“Oh, it’s only a penny for that piece of bubble gum," said the local grocer in the 1950s. Yet, that same piece of bubble gum can be had for 25 cents today, which is about 25 times the price it was in the ‘50s.
Yet, the price of healthcare in U.S. in the '50s was $84.49 per year per person. Guess what it costs today? At least $15,474 a year, roughly 183 times what it was in the '50s, and it keeps rising. Unless our nation addresses this rise, it will eventually price the middle and lower classes out of care altogether. We are already seeing many patients miss appointments and just avoid preventive care or even acute/urgent care simply because their insurance premiums and deductibles are so large.
You may say, "Yeah, but everything is going up." That is true, especially with ongoing significant inflation, but healthcare is in a league of its own. Just since 2015, insurance premiums for workers have increased approximately 50% from their paychecks, and deductibles have increased by 43%, leaving families with even less money to pay for their life-sustaining care, such as gas, food, utilities, housing, and medications. Our nation does not seem to care about these increases, nor about prioritizing measures to bring them under control without lowering our life expectancy and quality of life.
In my own practice, patients have dropped Affordable Care Act (ACA) coverage because they simply cannot cover the cost of the premiums, which has led to delayed or no care for some of my medically complex patients and which will only cost more for patients and the healthcare system in the short- and long-term. The costs may be as high as the death of the patient due to delayed care, compared to the cost of unpaid hospital bills for required care once the patient's chronic illness becomes out of control. These costs will lead to financial strain on the hospitals and the healthcare system even more.
It is saddening and sickening to have to turn seniors away who are in their 60s and who have not reached Medicare yet, but who don’t have the deductible to pay for their care. To see children missing wellness appointments because they have been removed from Medicaid due to their parents making $1 more than the current threshold to obtain coverage is something that should never happen in our nation but has become commonplace. It’s terrible to have Medicare patients unable to pay for their medications because they cost too much — even with a prior authorization and approval. These are real occurrences that happen daily in primary care and specialty clinics across the U.S. and are worse in rural, underserved areas.
We are the wealthiest nation on earth, but our citizens are being required to pay more and more for healthcare, with the costs rising exponentially and insurance corporations getting more and more profitable all while healthcare outcomes worsen. This has to stop. We must seriously readdress universal healthcare and what benefits it provides for our patients and our nation without the customary diatribe about "socialist medicine."
Our pursuit of a truly affordable option must be addressed, whether through universal healthcare, the expansion of the ACA, or another private/public option. One option would be to let acute care, elective procedures, and other care provided in a clinic or urgent care be billed through private insurance, HSA funds, or paid for out of pocket. This would continue to support the private sector in payments for hospitalizations, elective procedures, and surgeries with a likely significant savings in overall healthcare dollars. Our nation could work with our healthcare insurers to aid in providing this new type of coverage, thereby preventing large employee terminations in that sector. There are so many ways to provide this coverage, and I believe it’s even possible to do it with our current tax base, without a significant increase in taxes.
We must consider drastic changes to our current system or we will continue to have poor health outcomes with outrageous costs — for now, only financial. Once the system implodes on itself, the cost will be our patients.
