Health Insurance Costs In The United States
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Health insurance costs in the United States are a major factor in access to health coverage. The rising cost of health insurance leads more consumers to go without coverage and increase in insurance cost and accompanying rise in the cost of health care expenses has led health insurers to provide more policies with higher deductibles and other limitations that require the consumer to pay a greater share of the cost themselves.


Background

According to Senator
Dianne Feinstein Dianne Goldman Berman Feinstein ( ; born Dianne Emiel Goldman; June 22, 1933) is an American politician who serves as the senior United States senator from California, a seat she has held since 1992. A member of the Democratic Party, she was ...
, the United States is the "only industrialized nation that relies heavily on a for-profit medical insurance industry to provide basic health care." The Kaiser Family Foundation claims that health insurance costs are driven not only by the added cost of health insurers making their profits, but also by rising health costs and administrative costs. In 2004, employer-sponsored health insurance premiums grew 11.2% to $9,950 for family coverage, and $3,695 for a single person, according to a survey by the
Kaiser Family Foundation KFF (Kaiser Family Foundation), also known as The Henry J. Kaiser Family Foundation, is an American non-profit organization, headquartered in San Francisco, California. It prefers KFF since its legal name can cause confusion as it is no longer a ...
and Health Research and Education Trust. The survey also found that 61% of workers were receiving employer sponsored health insurance. Five years later, Kaiser's 2009 survey found that employer health insurance premiums were $13,375 for a family and $4,824 for a single person. About 60% of workers were receiving employer sponsored health insurance. Less than half (46%) of employees at small firms with 3 to 9 workers received coverage. As of 2008, the percentage of Americans receiving employer sponsored health insurance had declined for the eighth consecutive year, says the Kaiser Family Foundation. From 1999 to 2009, Kaiser found that the insurance premiums had climbed 131%, and workers' contribution toward paying that premium jumped 128%. In 1999, workers' average contribution to the premium was $1,543, and in 2009 it was $3,515. For employers, their contribution was $4,247 in 1999 and $9,860 in 2009. The lower a family's income is, the less likely that they can purchase health insurance, according to 2008 US Census figures. About 14.5% of households with $50,000 to $75,000 in income did not have health insurance. While 24.5% of households with $25,000 or less income went without health insurance. A March 2010 study by the Center for Studying Health System Change, a Washington DC think tank, found that out-of-pocket costs for health insurance premiums and services were rising faster than family incomes. Published in the journal
Health Affairs ''Health Affairs'' is a monthly peer-reviewed public health journal, healthcare journal established in 1981 by John K. Iglehart; since 2014, the editor-in-chief is Alan Weil. It was described by ''The Washington Post'' as "the bible of health poli ...
, the study found ''"…After accounting for general inflation, family incomes remained stagnant between 2004 and 2006, while out-of-pocket spending on premiums and health care services increased 8.5% over the two-year period. Overall, total out-of-pocket spending increased, on average, about 5 percent annually between 2001 and 2006, and was similar for the 2001–4 and 2004–6 periods."'' The report found the largest increases in out-of-pocket expenses were for those with private health insurance, including middle- and higher-income families. The study was based on 2001 through to 2006 data.


Impacted populations


Pre-existing conditions

People with
pre-existing conditions In the context of healthcare in the United States, a pre-existing condition is a medical condition that started before a person's health insurance went into effect. Before 2014, some insurance policies would not cover expenses due to pre-existin ...
typically cannot obtain any coverage, or at best can obtain limited coverage or more costly coverage for those conditions. This situation was expected to be corrected by the health reform bill being considered by the
US Congress The United States Congress is the legislature of the federal government of the United States. It is bicameral, composed of a lower body, the House of Representatives, and an upper body, the Senate. It meets in the U.S. Capitol in Washingto ...
in early 2010. Currently, those with pre-existing conditions must pay the cost
out-of-pocket An out-of-pocket expense (or out-of-pocket cost, OOP) is the direct payment of money that may or may not be later reimbursed from a third-party source. For example, when operating a vehicle, gasoline, parking fees and tolls are considered out-of ...
, and some resort to
medical tourism Medical tourism refers to people traveling abroad to obtain medical treatment. In the past, this usually referred to those who traveled from less-developed countries to major medical centers in highly developed countries for treatment unavailable a ...
, obtaining treatment in other countries or US regions, to obtain more affordable health treatment. This is especially difficult for those impacted by
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
, heart condition and other serious illnesses where treatment costs can easily run into the tens of thousands of dollars or higher within a few days or weeks. According to the
Kaiser Family Foundation KFF (Kaiser Family Foundation), also known as The Henry J. Kaiser Family Foundation, is an American non-profit organization, headquartered in San Francisco, California. It prefers KFF since its legal name can cause confusion as it is no longer a ...
, 21 percent of those who apply for health insurance on their own are turned down, charged a higher price or denied coverage for their pre-existing condition. Among the conditions that be considered "pre-existing" by insurance companies are
domestic violence Domestic violence (also known as domestic abuse or family violence) is violence or other abuse that occurs in a domestic setting, such as in a marriage or cohabitation. ''Domestic violence'' is often used as a synonym for ''intimate partner ...
,
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
,
asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, cou ...
, depression and occupations such as
police officer A police officer (also called a policeman and, less commonly, a policewoman) is a warranted law employee of a police force. In most countries, "police officer" is a generic term not specifying a particular rank. In some, the use of the ...
and
construction worker A construction worker is a worker employed in the physical construction of the built environment and its infrastructure. Definition By some definitions, workers may be engaged in manual labour as unskilled or semi-skilled workers; they may be sk ...
.


