79 million adults cannot pay their medical bills. And that is not the most startling number from the latest Commonwealth Fund report.
It’s that 61% of those people were insured, says Dana Blankenhorn. Dana is a noted journalist and blogs at Zdnet.com.
The report, called Losing Ground, validates the long held fear that the statistic indicating over 40,000,000 Americans without insurance is just the tip of the iceberg. There are people with insurance and still can not afford the needed care.
This creates two fold problems. First those who decide to go for care find out that they cannot afford it. The additional burden of healthcare cost in the time of highest inflation, bad economy, and rapidly rising unemployment is becoming unbearable. This is leading to increased bankruptcy.
Second set of the problem is just like a ticking time bomb. “To avoid bankruptcy 45% of us are putting-off needed care, which just makes it more expensive, or foregoing preventive care that might avoid the problems altogether.” Quotes Dana. The trouble with this trend is that avoiding preventive care is going to exacerbate the cost problem and in fact create more burdens on the already overloaded healthcare system.
This issue does not have significant impact on the people in the high-income bracket. The income group, according to study, spent only 5% of their income on out of pocket medical expenses in 2007 compared to about 10% many of us spent. The rich have the disposable income and they may not feel the pain. But those of us who are struggling to make ends-meet have to count every penny. And this is breaking our back!
Lead author Sara Collins called this a “perfect storm” of trends impacting Americans during what was advertised as a period of economic growth.
While this report may favor one candidate over the other in the presidential race, none of them have proposed a bold plan to provide solution.
We need total healthcare transformation…. may be charisma of Obama and courage of McCain might lead us to that place.
For the time being, it is US who has to make sure that they offer a complete solution. Less than that is not acceptable.
About the Author: Dr. R.K. “ravi” Pandey has years of experience in business and business process transformation, strategy, and Lean Six Sigma. Ravi currently serves as the President of BIPRO Inc.
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I see several problems with this.
1. There is NO health care crisis. The “crisis” is an invented one by those who want “universal” health care paid for by the taxpayers.
2. There is NO constitutional basis for the government to provide health care. Part of the reason this country is so screwed up right now is the extra-constitutional and anti-constitutional programs the government is involved in.
3. The number of those who are uninsured is silly. Are there 40 million Americans without health care? No way in the world. Every American (and non-American in the country, legal or not) has access to health care.
A hospital cannot refuse care to someone based upon an ability to pay. Does this drive up the costs for those of us who are insured? Absolutely. But, it is dishonest to suggest that Americans do not have access to health care. They do.
Now, are there 40 million UNINSURED Americans? Perhaps. But even this number is meaningless because it does not take into account WHY someone is uninsured. The author would like you to believe that these 40 million WANT health insurance but cannot obtain it. What it doesn’t take into account are those who CAN afford it but don’t WANT it.
Yeah, I know this flies in the face of sanity, but there are plenty of reasons as to why people CHOOSE not to have health insurance. Many of them are young adults who do not see a need for paying health insurance premiums since they are now healthy. You also have people who are very rich who do not feel the need to spend money on health insurance.
4. It is NOT health care costs that is driving bankruptcies. It is a wide factor of things, including the high cost of oil, the increase in loan rates compounded with the fact that so many people purchased loans they could not afford, the increased cost of food, etc. Health care costs MAY be a contributing factor, but it is NOT a driving factor.
Cheers, I suppose,
Jeff
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Jeff,
I appreciate your so passionate response. I have tried to address some of the points and hope they shed some additional ligts in refernce to your comments.
1) The crisis you do not feel as you might have insurance. But if you check with your employer, they will tell you that it is breaking their backbone. In addition to lot of other reasons, healthcare cost is one of the reason GM is not so competitive or close to bankrupt is the healthcare cost.
2. I am not an expert of constitution. So, I am not sure. Government’s job is create econominc and physical security of its citizens. Remember: pursuit of happiness! Government has not screwed up everything. Medicare cost is alot cheaper than the private mgmt healthcare.
3. 40 million unisured is a conservative number. There are about 40 millions more under insured. I think you are mixing up the issue between access and affordability. Of course every American has access if they can afford it. One way to deny access is to raise the price to the level of unaffordability.
Hospitals providing you emergencycare by law does not imply access or affordability. Have you asked the question, why people end up in emergency for common illnesses. It is because they cannot afford normal checkups.
There certainly are people who can afford but do not buy. That number is very limited. These are not rich people but small business owners. They do not make enough money to buy insurance.
Many young adults ( I will admit I have not seen that…when I was in school, it was a criteria for registration) have insurance. Unless they fall into the category of working for private business, employers do not provide insurance, or their parents cannot afford it.
THe macho feeling that theydo not need is not true. I can understand if you say they do not go for preventive check up…that is very common.
I am not sure if Rich people do not buy insurance. Insurance has nothing to do with your current health. It is about insuring unknowns.
4. Bankruptcy is not by single reasons. Lots of tiny things add up to it. Of course behavior, wasteful nature, etc are as much responsible.
That does not in anyway imply that healthcare is not responsible. If the price of water, and food goes up very hight. Would you say that people are not eating only because of food price. It has nothing to do with water prices?
