No cure in sight for US health care costs
WASHINGTON: “Every time I see what I pay for me and my family’s health it makes me sick,” says Fiona, a 46-year-old mother of two who, unlike some 50 million Americans, actually has health insurance.
Americans frustrated with their country’s notoriously expensive and complicated health care system are eagerly awaiting the Supreme Court’s ruling, expected Thursday, on President Barack Obama’s landmark 2010 reform law.
The law would expand coverage to another 32 million uninsured Americans and bar insurance companies from denying coverage because of pre-existing conditions, but only if the Supreme Court does not rule the law unconstitutional over a controversial requirement that all Americans acquire health insurance.
But even if the reforms, derided by critics as “Obamacare”, are upheld, the high costs and labyrinthine paperwork associated with US health insurance will remain, to the frustration of many Americans.
Fiona already has relatively good coverage by US standards: she pays $10 to go to the doctor and $100 for emergency room visits. Minor surgery would cost her around $400, some 20 per cent of the total bill, she told AFP.
But the costs add up. Fiona guesses she pays some $6,500 a year in medical expenses. “It is so frightening to think of what it would mean for my finances if I were really sick!” she says.
US health care costs are beyond the means of most of the uninsured. A physician visit runs $150, a visit to the dermatologist to get a mole removed can cost $200 and a mammogram can be as much as $1400.
And that doesn’t include the cost of prescription drugs.
In a pharmacy near the US capital Washington, a Chinese woman who had recently moved to the United States and asked not to be named described her shock when she first came in to buy ear drops.
“The pharmacist said ‘one thirty-seven,’ so I took out a dollar and 37 cents. She gave me a funny look and said: ‘No, madame, I meant $137.’”Those like Fiona, who are fortunate enough to have health insurance that covers part of the cost of drugs, say sorting out their costs and benefits is extremely complicated.
The “Remapping Debate” website, run by independent journalists, recently compared the number of staff in the billing department of a hospital in Massachusetts and another in Toronto, Canada.
The US hospital had 300; the Canadian facility had just three.
Heidi, 48, a schoolteacher in a suburb of Washington, says she is fortunate enough to be insured through her employer and is generally healthy, but fears that market forces drive much of the US health care system.
“In my limited experience, it does seem that our health care system is driven by a profit motive rather than a focus on helping people get well and stay well,” she says.
“If providers earn more each time another test is ordered, each time another prescription is written, the incentive is to keep the patient coming in for more treatment rather than simply addressing the illness.” The United States spends 16.2 per cent of its GDP on health care, or $7,400 per capita, compared with France, which spends 11.7 per cent of GDP, or $4,000 per capita, according to 2009 World Health Organization figures.
And yet France came out at the top of the WHO’s list of the world’s best overall health care providers, while the United States ranked 37th.
“There is a big crisis in this country that no one seems to hear or listen to,” said Stan Brock, the founder of Remote Area Medical, a charitable group that provides free health services through a fleet of mobile clinics.
“If people with the power to change things could only see what we do during our events they would realize the depth of the health crisis.” Americans with no insurance can and do go to hospital emergency rooms to receive care, with US taxpayers covering most of the bills, but that doesn’t cover less urgent medical needs.
“The people who attend our events are not only homeless or unemployed Americans,” Brock says.
“Now they are mainly middle class people who need their teeth to be fixed, a pair of glasses or a doctor checkup.”