This is the graph that will make you change your mind about how badly Americans need 'Medicare for All'
June 2, 2021
Historically, the United States has greatly lagged behind other nations in providing affordable health care to its citizens. Moreover, the Covid pandemic has put American health-care disparities in a bright spotlight. A glaring example, recognized throughout 2020, has been that African Americans, Hispanics, and indigenous Americans are experiencing an incidence of Covid infection and rates of hospitalization many times greater than white Americans.
On the 2020 campaign trail, President Biden frequently repeated that if elected, he would "take care of your healthcare coverage the same way I take care of my family." His promise to 'fix' health care in America mainly consisted of promoting a subsidized plan through expansion of The Patient Protection and Affordable Care Act of 2010 (ACA, aka 'Obamacare').
Once in office, he opened up a national special-enrollment period for the federal health-insurance marketplaces and started offering subsidized rates to some 30 million Americans who didn't have health insurance. By April 2021, his administration triumphantly proclaimed that nearly 940,000 Americans had newly signed up for health insurance. Great! That leaves only 29 million Americans without a health plan of any kind. So what is the president's plan for the rest of his 'family?'
By way of comparison, the number of families in Canada, the UK, Germany, and Japan without comprehensive health insurance in any year was and is, always 'zero.' Recessions and pandemics don't affect health coverage because it's something everyone in over 40 other wealthy countries enjoys as a birthright. They don't need a benevolent leader to bestow upon them a privilege they already have. Comprehensive health care also costs less than half per capita of what Americans pay for their uneven care benefits.
The health-care 'fix' that President Biden is attempting takes place in a country that is much changed since he and President Obama worked together on passage of the Affordable Care Act in 2010. For example, over 200 hospitals have closed since then, leaving huge swaths of rural America (colloquially known as 'health-care deserts') without any tertiary-care medical facilities. And rural hospital closures have only increased through the pandemic. In 2020 alone, 47 rural hospitals closed and another 673 suddenly became vulnerable to shutting down due to revenue challenges.
Secondly, mergers between big providers and big insurers are continuing to consolidate the majority of health-care services in the largest urban markets. Where these mergers occur, markets typically see price rises of between 40% and 65% for hospital services.
Thirdly, equity funds have been rapidly purchasing specialty-physician practices in local markets (such as all of the radiology services). These managed funds then 'roll-up' the package and sell to a 3rd-party investor for a quick profit. In the past decade, this monopolistic pricing scheme has been the source of 'surprise medical bills' frequently endured by patients for services that they didn't know weren't covered by their insurance.
None of these changes does anything to protect or improve the health of Americans. The same unimproved or reduced services are simply being sold in a different wrapper to the same client base for more money. The financial term for an industry that behaves this way is appropriately called 'corporate cannibalism.' And the grave consequences for this uncontrolled behavior can be seen in the accompanying chart.
American Health Care: Costing you more to live your shorter life
Fig 1 (below) indicates the shocking deterioration of the life expectancy of Americans against the rising cost of providing care. Why is this important? Various studies have demonstrated substantial mortality differences associated with insurance coverage. A quick analysis of the graph below reveals some painful truths about American health care when compared to other wealthy nations.
Fig. 1. Life Expectancy vs Health Expenditure- 1970-2020
Author's rendering from various sources: 1. World Bank Health Expenditure and Financing OECD Stat. 2. CDC Vital Statistics Rapid Release; no 10. Health Statistics. Feb. 2021.
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