America was founded on free rights and equality among all. The question we must ask ourselves is what is equal about our medical coverage in this country. One can argue that it is our right to buy medical coverage but it has become a privilege not a right. Health care and treatment is a privilege to those who can afford the high costs of insurance in a private driven economy. Since our nation was founded and science developed, the medical practice became aware of a great income potential. Costs having increasingly increased as technology advances and the greater need for health care increases. Paying for these out of pocket was impossible for the average person and insurance became the resolution. Insurance is a savior for millions of people to get the necessary medical care that otherwise they would not be able to afford. Millions of others cannot afford that luxury or they do not qualify. As our demand on health care increases, the private sector supplies, at a price. We all need health care but we are becoming a nation that only the rich can afford it.  

America once was mainly driven by a manufacturing based economy. Workers in these positions were at higher risk for injury, thus companies offered benefits as health, dental, and vision insurance and shared the cost of premiums to offset on the job hazards and injury. As technology advanced and machines took over what workers once did, on the job injury became less infrequent. Employers still offered benefits as a perk to gain qualified employees as sometimes it was difficult to fill vacancies. It became standardization for employers to offer health insurance to its employees. As America steadily moves towards a service-based economy and health care prices rise, fewer employers will offer health insurance coverage. An employer’s cost for providing a full time employee with benefits has increased so significantly employers are moving towards hiring part time employees, contract workers, and outsourcing to other countries to increase profits and cut expenditures. Employer sponsored health insurance is Americas number one way in obtaining medical insurance coverage and if this trend keeps progressing in this fashion the uninsured numbers will increase dramatically. The U.S. Census Bureau reported that in 2007 45.7 million people were uninsured. 15.8% of our population and the numbers keep growing. There are serious ramifications if we continue on this course.  

First, we must first figure out why our health insurance premiums keep rising. Some may argue that doctors charge an unreasonable price for their services. However, with a six to eight year medical degree and having to pay off school loans that may justify their salaries. It is questionable about the quality of care one receives in a doctor’s visit. The average office visit cost in a clinic or hospital range from $90 to$150 and the standard visit is now a standard 15 minutes per person. Thus, volume is how doctors are making their high profits. The average doctor can see between 15 and 25 patients a day. High volume, high profit. An average hospital stay for one night in the United States is about $1700 which is double than in other developed country. In the past insurance covered the whole hospital stay and all the treatments suggested by the physician, but slowly the insurance companies lost their profit for procedures needing a lengthy hospital stay. Insurance companies started denying coverage over a certain amount of days. Hospitals followed suit and would not keep the patient in the hospital for their full recovery period but would send a patient home to recover. By making the patients inpatient stay shorter, they were able to make a bed available for paying patients. One must consider why hospital stays in this country is much higher. Why are hospitals allowed to charge $6 for an aspirin you could buy a bottle of 50 at the local super market. People really then have to think just how badly they need that aspirin or whether they need the surgery at all.

Not only are doctors receiving high salaries but other hospital and clinic staff is as well. Saint PetersHospital is a Catholic sponsored non-profit hospital. They had the only involuntary mental health facility for three counties in WashingtonState. Four years ago they closed their doors to involuntary and reorganized it only to accept voluntary patients with insurance that would cover the hospital stay. St. PetersHospital was not making a profit because many of their patients had no insurance and could not pay for treatment out of pocket. The state had to build another psychiatric facility that cost over $3 million and it took over two years to build and open. As an administrator that implemented the court program for this new facility and having worked with St. PetersHospital for over nine years, I had in depth knowledge in both the facilities financing and accounting practices.

The insurance companies have gained much control over the health care system that they gained the authority of approving or denying procedures, treatment, and medications the doctor feels are necessary. It has only become this way because if the insurance company will not approve of the treatment, it is nearly impossible for the patient to pay out of pocket. It is arguable why companies with no medical degree can control your physician’s recommendations no matter in what capacity. As a long term employee and contributing to my premium for years it is my opinion that when I need my insurance, they would pay for the treatment. Take a careful look at their spending habits and profit margins. Insurance companies spend around $32 billion each year on marketing and analysis of premiums. That exorbitant amount of money could either be spent insuring the 15% of our uninsured or by decreasing their marketing expenses it could reduce the premiums making it more affordable. There are many more areas to research in why health care costs are so high. The tests our doctors order, such as lab work and x-rays, these costs are very costly considering what is involved in their process. Equipment such as cat scan machines, MRI machines, x-ray machines and such are extremely expensive. One MRI machine typically costs over 1 million dollars. With technological advances in machinery, facilities purchase newer and better machines to diagnose and treat illnesses. The manufactures, engineers, and everyone involved in the process are all making a nice profit. We must also consider the cost of procedures or surgeries as a culprit of the high costs in medical care. Having a gallbladder removed and spending one night in the hospital, the total bill was over $10,000. The surgery lasted four hours and one room was occupied for a 27-hour period. What can possibly justify these expenses. With recovery time over a week, with no insurance or paid vacation/sick time, the price of this surgery was not limited to the actual hospital stay and surgery. It extended to seven days of no pay along with the two prescriptions, anesthesia, and lab bills. There are the individuals in poor health that may be declined coverage due to their poor health by insurance companies because they are more likely to incur higher health care costs. Serious changes need to be made in this country to reduce medical costs and insurance premiums. We have discussed health reform, but what about insurance reform. Until America embraces a government run health system, the private health care insurance system will continue to make their $30 billion a year in after tax profits and hospitals, clinics, drug companies, manufacturers, doctors, nurses, and everyone else involved in the health care system will keep making their high profits year after year.

