Posted by & filed under Noah's Notes.

Many of us who are committed to universal access to healthcare have celebrated some of the successes of the Affordable Care Act, like 20 million more Americans having health insurance, but a recent UPI report reminds us that our healthcare system is far from perfect.  In a December 17 article they reported the results of a Gallup survey which showed the following:

  • 29% of adults in the US postponed treatment due to costs.
  • More than half of them reported a serious or somewhat serious medical condition (representing 19% of all US adults).
  • The extent to which people delay treatment depends on the nature of their health insurance coverage – those with no insurance are the most likely to forego treatment, those with Medicare and Medicaid are the least likely to delay, and those with insurance but higher deductibles and/or co-pays are somewhere in between.

It is likely that no one would find this data surprising, but it should be alarming to everyone.  Delayed treatment leads to escalated costs and unnecessary suffering and death, and this is compounded when public policy results in increased costs to individuals.  No matter where you stand on the ACA, the decisions last year to reduce support for the insurance exchanges and to remove the penalty for the individual who chooses not to get health insurance means that fewer people have insurance than otherwise would be the case, and that the pool of insured people have a higher disease burden and therefore higher costs, which unarguably leads to higher costs for all manifested in their deductibles, co-pays and premiums.

In addition, 30% to 50% of all health care costs are unnecessary and wasteful, the administrative burden on the system is unsustainable, and industries like Big PhRMA are profiteering from a broken model.  In the US we spend $3.5 trillion a year on healthcare – 19% of GDP.  There is a great deal of interest in congress in addressing this and the bills that result will represent either the interests of insurers and pharmaceutical companies or the interests of people living in our communities.  It compels all of us to learn and to engage on this issue and to work toward an outcome which moves us toward broader access to more affordable care.

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