The American Public on Health Care-The Missing Perspective - (Page 32)

Anxiety About Cost Figure T. Critical information for understanding candidates’ positions on health care 100% How candidates will pay for their plan How much plan will cost taxpayers 80 74% 70% 67% 68% 65% 66% 66% 72% 60 40 20 0 National San Francisco Detroit Miami The average cost of health insurance premiums in the U.S. has doubled since 1999, rising from $5,791 then to $12,680 in 2008, according to a new study by the Kaiser Family Foundation—far outpacing wage growth and general inflation.4 Deductibles have also risen sharply, leading an anxious public (over 80%) to say that controlling health care costs should be a major priority for the Presidential candidates. But the growing problem for individuals is rooted in the overall cost of health care in the United States, which is spiraling upward. The country spends 16% of its gross domestic product (GDP) on health care—nearly twice as much as in European countries—yet the quality of care and access to care are no better, and in many cases actually worse here than elsewhere, as evidenced by life expectancy rates and infant mortality rates.5 What can be done to contain costs for individuals and the nation as a whole? There are no simple solutions. Fragmented costs and excessive spending permeate the system. According to the Committee for Economic Development, 6 it is “a ‘cost unconscious’ environment. ” The U.S. spends more for hospital care, outpatient care, drugs, administration, and insurance than is expected for a country of its size and wealth: $480 billion more.7 This is complicated by the fact that, because of its unique for-profit elements and complex insurance/administrative structures, the U.S. system attracts a multitude of costs not seen in other countries. Factors ranging from drug prices to medical litigation to higher costs for hospital and outpatient care all contribute to the high cost of health care in the U.S.8 Americans evince a healthy skepticism about the solutions proposed by politicians to rein in health care costs. In our town hall discussions and polls, the public made it clear that presidential candidates must give top priority to controlling the cost of health care. They are eager for more details to help them understand the candidates’ plans. They want specifics. They want to know how candidates will pay for their plans (74%) and how much the plans would cost individual tax payers (70%) (see Figure T ). The current forecast for health care costs is: expensive today, more expensive tomorrow. Unless something changes, the numbers will continue to climb: by 2017, the U.S. health care burden is expected to more than double, reaching $4 trillion, or roughly 20% of the nation’s gross domestic product (GDP).9 4 The Kaiser Family Foundation and Health Research & Educational Trust, “Employer Health Benefits Annual Survey 2008,” p.1. , September 2008, 5 Robert Wood Johnson Foundation, “Overcoming Obstacles to Health,” p. 12. , February 2008, 6 Committee for Economic Development, “Quality Affordable Health Care for All,” , October 2007, 7 McKinsey & Company, “Accounting for the Cost of Health Care in the United States,” p. 9 January 2007, 8 McKinsey p. 8, 9 RWJF.org; 2017 estimates from Centers for Medicare and Medicaid Services: http://www.cms.hhs.gov/apps/ media/press/release.asp?Counter=2935 32 http://www http://ehbs.kff.org/images/abstract/7791.pdf http://mckinsey.com/mgi/rp/healthcare/accounting_cost_healthcare.asp http://www.rwjf.org/files/research/obstaclestohealth http://www.RWJF.org http://www.cms.hhs.gov/apps/ http://www.ced.org/docs/report/report_healthcare200710.pdf

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