Healthcare is as much of a driving factor as contributing factor. Look into the earning of an average person. And divide the money in many basic necessities. You will find what fraction of the earnings go into healthcare needs and it will speak to you of the driving/contributing nature of the healthcare expense to bankruptcies
rgds
ravi
With all due respect, Ravi, you’re incorrect.
With regard to Point 1: I know what our health care costs are. We have a generous policy and yes, it isn’t cheap. But, it is part of the cost of doing business. If you want good people working for you, you have to provide good benefits.
But, this has nothing to do with the price of tea in China.
With regard to Point 2: Nowhere in the Constitution does it suggest that you have the right to life, liberty and the pursuit of happiness. That term is from the Declaration of Independence.
If you don’t know what the Constitution says, Google it and read it. The Constitution outlines what the government CAN and CANNOT do. There is no provision – nothing even remotely close – to suggest that the government has a right, duty or ability to provide free health care for all.
If it isn’t in the Constitution, then the government (at least federal) does NOT have the authority to do it. Again, this is why the country is as screwed up as it is today.
Your comment about Medicare shows a lack of reality. Medicare does a crappy job, pays pennies on the dollar, and is why many medical facilities do not accept Medicare.
I will challenge you to provide documentation as to things the federal government does well. My guess is that you’ll come up with a list that you can count on using only one hand.
With regard to Point 3: You’re mistaking what you would like to believe with reality. Reality is that a hospital CANNOT deny medical services to someone based upon an ability to pay. That’s access. It has nothing to do with affordability, because affordability is taken out of the picture.
You state that the number of those who can afford to buy insurance but don’t is very small. Please provide documentation to support this statement.
You also confuse what a “young adult” may be. You indicate that someone in school must have insurance as part of their registration. So, at 21 or 22, they are no longer a “young adult?”
I spent 15 years in the insurance industry. I think I understand the concept of insurance better than many people outside of the industry. There ARE people who choose not to have insurance, whether it be life, health, auto or homeowners insurance. Just because you don’t believe these people exist does not mean that they don’t. The reasons are numerous – including the belief that insurance is a scam, that they can better spend the money they have elsewhere, that they are healthy and aren’t going to get sick, and yes, that they can’t afford it.
Point 4: The force is either driving OR contributing. It cannot be both.
Cheers,
Jeff
I think that’s a bit much. For 50 years Americans like me have spent more than they should have. This means that little is left to cushion a financial hardship.
This sort of blame mongering is a convenient form of leadership trickery. Finding a convenient enemy for resentment and fear mobilizes a populace. Other leaders have used the creation of enemies efficiently. But, it solves nothing. Nor does it do the hard/unpopular thing – point the finger back at ourselves.
Save more, spend less. I wish I had the forditude for it. But, my feelings of entitlement drown out prudence. I might fair better if I had stronger coaches to help me through my times of spending additiction / entitlement. Instead I gorge on cable, internet, cell phone, instant email, starbux.
I know my mortgage debt should be no more than about 2 times my salary. Yet, that would put me in house I don’t feel I’m entitled to. So, I am house poor.
Entitlement is driving bankruptcy. I think your coaching here is short sighted and saying what folks want to hear. I think it’s what we will hear from our elected officials because we let them.
If you want to point fingers regarding the root causes of healthcare expenses, have American put down their doughnuts. We are fat (and stupid but that’s a different rant). You can’t grow our lbs at 7% per year and not expect the cost of care not to grow exponentially faster than that. The financial expense associated with the chronic diseases caused by stupid food choices are devastating financially. Universal healthcare just shifts the money around. Instead of paying $1000/mo in insurance premiums – I will almost certainly pay $900 – 1200/mo in additional expenses somewhere else. The additional cost will filter slowly through the economy in the form of taxes or new costs now shifted to me because of funding cut in other areas. How about this, raise tarrifs to increase revenue results in less competitive markets, increases the cost of products domestically, I pay more. Not a tax, but a sneaky way of getting to the same place. How about cutting the preverbial “fat” from the budget. Except, most programs are lead by pretty aggressive folks who want to get ahead. With some exceptions, I think programs are run more efficiently than I could.
The irony, I think, is that to fix helathcare and help these poor uninsured familes we will go Universal Healthcare. To pay for it, we will fight taxes beause taxes are “bad”. In the end we to try to have our cake and eat it too and cut unpopular Fed services. Which, will probably be the services geared towards the “poor” since their lobbyists aren’t that handsome.
You can write me off as being in insurance. But, that’s my 2c.
John,
Great comment. I for one do not want to judge one idea vs the other. We are in the mess because we have shut down the voices. I think we need to educate each other so that we can evolve to an educate solution with consensus.
If you visit our blog, our mission is to look at healthcare from all perspective. I agree that more often than not insurance companies get the blame. The fact is we are all responsible for it to some degree..so for a total healthcare transformation, we need to look into hospitals (a place of big waste), insurance companies, and our own habits as you pointed out. We also need to look at over medication, globalization, and more importanly about the healthcare policy.