Drug companies also add to the high prices of health care costs. Drug companies charge up to 70 percent more for branded prescription drugs in America than any other developed country. Drugs are available to the U.S. much sooner than other countries so they can charge a higher price. It is reasonable to assume that drug companies need a sizable return to sustain their research and production but why is the bulk of their proceeds coming from Americans. One can certainly argue that other industries manage on profits that are more reasonable.

It is imperative to insure the 47 million Americans, but we also need to address the real issue which is to reduce the cost of medical care. If we only extend coverage to the uninsured, this will only create a sizable increase in health care spending. Taxpayers will pay for the difference, which will increase taxes and as health care costs keep rising, we will pay more for our own medical care and the care of others.

Many employers cannot afford to offer health benefits because of the rising health insurance premiums. Companies that do offer health insurance, often require employees to contribute a larger share toward their coverage than before. As a result, an increasing number of Americans have opted not to take advantage of job-based health insurance because they cannot afford it. 37 millions workers in 2007 were uninsured according to The National Coalition (2008). As the economy worsens, more Americans will lose their jobs and the number of uninsured will increase. The lack of affordable medical care is not only confined to the poor, it affects middle income workers as well. Lack of medical care means America is getting sicker and many will die each year because of lack of medical treatment. The National Institute of Medicine concluded that a lack of health insurance causes 18,000 unnecessary deaths every year. That is six times the number of people who died in the September 11 attacks. Millions live with a chronic condition such as diabetes, high blood pressure, and some more serious such as TB, Aids, or STDs. These people need treatment but cannot get it. Most states charge an average of $300 for an emergency room visit and a walk in clinics start at $90. The free clinics available are open maybe once a week for only a short amount of time. The people that cannot be seen must return home to wait another week and many cannot even get to the locations. The medical providers that volunteer their time try their best to get as many people seen, but that leaves to much room for misdiagnosis. Being uninsured and attempting to receive treatment from a free clinic a visit to the free clinic open once a week in the evening was necessary. It felt like a heart attack that happened twice in a two week period. Being only 36 and always having a job that provided health insurance, having to go to a free clinic was humbling. While sitting and waiting over three hours and having more and more chest the doctor finally sat down and gave a diagnosis. Arthritis in the chest causes great pains. However, a week later an ambulance was called at 3 A.M. and hours later an emergency surgery was performed removing the gallbladder. Sadly this free clinic has discouraged many as visits are rushed and diagnosis are handed out quickly.  

Imagine being uninsured, your son, age 6, falls at the playground and breaks his arm. Your on a budget and can’t afford to buy your son new shoes let alone $300 plus x-rays and casting. You have to get him treated but where will the money come from and what bills will you not be able to pay. If the emergency room you visited does not have a program to help cover the costs or you don’t qualify for that program, you slowly fall behind in your bills. The majority of credit card use is medical expenses. There are now credit card companies that have 0% interest for medical issues, but like all credit cards, monthly payments may even be to high for a person on a tight budget. Over half of all bankruptcies are because of medical bills. Something clearly needs to change in our troubled heath care system.

The growing demands of health care insurance is weighing hard on Medicaid and Medicare, a federal sponsored medical insurance. With federal budget cuts it is impossible for the States to provide everyone with state health care coverage. Low-income families may be eligible but this does not cover dental or vision. The requirements for qualifying for state health care is very low and anyone making above that state poverty line are still considered low income but must do without coverage. Even if government health care coverage wont solve the problem of high health care costs if they had not provided coverage there would have been a shocking 82 million uninsured people in 2007.

We all need to take more interest in the real reasons of why health care is so high and actively participate in helping our country make a change. If we wrote or called our legislatures and demanded better quality health care at a reasonable, affordable cost, maybe a change would take place. Change is not easy and sometimes is very costly in the beginning but a change is necessary.

There are many reasons why health care and coverage is so expensive, those reason needs to be addressed and maybe even regulated. Each year more Americans lose coverage and as prices continue to rise the uninsured will increase. Think of all the consequences not having insurance could do to you and your family.

References

National Institute of Medicine (2008). Uninsurance facts and figures. Project on the consequences of Uninsurance. Retrieved June 5, 2009, from http://www.iom.edu/Object.File/Master/17/736/Fact%20sheet%20overview.pdf

The National Coalition on Health Care (2008).Health insurance coverage. Retrieved on June 5, 2009, from http://www.nchc.org/facts/coverage.shtml

U.S. Census Bureau, Housing and Household Economic Statistics Division (2009). Health insurance, income, poverty, and health insurance coverage in the United States 2007. Retrieved  June 5, 2009, from http://www.census.gov/prod/2008pubs/p60-235.pdf