The American Health Care System is on the Brink of Collapse: How the Center for Health & Democracy Will Help Us Fix It
The health care system in the United States is not only fundamentally broken, it is on the brink of collapse. Big Insurance companies continue to rake in massive profits while patients continue to struggle to get the care they need at a cost they can afford.
The Affordable Care Act was a necessary and vital reform. But it is not enough.
As a former health care executive, I was a part of the problem. But I will not sit on the sidelines as this problem gets worse every day, which is why I am proud to announce the re-launch of the Center for Health & Democracy (CHD).
This organization will:
Expose the truth about Big Insurance. Just last week CHD launched this newsletter, HEALTH CARE un-covered, which will bring in expert voices to expose the truth about Big Insurance and how insurers and other health-care corporations put profits over people.
Work with allies on Capitol Hill to advance reform: CHD will work with supporters on Capitol Hill to advance legislation to reform this broken system and fight off efforts by industry lobbyists to continue to rig the system in their favor. We kicked off this effort this week, fighting back against the insurance industry lobby effort to undermine Medicare.
Engage in state-based fights: From California to Vermont states are at the forefront of advancing sensible reforms. CHD will work with local partners to advance this cause. Change doesn’t always come from Washington; sometimes it comes to Washington.
Be an action hub for the broader health-care reform movement: The movement for health-care reform is strong and vibrant at both the state and national level. CHD will bring resources to amplify and support this work as well as serve as a coordinating body to ensure we are combatting the massive resources Big Insurance is bringing to this fight.
Folks, the need to engage in this fight, and for an organization like CHD, has never been more urgent.
Despite what they may think, Americans whose health insurance is provided by an employer are not safe from the impending collapse of the U.S. health-care system. Executives at 87% of large employers believe that the cost of providing health benefits to employees will become unsustainable in the next five to 10 years. Fewer employers are even offering coverage, dropping from 69% to 51% since 2000.
This survey – provided by the Purchaser Business Group on Health (PBGH) and Kaiser Family Foundation – highlights what many followers of my work have long understood: the current U.S. health-care system is on the brink of collapse. Elizabeth Mitchell, president and CEO of PBGH, wrote: “Our large employer members support competition and prefer market solutions. But they have reached their limit; they’re tired of pouring tons of money into a broken health-care market that delivers uneven quality at bloated costs.”
The current system is failing all of us except insurance company executives and shareholders. Since the Affordable Care Act was passed in 2010, big insurers have amassed hundreds of billions of dollars in profits. Meanwhile employers and their workers have continued to be hit with steep premium increases even as out-of-pocket costs have spiraled out of control, leading to 100 million Americans, most with insurance, mired in medical debt. The out-of-pocket maximum in 2014, when the ACA’s maximum out-of-pocket limit went into effect, was $6,350 for an individual and $12,700 for a family. Today it is $9,100 for an individual and $18,200 for a family – a 43% increase in nine years, far outpacing inflation.
As costs continue to skyrocket, Americans are now dying younger than people in other wealthy countries despite spending more than twice as much on health care. Life expectancy in the United States actually decreased 2.8 years between 2014 and 2021, erasing all gains since 1996, according to the Centers for Disease Control and Prevention.
Working conditions for many doctors and nurses have become intolerable. More than 200,000 quit their jobs last year alone, to a large extent because of insurance company demands and restrictions on how medical professionals provide patient care.
Our system also continues to avoid addressing social determinants of health, the social and environmental factors that affect health outcomes. People of color are disproportionately disadvantaged, as are people in rural areas and small towns, where hospitals are closing and medical and dental professionals are increasingly scarce. Inequities are only growing, afflicting white middle-class American families as well.
In a recent study, the Commonwealth Fund found that 43% of working-age adults were inadequately insured in 2022. 29% of people with employer coverage and 44% of those who purchased coverage through the individual market and (ACA) marketplaces were underinsured last year. 46% of those surveyed said they had skipped or delayed care because of the cost, and 42% said they had problems paying medical bills or were paying off medical debt. Half (49%) said they would be unable to pay an unexpected medical bill within 30 days, including 68% of adults with low income, 69% of Black adults, and 63% of Latino/Hispanic adults.
The United States is now spending well over $4 trillion per year on health care, but getting less and less in return for our spending, especially for health insurance as the value of coverage diminishes year after year. And as insurers realize that there is a ceiling on how much more profit they can suck from employers and individuals, they have turned to raiding the Medicare Trust Fund by taking advantage of the government’s lax oversight of the Medicare Advantage program. By hoodwinking Americans into choosing Medicare Advantage (private insurance) over traditional Medicare (government-provided insurance) insurers have made Medicare Advantage their biggest cash cow.
All of this shows us clearly that the outlook for the American health-care system is bleak. It is poised to eat itself alive in the coming years. It’s worth noting that of the corporate executives surveyed in the study mentioned above, 85% expect the government will be required to intervene to provide coverage and contain costs.
This is a system that works for Big Insurance, providing them with sky-high profits, while the rest of us sink deeper into debt and die prematurely.
That’s why we’re re-launching CHD today to use the full breadth of my skills, and so many others who are fighting for change to help stop the United States health-care system from imploding, while building momentum for a new system that will provide Americans with the quality, access, and affordability that they deserve.
I hope you will join us.
We're in. COMBINE for Medicaid mental health care. combinebh.org.
Today in Colorado 's Health and Insurance Committee HB23-1116 will prohibit carriers from charging money for payers to get paid through direct deposit. Once again, Medicaid is forgotten and we are going to ask for an amendment so that Medicaid providers get the same protection. Fight for PUBLIC and PRIVATE health care providers.