Universal health care? How much does our current health care cost?

August 9, 2018

Dear Editor:
I have heard some big numbers suggested, what a universal health care system would cost us here in the US of A.  The most recent estimate I saw, in the Detroit News, was $32 trillion.  The article didn’t break down toe components that were calculated to arrive at this figure.  The estimate I’ve not yet seen is this:  How much is our current health care system costing us?

Before you say it isn’t costing us anything, consider Medicare and Medicaid – our current government run health care.  Medicare kicks in at age 65.  How many people does it cover?  How much does it cost?  We could break it down as dollars per person, and then extrapolate what it would cost to extend Medicare to all Americans.  Same with Medicaid – how many dollars to cover how many people?

Which brings me back to my original question:  How much is our current health care system costing us?  I heard an estimate a few years ago, that it would cost a healthy family of four $20,000 per  year to buy private medical insurance.  If 400 million Americans all belonged to healthy 4-person families that would be 100 million families x $20,000/year = $2 trillion/year, plus deductibles, co-pays and prescription drugs.

I hear a few of you saying, “But my health care doesn’t cost me anything since I and my family are covered by insurance through my job.”  Think again.  How much does your employer tell the government your health care package is worth?  How would you like to have that added to your paycheck?  Even with insurance, how much are you spending on deductibles, copays, prescription drugs, and other health related costs?

I am just recovering from sticker shock myself year after trying to change my primary care provider.  My yearly lab work had been costing me about $84/year – this year I was billed a whopping $416 for the same tests.  A couple of hours on the phone with several agents in my insurance company  revealed that although my new provider was billing the company $200+ less for the tests, it was costing me $332 more.  Why? Turns out the very same blood work, if billed as “routine” is fully covered (less a 10% copay) by my insurance, whereas, if billed as “medically necessary” is only covered after I meet my $400 deductible (less a 10% copay).  Shouldn’t the billing department at my new provider have known this?  I had to call them several times and never spoke to the same person.  What are they doing there?  Or did they know, but want me to pony up $400 ASAP so I’d be more likely to keep on spending?

Then there’s the way providers bill for their services.  On the insurance statement is a column entitled “Minus Discount*”.  Find the “*” to read “*…discounts are negotiated with hospitals, doctors and other health care providers which saves you money.”   How much do these discounts save us?  For one example, I recently called a provider to find out how much it would cost me for an MRI.  I was told $2,000+.  “However”, I was told, “your insurance has negotiated with us for a price of $360, of which you owe a $36 copay.”  So this provider gets 6x as much from everyone else?  How do we even begin to quantify what inequalities such as this are costing us as a country?  Or what our crazy patchwork of insurance companies, providers (in-network or out-of-network?), deductibles, copays, prescription drugs, rules of what’s covered and what’s not (emergency room visits are only covered if the patient is admitted), the 3-5 week delay in receiving bills and statement, the different answers to the same questions depending upon which of the 1,213 or so insurance agent you talk to…etc.  How much is all of this confusion costing us?  How is negotiating this maze and storing all of this paper good for our health?  Health is, after all, what this is supposed to be about.

I do have one idea about how we could arrive at an estimate for how much our current health care system is costing us.  Allow us to deduct 10% of our insurance payments and out-of-pocket expenses from our income tax.

Lee Thomas

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