The much debated, little agreed upon healthcare reform is now the law of the land.
Healthcare in this nation should have been reformed decades ago. Like any problem, the longer it continues, the more complex the solution becomes. Some things in our (non) system are very broken.
Uninsured people. The number is 45.7 million or 15.4% of the population, according to census figures. These people are not without healthcare, they just wait for emergencies and then often turn to hospital ER’s or community clinics, or carry outstanding bills for care. All of which drives up costs for everyone. Somehow healthcare needs to be made available at a rate based on income. Yet, it is inevitable that the majority of the costs will always be absorbed in everyone’s medical bills or in taxes.
Pre-existing conditions. Insurance companies will not assume a big risk and reject people with pre-existing conditions. This is penalizing someone for being sick and needs to be corrected. However, under previously existing legislation, if you had at least a full year of health coverage at your previous job and you enrolled in your new health plan without a break of 63 days or more, your new health plan cannot subject you to the pre-existing condition exclusion. However, there are still some loopholes that need to be closed.
Donut hole. The Medicare Part “D” prescription insurance relies on seniors to pay a deductible of $310.00, then 25% until the total reaches $2830.00, and then 100% until costs reach $4,550.00, before the plan kicks back in. This is a horrible insurance plan.
Higher prices. 2.3 trillion, nationally and $7,681.00, per person is what healthcare costs in the U.S., which is 16% of the GDP. Our costs are high because we have the best available healthcare in the world, do most of the world’s medical research, and have a free market approach. Partly because no single insurer holds enough market power to impose cost controls, American hospitals, physicians and other providers tend to be able to set higher prices on specific services than providers in countries with more concentrated insurance systems. Our patchwork system chews up 25% of all of our healthcare expenditures for administrative costs alone.
Malpractice lawsuits. Cover Your Ass medicine and malpractice insurance are significant contributors to high costs. A Health and Human Services study indicates that malpractice reform would lower costs by 5-9% or $60-$108 billion a year without affecting the quality of care.
American mentality. We tend to expect the best medical care and think that it should be magically paid for in its totality because we have insurance. It is not that simple anymore because our research and technology is so advanced and medical care has expanded at such a rapid rate, it has outstripped any sense of affordability. Realistically, the availability of reasonable medical care to the populace and the availability of extraordinary care are probably mutually exclusive.
Things like making healthcare affordable, covering presently uninsured individuals, and closing the donut hole all have a huge price tag.
I began to write about the current legislation, but thought I should research and first write about the issues. The next post on the topic will deal with the new law.
Can you think of other ways that the current healthcare system is broken?
Here is part 2.
This post was originally published March 26, 2010.
