During the past three decades, both Federal-funded healthcare programs like Medicare and private insurers have battled the rising tide of spending on personal health care with a variety of cost containment mechanisms. While other nations counter the fiscal onslaught with nationalized health care to provide universal coverage to its citizens, the United States struggles between partially funded nationalized care and a debilitating system of private insurance that denies patients proper care and undermines the moral codes of physicians. While the government continues to push health care towards the schism of corporate privatization, critics of the system unite with those un-served, proffering a viable transformation to medicate that would equal and exceed the private sector's ability to control the rate of spending growth, price aggressively for the services it covers, and provide health coverage to those citizens most desperately in need.
Currently, the United States struggles to cover its citizens between a poorly meshed private health care and publicly funded nationalized system. In the last five years, health care expenditures have increased at the fastest rates in national history, while many at the bottom struggle for adequate coverage from the government, those who can afford to buy private insurance from monolith health service corporations, and those in the middle remain unserved by the government and outpriced by private companies.
Those most desperately in need of care, those with previous illnesses or still needing expensive, thorough care, are forced out of the system for being "high risk" or, essentially, too financially need to cover. As coverage quality and proficiency decrease, the costs continue to rise. Total national health expenditures increased by 7.7% in 2003 over 2002, rising at four times the rate of inflation.
In 2004, the prices continued to rise with such gusto that they again outpaced inflation. Employer health insurance premiums increased by 11.2%, and the annual premium for an employer health care plan covering a healthy family of four averaged nearly $10,000.
Single-payer coverage averaged annual premiums of $3,695.
The recent rates are startling, but the increase in national spending for prescription medications averaged 14% less just three years earlier in 2001.
While administrators push for privatized coverage and continue to blame fraudulent insurance claims for the increase in financial hysteria, excessive administrative expenses, inflated prices, poor management, inappropriate care, waste, inefficiency, and the frauds circulated by those even as recently as the HealthSouth case truly debilitate the system.
In 2003, health care spending gin the United States reached $1.7 trillion, over four times the amount spent on national defense.
Nevertheless, the conversation has not followed form; discussion about national security and the war in Iraq have outpaced careful attention to the underpinnings of the health system that, were it not for focused public relations campaigns, captured the national attention in the last presidential election. 45 million Americans are uninsured, and while the United States spends more than all other industrialized nations on health care, they all manage to provide universal access to their citizens.
According to the Kaiser Family Foundation and the Health Research and Educational Trust, premiums for employee-sponsored health insurance in the United States have been rising five times faster, on average, than workers' earnings since 2000.
Surveys reveal with redundant repetition that most Americans remain uninsured because the prices are too high; they out-earn the limitations set forth by Medicare, yet the options available to them through work are incompatible with household budget realities.
Nearly one-quarter of the inunisured reported changing their way of life "substantially" in order to pay medical bills.
The prices of privatized health care, with its pay-as-you go plans that cushion the corporate heads with LearJets and houses in the Hamptons
, leave the vast amount of Americans on the fence: buy health insurance from private providers and empty the bank account, detracting from the ability to invest in a home or education, or ignore health insurance and pray for good fortune. A recent study by Harvard University researchers found that the average out-of-pocket medical debt for those who filed bankruptcy is $12,000. The study continued to note that 68% of all of those who filed bankruptcy had health insurance, a higher rate of coverage than the national average, and that 50% of those filing were doing so in part as a result of medical expenses.
The crux of the debate between public provision and privatized health care exists inside a discussion of cost. Clearly, rates and expenditures are on the rise, and the business of health care is doing well. While the government continues to support privatized care, two fundamental issues provide problematic addition to the cost increase: prescriptions and technology. Prescriptions are the catch-22 of private funding; many employers are forced to ignore prescription plans, and when medicines for easily treatable diseases can cost well into the thousands, the average American uncovered by the government faces huge financial burden for treatment. In 2003, drug spending in the United States rose 11% to $180 billion.
Americans consume over 3 billion prescriptions on average, and those over 65 face the greatest natural expense, spending over $2,300 a year on medication alone.
Chronic conditions like diabetes and hypertension combined with rising prices and unmatched coverage to result in doubling of co-payments for prescription drugs and a 10 to 12% reduction in these necessary medications due solely to cost.
Without question, the increase in prescription cost is directly correlated to the poor health care received by most Americans and the rising tide of concern over the structure of health care nationwide.
Technological innovation is the crux of modern health care and many peoples' infatuation with it. While it greatly increases the ability of the doctor to accurately diagnose and treat a problem, in combination with weak cost-containment measures it has become a major factor in the problem of rising health care costs. Both evidence and current practice suggest that improved health care technology increases health care expenditures instead of reducing them, the antithesis of a solution to the problem. Technological advances that have lead to the diffusion of magnetic resonance imaging, computed tomography, coronary artery bypass graft, angioplasty, neonatal intensive care units, cardiac intensive care, positron emission tomography, and radiation oncology facilities is associated only with greater per capita use and higher spending on these services.
Despite their ability to transform the health care for all Americans -- including those at the bottom rung, most desperately in need -- they remain isolated at the top, pushing up the cost of the whole system.
While technology remains in the upper class margin of use and cost in the United States, their spread is not limited by geography or by money to the same extent abroad. Many of these technologies have spread to other nations, where their use exists under nationalized plans that allow equal access to care, but because the United States locks their use inside a private:nationalized struggle, America ends up incurring a higher heath care cost for their use.
According to the physicians publishing health care reform opportunities in conjunction with the American College of Physicians, these nations are better off: "Nations with a greater degree of health system integration have relied on expenditure controls and global budgets to control costs."
A tightly budgeted system, unlike the United States, might not initially allow for their immediate acceptance; but, as has happened with the laundry list of technological advances born in the United States in the last decade, their use is honed someplace where weak budgeting allows for it, and once the system is firmly established, it can spread easily to the other countries where cost initiatives are tightly governed and equally weighted by need; "in those systems, [technological advance] tends to catch up over time."
The role of technology in creation of a viable health care system, either private or public, is important. Technology is only able to be developed someplace where money is spent not just on research and innovation, but also on the marketplace capitalism of the business of medicine. While the technology may eventually spread to the corners of the earth and be coherently integrated into more destitute health care plans as provided by national governments for those most in need, like in India, its advancement can never originate there. Without question, the role of technology is a double-edged sword; the better practices developed by it can exist only with such insurgence in a privatized system and its integration to those who need basic care is slow in coming, while all bear the financial burden in the privatized system. "The doctor never gets anything out of technology," reports one doctor with the Annals of Internal Medicine. "It is like the artificial brain which dulls the clinical skill of a physician. It is probably helpful to fill the coffers of large corporate hospitals and the pharmaceutical firms."
While these coffers overflow, the pockets of the average American empty. On both sides of the debate, policymakers, lobbyists, public officials, leaders, and concerned citizens agree that…