Setting the Record Straight
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The document discusses perspectives on the US national debt and health care costs. It notes that while the current national debt is 40% of GDP, it has been higher historically. It argues that economic growth through infrastructure investment can help reduce the debt. It also notes that rising health care costs, not entitlement programs, are the main fiscal problem. Health care spending has grown faster in the US than other nations in recent decades and threatens to absorb half the economy. Solutions require addressing the underlying health care cost crisis.
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Chapter 2Where Are WeAmerican health care is in a state of fl
Chapter 2
Where Are We?
American health care is in a state of flux as new scientific knowledge and clinical experience continue to change our definitions of illness and wellness. As a society, we respond by changing the ways health care is delivered. Health services increasingly impact our society—from health status to employment to budgetary economics to recreation to professional concerns to our perceptions of our own well-being.
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• Complexity
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• Medicalization of our society
• Redistribution of wealth
2.1 Current Outcomes and Costs
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2.1 CURRENT OUTCOMES AND COSTS
Health care expenditures were projected to rise to close to 20% of the U.S. gross domestic product (GDP) by 2015 (Borger et al., 2006), but more recent estimates from the Centers for Medicare & Medicaid Services (CMS) project it to be 18.2% for 2015 and 19.5% by 2021 (CMS, 2012). Average annual family health insurance premiums were estimated for 2012 at $15,745, with $11,429 paid by employers. The 4% growth rate for 2012 was slow by historical standards but still more than twice the growth rate of wage income. The comparable total insurance cost for a single individual was $5,615. Large employers (98%) offered health care benefits to workers but were cutting back on retiree health benefits. Only 50% of firms with 3 to 9 workers and 73% with 10 to 24 workers offered health benefits. Many small companies do not provide health benefits. At the same time, control of health care by health professionals is being threatened by outsiders calling for more reliance on government programs, more consumer-centered care, or both.
High Comparative Costs and Low Comparative Outcomes
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Mr. Wojcik provides a newsletter update for his clients on various healthcare topics. He explains that he took a break from newsletters to avoid spreading misinformation during the uncertain healthcare reform period. The newsletter includes sections on "Know Your Employee Benefits" tips, healthcare cost analytics, compliance updates, wellness program trends, and industry news. It aims to help clients control costs, workload, and anxiety around benefits.
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Douglas Elmendorf, the Director of the Congressional Budget Office, presented on the shifting priorities in the federal budget under current law. He noted that federal debt will be much larger relative to GDP than in history and spending on benefits for older Americans and healthcare will rise substantially while other spending falls. By 2020, spending on Social Security and major healthcare programs will be 50% larger than the past 40 years average while all other spending will be at its lowest level in over 70 years. This unsustainable path will require cutting benefits, raising taxes, or a combination of both.
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Setting the Record Straight
- 1. Setting the Record Straight on Our Nation’s Finances
- 2. Putting The National Debt Into Perspective
- 4. Sources: Department of the Treasury and Office of Management and Budget
- 13. Source: CBO, http://www.cbo.gov/doc.cfm?index=8877
- 15. 2006 Medical Spending as a Percent of GDP Source: OECD, http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_1,00.html
- 17. Increase in Health Care Cost as a Percent of GDP, 1970 to 2006 Source: OECD, http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_1,00.html
- 19. Source: CBO, http://www.cbo.gov/doc.cfm?index=8758 Projected Health Care Spending as Percent of GDP
- 20. Private employers and families are suffering from rapidly rising health care costs. 119% increase Source: Kaiser Family Foundation, http://facts.kff.org/chart.aspx?ch=706 117% increase $5,791 $12,680
- 22. Source: CMS, http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf Changes in Spending per Enrollee, Medicare and Private Insurance
- 24. The Relationship Between Quality and Medicare Spending, by State, 2004 Source: Congressional Budget Office, http://www.cbo.gov/ftpdocs/90xx/doc9016/03-03-2008-NABE.pdf