Though the United States has the most expensive healthcare system in the world, 47 million Americans have no health insurance. Healthcare is the country’s largest economic sector, accounting for over $2 trillion in annual expenditures—four times larger than national defense!
Yet millions cannot afford to take care of their health needs.
And the prospects are getting worse. During the past eight years, insurance premiums have nearly doubled, resulting in health insurance moving farther out of reach for millions. Burgeoning medical bills are increasingly leaving families drowning in debt. Tragically, one-half of all personal bankruptcies are caused by medical bills, according to the organization Health Care for All – California.
Hospital emergency rooms are stretched beyond capacity, as the number of emergency visits increased to 120 million a year in 2006, up from 90 million ten years earlier. At the same time, the number of hospital emergency departments dropped by 7%, according to the 2009 National Report Card on the State of Emergency Medicine. Millions of sick people who cannot afford medical care are desperately pouring into emergency rooms, which by law cannot turn them away.
Adding to the misery, by 2015, the National Coalition on Health Care projected that the government will double healthcare spending to $4 trillion per year, or 20% of the nation’s budget. With millions of uninsured people unable to access proper healthcare, overstretched hospitals and escalating costs, America’s healthcare system is collapsing.
Can anything be done to save it?
The U.S. healthcare system is financed by premiums, the collection of monies paid for health insurance. At the same time, healthcare providers must be reimbursed for services dispensed. The responsibilities for these are shared by insurance companies and the government.
The U.S. is the only developed country, except for South Korea, that does not provide healthcare for all its citizens. What is unique about the U.S. system is that the private element dominates the public one. For example, the Kaiser Foundation reported that 61% of non-elderly Americans in 2006 received insurance through their employers; 14% were enrolled in public insurance programs like Medicaid; and 18% were uninsured. Those over age 65 were usually enrolled in Medicare.
Here is how the system is organized:
• Employer-sponsored Insurance: The main way Americans receive health insurance coverage is through their employers. Companies provide this as part of their benefits package. These plans are administered by insurance companies both for-profit (Aetna, Cigna, State Farm, for example), and not-for-profit (Blue Cross/Blue Shield).
Some large companies choose to “self-insure,” that is they pay the health costs directly while choosing a third-party (usually an insurer) to administer the plan. Employer-sponsored plans are financed partly by the employers who pay most of the premium, and partly by employees who pay the remainder.
• Individual Health Insurance: This option covers individuals for whom insurance is not provided through their employers, those who are self-employed, and retirees. Plans are provided by private insurance companies. Insured individuals pay the full health insurance premium.
• Medicare: This is a program provided by the federal government which covers individuals aged 65 and older, and disabled individuals as well. It is funded through federal income tax, as well as taxes on employers and employees, and premium payments by those enrolled. Medicare covers hospital services, physician services and prescription drug benefits.
• Medicaid: This program is designed for low-income individuals and those who are disabled. States are required by law to provide coverage for children, the elderly, the disabled, parents and poor pregnant women. Adults without children are not covered, as well as poor individuals who earn too much. A comprehensive set of benefits is offered by the program, including prescription drugs. However, in spite of this, many of those enrolled still have problems finding providers that accept Medicaid, because of its low rate of reimbursement.
• Other Public Systems: These include the Veteran’s Administration (VA), which provides healthcare for military veterans in VA hospitals and clinics, which are government-owned, and the State Children’s Health Insurance Program (S-CHIP), which covers children whose families earn too much to qualify for Medicaid, but too little to purchase private health insurance.
Individuals and businesses pay premiums to insurance companies that pay those insured when claims are made. In many cases, insurers make payments directly to the healthcare providers instead of to the claimants; this depends upon the type of plan chosen. Both individuals and businesses pay income taxes to the government, which fund programs such as Medicare, Medicaid and other government-funded health insurance programs. The government also uses money from taxes to reimburse providers for services to members of government programs.
The federal government substantially subsidizes employer-sponsored insurance because employees receive this as a tax-free benefit, and employers are able to deduct health insurance benefits as a cost of doing business. The size of the subsidy is estimated to be approximately $100 billion annually.
The U.S. spends a higher percentage of its Gross Domestic Product (GDP) on healthcare than other industrialized countries; in 2003, it was 15%, versus an average of 8.6% in the OECD nations (the Organisation for Economic Co-operation and Development, a group of major industrialized countries). The United States also spends more per capita than any other industrialized country, spending $5,635 per capita in 2003, versus the OECD’s $2,307. And coupled with high expenditures is the high cost of care for individuals.
The reasons for the high cost of care in the U.S. include factors such as the rising cost of technology and prescription drugs, and high administrative costs from the country’s complex multiple payer system. Approximately one-third (31%) of all healthcare dollars are spent on administrative costs. Further, another 10% of U.S. expenses are spent on “defensive medicine”—the costly tests by doctors, afraid of missing anything, who risk being sued for malpractice.
