Health Care Facts to Think About

Congress directed the Citizens' Health Care Working Group to prepare a report to provide all Americans with a basic set of information to help start a national discussion on health care and lead to solid ideas and recommendations for creating a health care system that works for all Americans.  The Health Report to the American People can be found, in full, by clicking here. A snapshot of the report is found below.

1.  We pay for health care through both private funds and public dollars. Either way, it comes out of our own pockets.

• Private spending is what we pay for health care, either through insurance or directly with our own money.
• Public spending for health care comes from tax dollars that federal, state, and local governments use to pay for programs like Medicare and Medicaid.   Today, Medicare and Medicaid spending account for almost one out of every five dollars the federal government spends.  That’s likely to become one out of every three dollars by 2040.
• Government also helps to pay for health care through tax breaks for employees whose employers offer health benefits.

2.  Costs are rising sharply.

• Back in 1960, we spent about a nickel out of every dollar we earned on health care in the United States.   That was about the same amount we spent on education.  Today, the percent going to health care has tripled, while what we spend on education hasn’t even doubled.
• In 2004, America’s total health care bill came to $1.8 trillion.   If you added up every dollar earned by every American worker in the first two months of the years, the total would be this amount.
• For each person, we spent about $6,400 on health care in 2004.   In ten years, this amount is expected to rise to $11,000.
• Part of the cost of care is the money spent on medical research. It underpins significant advances in the care we receive.   As a result, the U.S. is the leader in development of new technologies and remedies, especially drugs, which greatly improve our lives.

3.  Higher costs can result in less coverage and less care.

• Higher health care costs mean insurers have to charge higher premiums.   This makes employers less likely to offer coverage that employees can afford.
• In 2004, about one in 20 Americans reported that costs prevented them from obtaining needed care.

4.  Our need for health care and spending varies a lot and changes over the course of our lives.

• In any given year, close to 50 percent of all health care spending pays for the care received by only 5 percent of the population.
• Health care for people with chronic diseases accounts for 75 percent of our total health care costs.  Managing these illnesses can be expensive.  For example, in 2002, people with diabetes spent, on average, $13,243 on health care bills.
• Other things, such as serious illnesses, accidents, or premature births, can be very expensive.  Hospital charges alone can top $100,000 for these cases.
• Health care needs tend to increase over time.   On average, only about one-fifth of all money that will ever be spend on our health care in for health care we use in the first half of our lives. But half of all the money spent on our health care will be for care we get after we turn age 65.  On average, health care costs for people ages 76 to 84 are about $8,000 every year.  This is almost eight times as much as for children between 1 and 5 years old.

5.  Waste and inefficiency also contribute to higher costs.

• We pay for health care in a very complicated way. Complex billing and paperwork may result in relatively high administrative costs in the United States and can be frustrating for patients, hospitals, and insurance companies.

Quality:  Are We Getting Our Money’s Worth?
Key Facts about the Quality of Health Care in America:

1.  Despite all the money we spend, people often do not get the care they need.

• Overall, adults get only 55 percent of the recommended care for many common conditions.

2.  Despite spending more per person on health care than other developed countries, our results are not consistently better and are sometimes worse.

• For example, the United States has seen an increase in the death rate from asthma in recent years, while death rates for asthma have declined in Canada, the United Kingdom, Australia, and New Zealand.

3.  The quality of our health care often depends on where we live and who we are.

• There is consistent evidence of a difference in the availability and quality of care related to race, ethnicity, and income.
• In fact, African Americans, Asian Americans, American Indians, and Alaskan Natives – and particularly Hispanic Americans – generally receive poor quality of care and have poorer access to care than white, non-Hispanic Americans.
• People with incomes below the poverty level report poorer access to care and have more problems with the quality of their care than people with higher incomes.

4.  Poor quality can consist of either too little or too much care.

• Certain services – like vaccines, colonoscopies, complete preventive care for diabetes, treatment for depression, and medicines to prevent additional heart attacks – are all underused.   That means that not everyone should receive services does.
• On the other hand, some health care services are used too much.   Some surgeries are not necessary and do not help people.  Antibiotics are not effective in treating colds and other viruses, but they are still being prescribed for treating these conditions.
• The amount of health care services that people use varies a lot across different parts of the United States, and can be affected by the number and types of health care providers where they live.

5.  Medical errors are a particularly harmful form of poor quality.

• An estimated 44,000 to 98,000 Americans die every year as a result of medical errors.   This is more than the number of people who die from car accidents, breast cancer or AIDS alone.
• It’s believed that medical errors occur in 2 to 4 percent of hospitalizations.

6.  Our health habits affect our health and quality of our lives.

• About 40 percent of American adults are not physically active, and nearly two-thirds are overweight or obese.   While not everyone can be physically active, many people and reduce their risk of heart disease, diabetes, and some types of cancer by losing weight and exercising more.
• Many people begin smoking despite its serious harmful effects.

Access:  Who is Getting Care – And Who Isn’t?
Key Facts about Access to Health Care in America:

1.  Almost 46 million Americans have no health insurance.

• The uninsured are not necessarily “poor.”   Most are members of working families, and most have incomes above the poverty line.  Even so, many people can’t afford to buy health insurance.  Some uninsured people who could afford to buy it choose not to do so.

2.  Those without coverage often don’t get the care they need.

• Uninsured Americans are nearly eight times more likely than people who have insurance to skip health care because they can’t afford it.   And, this can lead to more serious illnesses that need to be treated in an emergency room or the hospital.  These services cost much more than it would cost to treat the original problem.  About half of uninsured adults with chronic health conditions go without recommended health care or medicines because of cost.

3.  The most important source of health insurance for workers is employer-sponsored “group” coverage.  But this is getting less common and more costly.

• Seven out of 10 Americans who have some form of health insurance coverage get it through an employer.
• The percent of people covered by employer-sponsored health insurance declined from 64 percent in 1999 to 60 percent in 2004.
• In 2004, just about all large companies offered their employees health insurance.   But only half of the smallest companies (with fewer than 10 employees) did.
• Employers that do offer coverage are paying a lot more than before.   They are also asking employees to pay more.
• Sometimes when Americans need coverage the most, they don’t have it.   This can happen because a severe illness may force them to quit work, lose insurance and that income that allows them to afford care.

4.  Some areas of the United States do not have enough health care providers to serve everyone’s needs.

• The availability of services varies a great deal across the country.   It is different among the states, between urban and rural areas, and from one community to another.
• More than 10 percent of Americans report not having a regular place to go when they need health care.
• Even when care is available, people can have problems getting through the health care system.   For example, communication problems can make it hard to get the care you need.