U. Most common among these are relying on home remedies or over-the-counter drugs instead of going to see a doctor 31 percent , skipping dental care 30 percent , and putting off or postponing getting health care they needed 26 percent. About one in five also report they have skipped a recommended medical test or treatment 21 percent while fewer say they had problems getting mental health care because of costs 12 percent.
About one in eight say their medical condition got worse because they delayed their care or relied on alternative treatments due to costs. In addition to putting off care, about three in ten of all adults 29 percent report not taking their medicines as prescribed at some point in the past year because of the cost. In addition, three in ten 29 percent of those who report not taking their medicines as prescribed say their condition got worse as a result of not taking their prescription as recommended eight percent of total.
While the ACA resulted in more than 16 million uninsured adults getting health insurance, the uninsured population still faces significant struggles in their ability to access care. Three-fourths of adults 76 percent who do not have health insurance say they or a family have postponed or put off care due to costs. The most common experiences reported by the uninsured include relying on home remedies or OTC drugs 57 percent , postponing needed care 50 percent , or skipping dental care or checkups 47 percent.
One-fourth say their medical condition got worse because they delayed their care or relied on alternative treatments due to costs.
Households with Serious Medical Conditions This survey includes self-reports and family member in household measures of five serious medical conditions: cancer, stroke, heart disease, diabetes, or a serious mental health illness.
One-fourth of adults 26 percent ages say they, themselves, are receiving medical treatment for either diabetes, heart disease, stroke, cancer, or a serious mental health illness such as depression, bipolar disease, or schizophrenia while a similar share 28 percent say the same about a family member in their household.
And unfortunately, many of us may have firsthand or secondhand experience with this. Medical care in the U. With health insurance often tied to jobs, and the fact that many lost their jobs due to the pandemic, many lost their health insurance coverage. As of July , about 5. Although there are insurance options, such as Medicaid, for those who qualify, this often does not cover all the costs of healthcare.
For example, Medicaid is federally required to cover inpatient and outpatient hospital visits. However, aspects of healthcare such as dental care, optometry, podiatry and respiratory services are considered optional , meaning states decide whether or not these services are covered. Even something as essential as eyeglasses, which many of us take for granted, are deemed optional.
Health insurance is in dire need of change. People should not have to pick and choose what aspects of healthcare they need most solely based on what they can afford at the time.
Instead, health insurance must be universal. Many nations around the world have some form of universal healthcare, which makes healthcare more financially accessible for everyone. This is not just one set-in-stone framework — most nations with universal healthcare differ on its implementation, but they all share the same goal of making healthcare accessible.
Switzerland, the Netherlands and Germany have a blended system of universal healthcare that ensures everyone is covered. In Germany, the quality of care people receive from the private and public systems are supposed to be equal. In Denmark , residents, including immigrants and asylum-seeking refugees, are covered by publicly funded healthcare.
Additionally, undocumented immigrants have access to healthcare services through privately funded initiatives.
The U.
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