Compared to other developed countries, the U.S. spends far more overall.
In 2011, that was 17.7% of our entire economy (GDP) or about $2.7 Trillion, with more than half coming from private spending. And we still leave 50 million folks (16% of the population) uninsured and many more underinsured.
The next biggest spenders are France, Germany, Canada and Switzerland, which each spend only 11% to 11.6% of GDP and still manage to cover all their people.
If America would follow the lead of other civilized democracies by adopting a single payer Medicare-For-All system or by injecting fairness and pricing transparency into the private market so patients actually have buying leverage, we too could cover all our people and get health spending down to 11% to 12% of GDP. That would save a whopping $900 Billion per year! That’s more than current federal spending on Medicare & Medicaid combined.
And just think of what else you could do with the savings if your personal healthcare/insurance costs were cut by a third!
While average per capita health spending has gone up for every country in the last four decades, it has skyrocketed in the U.S. We now spend more than twice the per person average of all other industrialized countries.
In 2011, that was a whopping $8,500 per person.
This chart shows how U.S. healthcare spending started to peel away from the pack in — surprise, surprise — the deregulation days of Reagan. Then it takes off in the mid 1990s after Clinton’s failed attempt at major health care reform, while at the same time formerly non-profit health insurance companies started answering to Wall Street’s relentless profit demands.
The steepest rise in U.S. healthcare spending, however, clearly happens in the 2000s with Bush 2 and the pushing of tax-exempt health savings accounts (HSAs) paired with a high-deductible plan (euphemistically branded as “consumer-driven care”). Far from bending the cost curve down, this touted “market-based” approach helped fuel the escalating costs. The promise that people would be more prudent shoppers of health care when forced to spend their own money did not pan out.
As former CIGNA executive turned industry whistleblower Wendell Potter explains in his book Deadly Spin,
“...high-deductible plans are best suited for relatively young and healthy people who have a few dollars left over after they pay their bills. For the rest of the population, they frequently turn out to be a very bad deal.” (p. 112)
Potter recounts the story of a leadership retreat where a vice president of a large insurer was trying to explain the benefits of consumer-driven care to about one hundred of his colleagues:
“He was peppered with questions about how the plans could be a good deal for people with chronic conditions and people who didn’t have extra money to put in a savings account or otherwise meet high deductibles. After about thirty minutes of nonstop questions, he finally said, ‘Look, you’re just going to have to drink the Kool-Aid.’ That was the end of the Q&A” (p. 112-113)
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