Even though the general picture, that US health care costs way too much and delivers way too little, is well known, the fact that things are getting even worse may not be. From the New York Times:
Health care remains stubbornly unaffordable for millions of people, according to a new survey released Wednesday that underscores the struggle many people have in paying for a doctor’s visit or a prescription drug — even before any talk of cutting government coverage.
In the survey, 11 percent of people said they could not afford medication and care within the past three months, the highest level in the four years the survey has been conducted. More than a third of those surveyed, representing some 91 million adults, said if they were to need medical care, they would not be able to pay for it….
Higher premiums, the added cost of going to the doctor and the recent rollback in Medicaid coverage have all contributed to making it harder for people to afford care. Health care costs continue to rise, and dramatic cuts to Medicaid and the elimination of tax subsidies that lower the cost of Obamacare plans, as discussed by the Trump administration and Republican lawmakers, will likely exacerbate the problem, according to experts.
“It puts further pressure on a system that already has a financial toxicity that is pervasive, “ said Tim Lash, president of the West Health Policy Center. Many families are already struggling with medical debt, he said. Unlike doing without a new blender, people who forgo care can suffer or die, he said.While there have been significant improvements in the past 15 years under the Affordable Care Act, which significantly expanded Medicaid, “we’re not a country where health care is affordable,” said Sara R. Collins, a health economist who is vice president for health care coverage and access for the nonprofit Commonwealth Fund. Even when people have insurance, many do not have sufficient coverage to pay their medical bills.
If the hundreds of billions of dollars in cuts go through that Republican lawmakers and the Trump administration are considering, the number of people who will not able to afford care is likely to climb, she said, as millions of people lose their coverage or replace it with less generous plans.
To add insult to injury, this survey took place in the last six weeks of 2024, meaning while the economy was still showing good groaf, if too much inflation for many, and was benefitting from optimism about Trump’s election. Now that confidence has gone into reverse and the Atlanta Fed “nowcast” predicts the first quarter GDP release will show a contraction, the results if the same poll were taken now, would if anything be worse. Fear and worsening prospects lead many to clamp down on spending, even on seeming necessities like health care.
Reader resilc, who sent on this story, pointed to other impediments to getting care besides money:
Then there is the problem of access…….I even have problems with excellent insurance in the Chapel Hill area. Not enough medical staff in a growing area. Rural New England the same. No labor.
In addition, aside from queuing, many patients face the “access” problem of gatekeeping, of needing to see a PCP first rather than go directly to a specialist, even in cases where a specialist visit seems obviously warranted, or worse, having to get a prior authorization for a treatment or imaging.
And the US has a demonstrably lousy health care system. The first chart is from the Commonwealth Fund Mirror, Mirror 2024 report:
The one below is from the Legatum Prosperity Index 2023:
Another indicator:
Unique to America, our health care system is designed not to make people well, but to make CEOs & wealthy stockholders incredibly rich. The result: We have the highest infant mortality rate of any wealthy country on earth. How cruel, how immoral is that? We need Medicare for All. pic.twitter.com/a3Ty6Haw3s
— Bernie Sanders (@SenSanders) March 23, 2025
And the Trump Administration is setting out to destroy one of the few areas where the US was a leader, which was in R&D, which depends on government funding for basic research.
Absolute BLOODBATH at HHS/NIH/CDC this morning. Generation of scientists, health care officials being wiped out pic.twitter.com/ikJjcOiqhp
— Sam Stein (@samstein) April 1, 2025
As we pointed out, over 80% of Big Pharma’s “new drug applications” are for minor tweaks of existing drugs, like extended release formulations. to extend patent life.
And to put not too fine a point on it:
Luigi’s done more for healthcare than any politician in the last 50 years pic.twitter.com/5CD2CO69IH
— Pat Just Pat 🍉 (@PatTheSocialist) March 29, 2025
No wonder the Trump Administration wants Mangione executed. He’s threatened too many rice bowls, a far worse sin than mere murder.