Self-employed

The 9 million
self-employed Self-employment is the state of working for oneself rather than an employer. Tax authorities will generally view a person as self-employed if the person chooses to be recognised as such or if the person is generating income for which a tax return n ...
workers have a greater challenge than many people to find affordable health insurance. They represent 8 percent of the US
labor force The workforce or labour force is a concept referring to the pool of human beings either in employment or in unemployment. It is generally used to describe those working for a single company or industry, but can also apply to a geographic regio ...
, and essentially pay a tax on their health insurance premiums, unlike any other workers. They pay a tax of 15.3 percent of their net earnings, double the rate of wage and salary earners.


Low-income families

For Americans earning less than $24,000 per year, few have health insurance, or, they rely on government insurance (
Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and pers ...
). In this income bracket, more than half of people ages 27 to 37 do not have health insurance. This number drops when people reach their 40s, but even into their late 50s, more than one-third of these Americans are uninsured. When new health reform laws take effect, low-income families will receive subsidies to help them pay for health insurance. These subsidies will paid through higher taxes paid by people with higher incomes.


State cost-control efforts

* California: On March 23, 2010, the California State Assembly's Health Committee passed a bill that would require health insurers and health maintenance organizations to have same strict regulation that has covered automobile and other types of property insurance for the last two decades. The bill would require approval of some rate hikes by state agencies, and must next be considered by the state legislature. * Iowa: In March 2010, Iowa senior advocates and the AARP asked state legislators to act on a measure that would require state regulators to hold hearings when rate increases are proposed and issue an annual report about insurance rates. * Massachusetts: The State of Massachusetts held a three-day hearing in March 2010 to discuss ways to better control health insurance and other costs. Addressing these costs, Massachusetts Secretary of Health and Human Services Dr. JudyAnn Bigby said "As we examine all of the causes of increasing health care costs and implement reforms, we must strive to bring premiums down without sacrificing access to care or requiring consumers to pay more out of pocket."


See also

*
Health care Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...
* Health care politics *
Health care reform Health care reform is for the most part governmental policy that affects health care delivery in a given place. Health care reform typically attempts to: * Broaden the population that receives health care coverage through either public sector insur ...
*
Health economics Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and healthcare. Health economics is important in determining how to improv ...
*
Health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
*
Health insurance in the United States Health insurance in the United States is any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include ...
*
Health insurance exchange In the United States, health insurance marketplaces, also called health exchanges, are organizations in each state through which people can purchase health insurance. People can purchase health insurance that complies with the Patient Protection ...
*
Health insurance mandate A health insurance mandate is either an employer or individual mandate to obtain private health insurance instead of (or in addition to) a national health insurance plan.D. Andrew Austin, Thomas L. Hungerford (2010). Market Structure of the He ...
*
Health maintenance organization In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded healt ...
*
Insurance in the United States Insurance in the United States refers to the market for risk in the United States, the world's largest insurance market by premium volume. According to Swiss Re, of the $6.287 trillion of global direct premiums written worldwide in 2020, $2.530 t ...


References

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External links


Commonwealth Fund: How Health Care Reform Can Lower Costs of Insurance Administration

Families USA: The Cost of Failure to Pass Health Care Reform
Medicare and Medicaid (United States)
Costs In production, research, retail, and accounting, a cost is the value of money that has been used up to produce something or deliver a service, and hence is not available for use anymore. In business, the cost may be one of acquisition, in which ...