Another contributing factor is the shift from “non-profit” to “for-profit” healthcare providers, such as the growth of for-profit hospital chains. Also, the large number of uninsured people is significantly contributing to rising costs because conditions that could have been detected, treated and prevented in their early stages go undetected and later develop into full-blown crises. These then require more expensive procedures that may even include intensive care or emergency room treatment.
Due to rising costs, many employers have been forced to cut back or drop their health insurance plans. As the number of uninsured grows, hospitals and other healthcare providers must compensate through “cost shifting” at the expense of taxpayers and higher premiums for those with insurance.
Even public programs have been affected. The country’s aging population is boosting spending on healthcare. It is estimated that one-half of Medicare funds are being used to support sick people in their last stages of life. Experts estimate that Medicare funds will be exhausted by 2018.
The 2009 National Report Card on the State of Emergency Medicine gave the nation an overall grade of C-minus, with 90% of the states earning mediocre or near-failing grades. Hospital emergency rooms are stretched to the breaking point. If the economy continues to falter, the already long waits for care are likely to get much longer.
Every year, hospitals turn millions of dollars in unpaid bills over to collection agencies.
Here are a few statistics (from ABC News, Science Daily and the National Coalition on Health Care) that put the crisis into perspective:
The U.S. has the world’s most expensive healthcare system, yet one-sixth of Americans are uninsured. National surveys reveal that the primary reason is the high cost of coverage.
Approximately one-third (31%) of adults and a little more than one-half (54%) of children do not have a primary care doctor.
Federal spending on healthcare in 2005 alone totaled $600 billion, a massive one-quarter of the federal budget.
Someone files for bankruptcy every 30 seconds because of health concerns. And every year, 1.5 million families lose their homes to foreclosure due to unaffordable medical costs.
The U.S. spends six times more per capita on the administration of the health insurance system than Western European nations, who insure all of their citizens.
The total medical expenditures for the uninsured of nearly $124 billion in 2004 was more than the combined expenditures of the Iraq war and “war on terror” programs.
The percentage of adults who receive recommended preventative care and screening tests according to guidelines for their age and sex is only 49%.
Each year, the number of Americans who die from medical errors is close to 100,000—more than double the annual number of deaths from car crashes.
The list could go on. The critical problems that need urgent resolution are the lack of access to healthcare, the high cost, a perceived lack of fairness in the system along the lines of race and class, and ineffectiveness in improving the overall health of the populace. Other major contributing issues include declining patient choices; the increased control in healthcare decisions by managed care companies as they seek to further limit access to care; frustrated, overworked medical practitioners; nurses departing from the medical profession in droves; and quality of care issues.
America’s healthcare system is in turmoil.
Experts offer numerous theories as possible solutions. One that appears to be gaining support is a single-payer system, a universal form of government-provided healthcare, similar to Canada and certain Western European nations. Under this system, the federal and state governments play the major role in providing healthcare. Advocates of this approach believe it will resolve the problems of cost, access and fairness.
Other solutions include expanding Medicare to the entire population. Some favor price controls and imposing strict budgets. Others believe that free market competition is the way to go.
A common thread exists among the popular solutions offered: to create a better healthcare system. Yet few ask, “Why are so many Americans sick and out-of-shape?” In other words, why do so many need medical care in the first place?
There is a cause for every effect. Many attempt to solve problems by addressing the symptoms rather than the cause. The country’s healthcare problems will not be solved by more money, easier access to providers, a more efficient administration, greater government involvement, or any other solution that address the symptoms.
True progress will be achieved only when people take personal responsibility for improving their health. This involves eating a proper diet, regular exercise, sufficient sleep, living less stressful lives—and, most importantly, obeying the laws and principles of God, which were designed to benefit human beings both physically and spiritually.
These changes demand a level of character and commitment so lacking today. Too many are willing to blame “the system” for their problems rather than take personal responsibility. Until these steps are taken—which will build sound lives, resulting in vibrant health and, subsequently, a lesser need for healthcare—the crisis will not be solved.
A time is coming when America’s healthcare crisis will finally be solved. A new, world-ruling government—the kingdom of God—will be established on earth. This divine supergovernment will replace the governments of men and establish the Law of God throughout the world. The sick will be restored to perfect health (Isa. 35:5-6). Humanity will be taught the laws and principles of good health. Consequently, today’s complicated, expensive and burdensome health insurance systems will be a thing of the past.
God’s kingdom will soon come. But you do not have to wait until then to benefit from God’s laws. You can implement them now. Start by reading our booklet God’s Principles of Healthful Living. You will be glad you did!