Health Insurance The United States is the only wealthy, industrialized nation that does not have a universal health care system. Source: Institute of Medicine of the National Academy of Sciences In 2006, the percentage of Americans without health insurance was 15.8%, or approximately 47 million uninsured people. Source: US Census Bureau Among the 84.2% with health insurance in 2006, coverage was provided through an employer 59.7%, purchased individually 9.1%, and 27.0% was government funded (Medicare, Medicaid, Military). (There is some overlap in coverage figures.) Source: US Census Bureau The primary reason given for lack of health insurance coverage in 2005 was cost (more than 50%), lost job or a change in employment (24%), Medicaid benefits stopped (10%), ineligibility for family insurance coverage due to age or leaving school (8%). Source: National Center for Health Statistics More than 40 million adults stated that they needed but did not receive one or more of these health services (medical care, prescription medicines, mental health care, dental care, or eyeglasses) in 2005 because they could not afford it. Source: National Center for Health Statistics Medicaid, which accounted for 12.9% of health care coverage in 2006, is a health insurance program jointly funded by the federal and state governments to provide health care for qualifying low-income individuals. Source: US Census Bureau Medicare, a federally funded health insurance program that covers the health care of most individuals 65 years of age and over and disabled persons, accounted for 13.6% of health care coverage in 2006. Source: US Census Bureau Medicare operates with 3% overhead, non-profit insurance 16% overhead, and private (for-profit) insurance 26% overhead. Source: Journal of American Medicine 2007 Health Care Expenditures In 2005, personal health care expenditures were paid by private health insurance 36%, federal government 35%, state and local governments 11% , and out-of-pocket payments 15%. Source: National Center for Health Statistics The United States spends twice as much on health care per capita ($7,129) than any other country . . . and spending continues to increase. In 2005, the national health care expenditures totaled $2 trillion. Source: National Center for Health Statistics 75% of all health care dollars are spent on patients with one or more chronic conditions, many of which can be prevented, including diabetes, obesity, heart disease, lung disease, high blood pressure, and cancer. Source: Health Affairs From 2000 to 2006, overall inflation has increased 3.5%, wages have increased 3.8%, and health care premiums have increased 87%. Source: Kaiser Family Foundation The average family health insurance premium, provided through an employer health benefit program, was $11,480 in 2006. Employees paid an average of $2,973 towards the premium amount. Source: Kaiser Family Foundation Infant Mortality The United States ranks 43rd in lowest infant mortality rate, down from 12th in 1960 and 21st in 1990. Singapore has the lowest rate with 2.3 deaths per 1000 live births, while the United States has a rate of 6.3 deaths per 1000 live births. Some of the other 42 nations that have a lower infant mortality rate than the US include Hong Kong, Slovenia, and Cuba. Source: CIA Factbook (2008) Approximately 30,000 infants die in the United States each year. The infant mortality rate, which is the risk of death during the first year of life, is related to the underlying health of the mother, public health practices, socioeconomic conditions, and availability and use of appropriate health care for infants and pregnant women. Sources: CDC and National Center for Health Statistics Life Expectancy Life expectancy at birth in the US is an average of 78.14 years, which ranks 47th in highest total life expectancy compared to other countries. Source: CIA Factbook (2008) Bankruptcy About half of the bankruptcy filings in the United States are due to medical expenses. Source: Health Affairs Journal 2005 Health Care vs. Health Insurance Health care is not the same as health insurance. Everyone in the U.S. - including those illegally in the U.S. is guaranteed access to basic health care. Under a 1968 federal law, all patients seeking care in hospital emergency rooms must be given a minimum level of treatment, regardless of their ability to pay or health insurance status. The law applies to all hospitals that participate in Medicare -- which most do – and requires the hospitals to provide initial patient screening, life-saving and "stabilizing" emergency care and transfers to advanced trauma centers, if needed. Those services must be provided without asking about the patient's ability to pay. Of course, the growing demand on hospitals to provide this minimum level of free care contributes to rising health care costs. Health Insurance Not Always a Financial Savior People with health insurance are far from immune to soaring health care costs. In a June 30, 2009 article, the New York Times reported that, "An estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured." Number of Uninsured is a Quickly Moving Target In his nationally televised press conference on July 22, President Obama stated, "If we don't act, 14,000 Americans will continue to lose their health insurance every single day." While this figure may be accurate, not all of those 14,000 people will lose their insurance permanently. The Congressional Budget Office estimates that over the course of every year millions of Americans lose their health insurance, but only temporarily. Most people become uninsured because they lose or leave their jobs and regain insurance coverage when they return to work. In 2007, the Census Bureau reported that 253.4 million people -- about 85 percent of the total population -- did have health insurance. The Citizenship Factor According to Census Bureau data, of the estimated 46 million "Americans" without health insurance, more than 10 million are non-U.S. citizens. Some Just Don't Want Insurance Many young workers, whose employers do offer it, simply do not consider health insurance. According to the Census Bureau, 18.3 million of the uninsured are under age 34. Under the Affordable Health Care Choices Act, health insurance will be mandatory. Individuals who fail to carry adequate coverage will face a tax penalty of 2.5 percent of their adjusted gross income, capped at the national average premium for individual basic coverage. The Affordability Factor In 2007 the Census Bureau reported that more than 14 million people without health insurance earned annual incomes of at least $50,000, with 7.2 million of them making over $75,000. In December 2007, the Association of Health Insurance Plans issued a report showing that nationwide annual premiums for private health insurance policies averaged from $2,613 for individuals to $5,799 for families. Existing Government Health Care Plans Not Being Used A 2003 Blue Cross/Blue Shield Association study concluded that, "More than 14 million uninsured Americans are already eligible for health insurance through Medicaid and State Children's Health Insurance Program (SCHIP)." These people could automatically be signed up for these programs by seeking care at a hospital. In addition, a Georgetown University's Health Policy Institute study shows that 7 out of 10 uninsured children could be covered if their parents chose to sign up for existing government programs. Quick Summary of the Health Care Reform Bill The Affordable Health Care Choices Act of 2009 aims to see to it that 97 percent of the U.S. population has health insurance by 2015. The bill creates a public health insurance option called an "exchange" operated through state-based "gateways" which would act as marketplaces where individuals and businesses could shop for health insurance. The bill requires all individuals to have health insurance or face tax penalties. Businesses that do not provide health insurance for their employees would be required to pay 8 percent of their total annual payroll into the public health insurance exchange system. The bill bans insurance companies from denying coverage or increasing premiums because of pre-existing health conditions. For a more detailed look at the bill, see Key Provisions of the House Healthcare Bill by Deborah White, Guide to Liberal Politics. Health Care Statistics Healthcare is one of the top social and economic problems facing Americans today. The rising cost of medical care and health insurance is impacting the livelihood of many Americans in one way or another. The inability to pay for necessary medical care is no longer a problem affecting only the uninsured, but is increasingly becoming a problem for those with health insurance as well. In 2007, nearly 50 million Americans did not have health insurance, while another 25 million were underinsured. (Source: Commonwealth Fund Biennial Health Insurance Survey 2007) The amount people pay for health insurance increased 30 percent from 2001 to 2005, while income for the same period of time only increased 3 percent. (Source: Robert Wood Johnson Foundation) The total annual premium for a typical family health insurance plan offered by employers was $12,680 in 2008. (Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2008) Healthcare expenditures in the United States exceed $2 trillion a year. (SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group;) In comparison, the federal budget is $3 trillion a year. http://www.commonwealthfund.org/Multimedia-Center/Podcasts.aspx