The increasing number of people who need governmental assistance to access health care, combined with the high cost of health care, are moving our current system of delivering health care toward implosion.

The federal government shoulders the largest cost of total health care at 28.1 percent. We all feel good about universal health care for persons over 65 called Medicare, but it’s important to remember that Medicare is not “free.” Total expenses for persons covered by Medicare were $705.9 billion in 2017.

Opinions begin to diverge around Medicaid, and who should qualify to receive it. Medicaid currently is available for persons living with disabilities, pregnant women (50 percent of all births in the U.S. are paid for by Medicaid), people living in poverty, and children under the age of 18 (one-third of the nation’s children are covered by Medicaid).

It also covers almost two-thirds of nursing home residents. Nearly one in five Americans — or 74 million people — access health care paid for by Medicaid, which resulted in costs of $581.9 billion in 2017.

Individual households contribute 28 percent of total health-care costs in the U.S. Employees of private companies pay on average per person $10,739 a year out-of-pocket to access health care. Meanwhile, private businesses’ share of health-care costs accounted for only 19.9 percent of total health-care costs.

Businesses are passing the growing costs associated with health care along to their employees through increases in premiums, deductibles and copays. Small companies don’t have to provide health care for their employees, and many larger companies limit the hours their employees work so the company doesn’t legally have to provide assistance with health-care costs. This leaves workers with the option of applying for government assistance, purchasing insurance through the Marketplace (a provision of The Affordable Health Care Act) or going without.

The largest employer in the U.S. is the federal government, and the health-care costs for those 2 million workers are an additional cost to taxpayers. Additionally, over 9 million military personnel receive government-sponsored health care. All eligible (and proving you are eligible can be daunting) American Indians and/or Alaska Natives qualify for government- sponsored medical care through the Indian Health Service.

Health care in America has become a privilege; only people with the necessary income or a specific set of attributes can access it. Unconstrained capitalism has created a health-care system that fewer and fewer people can afford. All providers of goods and services utilized in health care will charge as much as the market will bear.

However, as Barbara Kingsolver wrote in her book “Unsheltered,” “Capitalism can only survive on permanent expansion, but the well eventually runs dry.”

Among developed nations, the U.S. stands almost entirely alone in not providing its citizens with universal health care. The government, funded by taxpayers, is struggling to pay for the health care of its citizens. All told, taxpayers are on the hook for over 73.2 percent of health-care spending (government programs and individual household costs for private insurance).

All of the proposals for improving access to our expensive health-care system ought to be underpinned by the discussion of whether we, as a society, believe all humans should have access to health care (a right) or that health care is finite and only certain human beings who meet changing criteria should be allowed to access health care (a privilege).

Cynthia Allen is an assistant professor of exercise and sport science at Carthage College.

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