Growing Unaffordability of Health Care: Incremental vs. Real Health Care Reform

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Increased Costs Decreased Access Variable Quality Increased Fragmentation Increased Administrative Burden Technological Imperative Medicolegal Liability System Out of Control. Major Problems of Health Care System . DRIVERS OF HEALTH CARE COSTS . 1.Technological advances2. Aging of population3.Increase in chronic disease4.Inefficiency and redundancy of private insurers5.Profiteering by investor-owned companies, facilities and providers6.Consumer demand7.Defensive medicine.
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1. Growing Unaffordability of Health Care: Incremental vs. Real Health Care Reform John P. Geyman, MD Professor Emeritus- Family Medicine University of Washington, Seattle

3. DRIVERS OF HEALTH CARE COSTS 1.Technological advances 2. Aging of population 3.Increase in chronic disease 4.Inefficiency and redundancy of private insurers 5.Profiteering by investor-owned companies, facilities and providers 6.Consumer demand 7.Defensive medicine

6. GROWING UNAFFORDABILITY OF HEALTH CARE ? ?Medical divide? at about $50,000 annual income ? Median household debt over $100,000 ? Median family income $41,000 a year ? Health insurance premiums to consume one-third of average household income by 2010

9. UNDERINSURANCE A GROWING PROBLEM Average deductible of CDHC/HDHI plans $4,000 a year Blue Cross PPO plan in Massachusetts up to $12,000 deductible Annual caps of limited benefit plans as low as $10,000 (Aetna, Cigna) Profitable industry with little value of coverage

10. PRIVATE HEALTH INSURANCE INDUSTRY IN U.S. 1,300 companies fragment risk pools Medical underwriting, favorable risk selection $300 billion a year industry Minimal regulation, mostly at state level Average of 80% medical-loss ratios


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