How could you design a fundamentally unhealthy healthcare system? On one hand, have healthcare and health insurance provided by private, for-profit companies; on the other hand, make sure the rest of the private economy keeps workers’ wages and salaries from increasing.
The result of such a system would be that healthcare costs and insurance premiums continue to increase and workers can’t pay their medical bills.
And, of course, as a new study by the Kaiser Family Foundation and the New York Times confirms, that’s exactly what has happened in the U.S. healthcare system.
Overall, about a quarter (26 percent) of U.S. adults ages 18-64 say they or someone in their household had problems paying or were unable to pay medical bills in the past 12 months.
Not surprisingly, problems paying medical bills are more common among people with lower or moderate incomes, with high deductibles, and with some kind of disability.
Insurance status also has a strong association with medical bill difficulties, with over half (53 percent) of the uninsured saying they had problems paying household medical bills in the past year. However, as previous surveys have shown, insurance is not a panacea against these problems. Roughly one in five of those with health insurance through an employer (19 percent), Medicaid (18 percent), or purchased on their own (22 percent) also report problems paying medical bills. In fact, overall among all people with household medical bill problems, more than six in ten (62 percent) say the person who incurred the bills was covered by health insurance, while a third (34 percent) say that person was uninsured.
In fact, many of those with medical bill problems report struggling with bills less than $5000, including 24 percent of the insured and 22 percent of the uninsured who say their bills amounted to less than $1,000. While these lower amounts may seem small, even a bill of $500 or less can present a major problem for someone who is living paycheck to paycheck. In fact, when asked to describe their financial situation, about six in ten (61 percent) of those who’ve had problems paying medical bills say they either just meet their basic expenses (43 percent) or don’t have enough to meet basic expenses (18 percent).
The survey also shows that medical bill problems can have real and lasting impacts on individuals and families in terms of their standard of living, their financial stability, and their ability to access needed health care. While insurance provides some protection against incurring medical bill problems in the first place, once these problems occur, the effects on individuals and families are often as serious for the insured as they are for the uninsured.
The problem of affordability stems from the combination of rapidly rising healthcare and insurance costs and slowly rising incomes, both of them a product of the way our economy is currently organized.
Clearly, we need a much better prescription for our unhealthy healthcare system.