Health care

National Voter, Oct, 2008

What We Must Do:

America is facing a health care crisis caused by a combination of skyrocketing costs and an insurance system that leaves 47 million of us without any coverage. We must make quality, affordable health care available to all U.S. residents. All Americans should have access to a basic level of care that includes the prevention of disease, health promotion and education, primary care (including prenatal and reproductive health), acute care, long-term care and mental health care. At the same time, the federal government needs to take action to reduce the costs of health care for individuals, businesses and communities.

Why It's Important:

As a nation, we are spending $1 out of every $6 we earn on health care. Over the last three decades, increases in the amount we spend on health care have consistently risen faster than wages and inflation. If nothing is done to control costs, we could be spending $3 trillion for health care by 2011 and $4.2 trillion by 2016. That's 20 percent of U.S. gross domestic product (GDP).

If the true measure of a country's health care system is the health and well-being of the people it serves, then Americans are getting a raw deal. Women and children suffer the most under the current U.S. system. More than one in five pregnant women in the United States do not receive timely prenatal care starting in the first trimester. Among the results: the wealthiest nation in the world regularly ranks near the bottom among developed countries in infant mortality and low birthweight rates.

Today, 47 million Americans have no health insurance at all, up from less than 40 million in 2000. The uninsured include more than 9 million children. And, if you think this is a problem that mostly affects the poor and unemployed, think again: 70 percent of the uninsured are in families with at least one full-time worker.

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In addition, critics charge that the U.S. health care system is geared too much to treatment of problems and not enough to prevention, which costs less in the long run and results in a healthier America. Today, 75 cents of every health care dollar spent in the United States is spent on treating chronic diseases, many of which are completely preventable.

Part of the reason our system focuses on treatment over prevention is shrinking access to needed health insurance and services. Most uninsured Americans can't afford check-ups and preventive care, so they don't go to the doctor or the hospital until it's an emergency.

What's in It for Us:

Providing quality, affordable health care coverage will reap rewards for all Americans:

Health care for all. A comprehensive federal health care system will guarantee health care coverage for all Americans as a matter of public policy. In recent polls, a majority of people support universal health care coverage for all Americans.

Reduced costs. The average annual premium for employer-sponsored health insurance was more than $12,000 per family in 2007; the average worker's share was about $3,300. For individuals and families without employer-sponsored plans, the costs can be much higher. Every year, health insurance is becoming less and less affordable for families and businesses. Part of the problem is "cost shifting"--i.e., insured Americans continue to foot the bill for expensive emergency care for the uninsured. Experts recommend two key steps for reducing costs for everybody: 1) an increased focus on prevention for all Americans; and 2) the expansion of health insurance coverage to the uninsured. Any health care reforms must reduce or eliminate cost-shifting and excessive administration costs.

A stronger U.S. economy. Other industrialized countries are getting a lot more bang for their health care buck. The United States spends nearly 16 percent of GDP on health care, while the average for all industrialized countries in the Organization for Economic Cooperation and Development is roughly half that number: 8.9 percent. Most of the other developed countries also spend far less on health care than the United States on a per capita basis. Are the people of these countries less healthy than Americans? For the most part, no.

The United States will have trouble competing in a global economy if it can't keep health care costs under control. It's been widely reported, for example, that the price tag for every car produced by U.S. auto manufacturers includes as much as $1,500 for health care that their competitors in Japan and other nations do not have to pay. The annual bill for chronic diseases alone threatens to reach $6 trillion by the middle of the century--money that could be put to more productive uses in the economy.

Where We Are Now:

Over the past eight years, the President and Congress have done little to reduce health care costs or expand coverage for care, while costs have climbed and the numbers of uninsured have grown.

President Bush's main reform was the expansion of Medicare to cover a portion of the cost of outpatient prescription drugs. Another change enacted under President Bush was the creation of health savings accounts (HSAs), which are touted as a way for consumers to save for future health expenses using tax-free dollars. Studies have shown, however, that HSAs, which require consumers to enroll in health plans with higher-than-normal deductibles, are primarily an option for "healthy and wealthy" Americans. Furthermore, HSAs may actually encourage consumers to skip necessary health care services because they have to pay more money out of pocket.