Okay, here is the the most important of all issues among voters, according to recent polls.
If you were President and had a House majority and a Senate supermajority on your side, how would you fix the nation’s health care crisis and, if spending is involved, how would you pay for it.
For a summary of the issue, read below...
In 2016, approximately 67% of the US population was covered by private health insurance companies, with 56% being covered under an employer-sponsored plan and 16% being covered under a directly purchased plan. Medicaid, a government sponsored health insurance program for those living in poverty, covered 19%, Medicare, a government sponsored health insurance program for individuals over 65, covered 17%, and the US military covered 5%.
Approximately 9%, or 27 million, were uninsured in 2016. This marked the lowest point in a decline that began after the 2010 Patient Protection and Affordable Care Act took effect, also known as Obamacare, which included an individual mandate that required everyone to have insurance or face a tax penalty. The rate of uninsured Americans was at 16% in 2010. Recently, in 2017, however, this individual mandate was lifted, resulting in an additional 4 million Americans coming off health insurance since then. The United States is the only industrialized nation in the world that does not have universal health coverage for all its constituents.
The primary reason for the lack of coverage for millions is due to the rising costs of health care, which has far outpaced the rate of inflation and worker pay. Employer-sponsored health insurance premiums rose 160% from 2000 to 2010 and rose 19% from 2011 (after Obamacare took effect) to 2016, resulting in an overall increase of 213% from 2000 to 2016. Whereas, by comparison, inflation had an increase of only 44% and worker pay increase of only 60% from 2000 to 2016.
While the rate of increase in premiums has slowed down since Obamacare took effect (even though the rate remains higher than the rate of inflation and worker pay increases), the rate of increase in deductibles (what an individual must pay out of pocket for care before the insurer covers the cost of care) has increased 63% from 2011 to 2016.
Today it is estimated that employer based plan premiums are an average of $6000 per year for individuals and $18,000 per year for families, with workers contributing $1000 and $5,000 respectively towards that figure and employers covering the rest (and likely tamping down wage increases). Yearly deductibles in these plans average $1,500 for individuals and $3,000 for families.
Individually purchased plans average $5000 per year for individuals and $14,000 for families in premiums, with additional out of pocket costs maxing out at $7,350 for individuals and $15,800 per family in these plans. Obamacare provides subsidies to individuals earning less than 400% of the poverty level to help offset these costs. Obamacare also provided subsidies to insurers as well, but that was discontinued in 2017, resulting in an increase to average premiums by 20%.
Drug prescription prices have increased as well in a rapid fashion, and now average over $1,000 per year for an individual, double what it was in 2000, and even higher for those on Medicare.
Overall, health care costs are approximately $10,000 per person in the US, far higher than that of any other country in the world, about $3,000 more per year than the next highest country. The higher costs in the US are attributed to the administrative costs associated with the private insurance industry, lack of negotiated prices of care and drugs, high salaries of medical professionals, and larger spending practices in the US.
Despite having the highest per capita expenditure of health care, the life expectancy of Americans is 34th in the world at 78.6, which has itself been going down from its high point in 2014. Obesity rates have tripled in the US from 13% in 1962 to 40% today. And while smoking has decreased at the same rate in that time span and alcohol consumption has gone down as well, prescription opioid addiction has increased dramatically in the past several years, with sales and overdose deaths each quadrupling since 2000. Daily dosage per capita is almost double that of the next highest country. Illicit drug use has decreased in recent years with the exception of heroin and marijuana, although the latter has been legalized in many states.