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Prescriptions For Change
About This Series: We have the most expensive health care system in the world, yet millions are uninsured. President Obama is asking Congress to find a way to extend coverage to every American. Can they do it?
Prescriptions For Change
The Rising Costs Of U.S. Health Care
This summer, lawmakers, industry groups and lobbyists are working at a fevered pace to negotiate proposals to remake by President Obama's October deadline how health care is delivered. But one element of overhaul is not up for debate: Any policy changes put forth must slow down the skyrocketing growth rate of health care spending.
U.S. Health Care Costs
- The U.S. spent $2.2 trillion on health care in 2007. That's $7,421 per person and 16.2% of the nation's GDP.
- Health care costs more than tripled from 1990 to 2007. They're projected to rise to 25% of GDP in 2025 and 49% in 2082.
- In 2008, an employer-sponsored family insurance policy cost $12,680 on average, nearly the annual earnings of a full-time minimum wage job.
- From 2000 to 2008, premiums for employer-sponsored family health coverage more than doubled.
- Premiums paid by employers are the nation's largest pool of untaxed money. In 2007, the the contributions totaled $246.1 billion, more than half what the government paid for Medicare that year.
The Health Care Dollar
NOTE: Numbers may not add up to 100 due to rounding.
Source: Alliance For Health Reform, Covering Health Issues, 5th Edition 2009
Medicare Patients Experience Similar Or Better Access To Care Compared With Privately Insured Individuals
As required by Congress, each year, the Medicare Payment Advisory Commission reviews the Medicare systems. The data below comes from an annual patient telephone survey of a nationally representative, random sample of Medicare beneficiaries age 65 and older, and privately insured individuals ages 50 to 64.
| For routine care | Medicare (age 65 or older) | Private insurance (age 50-64) | ||
|---|---|---|---|---|
| 2005 | 2008 | 2005 | 2008 | |
| Never | 74% | 76%* | 67% | 69%* |
| Sometimes | 21 | 17* | 25 | 24* |
| Usually | 3 | 3* | 5 | 5* |
| Always | 2 | 2 | 3 | 2 |
| For illness or injury | Medicare (age 65 or older) | Private insurance (age 50-64) | ||
| 2005 | 2008 | 2005 | 2008 | |
| Never | 82 | 84* | 75 | 79* |
| Sometimes | 15 | 12* | 19 | 16* |
| Usually | 1 | 1 | 3 | 2 |
| Always | 1 | 1 | 2 | 2 |
| Primary care physician | Medicare (age 65 or older) | Private insurance (age 50-64) | ||
|---|---|---|---|---|
| 2005 | 2008 | 2005 | 2008 | |
| No problem | 75% | 71% | 75% | 72% |
| Small problem | 12 | 10 | 16 | 13 |
| Big problem | 13 | 18 | 9 | 13 |
| Specialist | Medicare (age 65 or older) | Private insurance (age 50-64) | ||
| 2005 | 2008 | 2005 | 2008 | |
| No problem | 89 | 88* | 86 | 83* |
| Small problem | 6 | 7 | 7 | 9 |
| Big problem | 5 | 4* | 6 | 7* |
NOTES:
1) * Indicates a statistically significant difference between the Medicare and privately insured populations in the given year at a 95 percent confidence level.
2) "Unmet need" was determined by asking survey respondents about problems in accessing physicians, experiences delaying needed medical care and overall patient satisfaction.
3) Numbers may not sum to 100 percent due to rounding.
SOURCE: MedPAC-sponsored telephone surveys, conducted August-October 2005, 2006, 2007 and 2008; Medicare Payment Advisory Commission March 2009 report
Medicare Patients Have Low Rates Of Access Problems
The Medicare Payment Advisory Commission survey found that in 2008, Medicare beneficiaries were less likely than their privately insured counterparts to report they didn't see a doctor when they needed to. The survey also found that minorities and those with lower incomes were more likely to report that they didn't see a doctor when they thought they should have.
| Percent with unmet need | 1996-97 | 2003 | 2007 |
|---|---|---|---|
| Total (overall unmet need) | 5.2% | 5.2% | 8%*† |
| Age 65 or over | |||
| Enrolled in Medicare only | 1.9 | 3.1 | 3.5 |
| Enrolled in Medicare and other public or private supplemental coverage | 1.3 | 1.6 | 3.2*† |
| Younger than age 65 | |||
| Employer-sponsored private insurance | 3.7 | 3.6 | 5.6*† |
| Nongroup private insurance | 4.2 | 4.6 | 7.2* |
| Medicaid and other state coverage | 6.9 | 5.3 | 10.7*† |
| Uninsured | 13.5 | 13.2 | 17.5*† |
NOTES:
* Change from 1996-97 is statistically significant at 0.05 level.
† Change from 2003 is statistically significant at 0.05 level.
SOURCES: Center for Studying Health System Change Community Tracking Study Household Surveys, 1996-1997 and 2003; Center for Studying Health System Change Health Tracking Household Survey, 2007; Medicare Payment Advisory Commission March 2009 report