You may have heard that we are free economy…but not healthcare. The number of doctors is controllled by congress and inturn by lobbyist. If you assume for a second the principle of supply and demand, we have artificially created the shortage ( I can not validate this).
I am going to start writig on improvement methods in the future.
I look forward to more of your comments.
rgds
ravi
I have to agree with John that entitlement is the core of our current difficulties. We as a people expect to be given too much. Why is healthcare a right that should be provided by the government? Before I need a trip to the doctor and a flu shot, I need breakfast and a place to sleep. Why don’t we expect that the government will provide all our meals and a housing plan? Aren’t those basic human needs? Perhaps we could hand over 100% of our income as taxes and receive all our basic needs from the government. Of course, that wouldn’t be freedom. The price of autonomy and human dignity is taking responsibility for our own needs and earning the means of paying for them.
Good work BiPro Team! The post is very much on target in identifying the position many average americans find themselves in. A good friend is a diabetic, as is his daughter and the medications, etc are eating a hole in their pocket book even though they have insurance. Add to that a month off for backsurgery. It won’t bankrupt them by itself, but it does place them in increasingly precarious position. They have it good. Daily I see people who can’t afford their medication and try to do without on some days or take 1/2 the pill. It makes me wonder why we continue to look for cures to more illnesses when we can barely afford to be cured of the illnesses where treatment is available. Just my thoughts….
Brandon,
I am not sure of this entitlement topic. I do not know anything being given to me!
Government has the responsibility to provide or help provide basic needs. If I can take your logic, then by that token ,we would not need police as you can buy guns to defend yourself.
We do not need public libraries as you can buy books.
It is not about entitlement…it is about providing the basic needs so that people are able to compete, be productive, care for themself.
We have somehow demogogues tell us that we have too much government…and yet those are the one who have spent more money in the government…
We need to read carefully, analyze every situation, and yes come to conlcude what type of community we want to create?
We are social animals and living like others do not exist does not help. We need capitalism but what we have is not capitalism..we have survival of the fittest. Which is a jungle rule! That is not civilized.
[...] respectively. Patient safety is quite often at stake. And the cost is so high that many are becoming bankrupt while over 40,000,000 without [...]
Most people I know are afraid that one serious illness, even with insurance, including disability and long-term care, will wipe them out.
Blaming Americans for improvidence, weight gain, and doing the double-talk of “there IS no crisis” strike me as, somehow, in stark contrast to these people’s fears.
Especially when we are constantly exhorted that emergency ward care drives up the cost of overall care and is irresponsible (but I suppose if we’re improvident and eat burgers, we can’t expect to do better).
In Aesop’s parable of the ant and the grasshopper, the ant is an unlovely creature. But Aesop’s ant is blunt and does not rationalize.
What I’m reading here is rationalizations of other people’s fears.
Flag me if you will. I don’t consider that admirable or useful.
Jeff for President!
It is evident that there is a health care crisis, this has become a focal discussion point in both developed and developing economies.
What may be considered acceptable in a developed country differs in a developing country. Namely;
1. Clean water (washing hands)
2. Proper sanitation etc…
When one expresses gratitude, we must also realise that no resources can remain fixed for indefinite periods of time. They will continue to attract cost, hence the reason for the transformation. Be the change that you would like to see.
Most economies are encouraging people to take responsibility and accountability for their own health. We are not talking about inherent disabilities. Everybody that is born healthy has a choice to continue to nurture the gift from their creator.
Purposeful living and serving others will remove a considerable burden on any overloaded Health system. People’s behaviour will have to change toward their health because risks and consequences are severe.
Do not expect the state to meet your expectations you will be disappointed. Your habits determine your destiny. If a population group is overweight, deal with the root cause.
Disease surveillance management interventions
can address many root causes but requires a spirit of co-operation from every individual so that the flow can occur in the same direction.
Best Regards
Kg
I couldn’t understand some parts of this article, but I guess I just need to check some more resources regarding this, because it sounds interesting….
Jeff,
Did you know the United States generates $400 billion more in health care costs than other countries that provides universal care but there is no disease that can explain it?
Did you know that half of the four million bankruptcy filings in 2001 were due to high health care costs?
Have you read the McKinsey study on health care in the United States?
Have you studied any of the excellent reviews that are backed by years of research on such sites as:
http://www.nchc.org/facts/cost.shtml
If I could afford the $300 a month as a young, healthy adult for coverage that would still drive me to bankruptcy, I would.
[...] leading causes of individual bankruptcies are the massive expenses of a family medical crisis, and many of those people had insurance. We are told the United States the best health care system in the world. Yet we spend 20 percent or [...]
Jeff has nailed it on the head…Ravi is disingenuous because if “our (THT) mission is to look at healthcare from all perspective” as he states then why is it I not seen any analysis of alternative proposals from other sources such as American Solutions, Sean Hannity, or Conservative for Patient’s Rights?
Rudy,
The mission is to look at all perspectives. I did an article on republican bill too.
I am willing to publish any article supporting any view.
It is a platform for ideas and debates…As you will see some of the passionate debates on some of the articles.
ravi
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