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.
Most of those two-thirds (sans about 5% give or take) of people just haven’t been stricken with a condition or conditions that make them understand they can’t afford it either.
Who knew there were so many fraudsters out there?
From Obama with a super majority who ran on health care or Biden with a simple majority and who inherited the largest medical crisis in 100 yrs, the Dems just won’t do the right thing.
It’s clear the party we still think of as the old Dems, who have us SS etc, is dead and gone.
I don’t know what it will take or what it will look like, or if it’s even possible.
Sadly, It’s not a matter of “doing the right thing” it is a matter of doing the bidding of the bribe-masters. Political bribery is legal, and money is free speech. Let’s not forget. The blanket term for this is “institutionalized corruption”. The US has no functioning democracy, we have oligarchy front and center.
As this piece illustrates, “health care” in the USA is just an extortion racket. The best extortion rackets offer a choice: “your money, or your health/life”
Much has changed since FDR and the “new deal” saved capitalism
institutionalized corruption…a flourishing business model…global in scope, usually befitting of an iconoclast
the Dems just won’t do the right thing.
I’m sorry, but you can only have one increment at a time…
My cancer is incurable and I am currently waiting around to die. When I was first diagnosed, I had no health insurance at all because I couldn’t afford it. Now I have minimal coverage but it doesn’t cover my medication (which lessens some symptoms but does little else), Luckily, my medication is a generic so I pay for it myself. For people who require much more costly medication, I don’t know how they can manage.
🙏🏻
I am so so sorry.
I am also very sorry to hear that Lena. A close relative has a rare terminal condition, he is only 56 years old (not old enough for Medicare). At least his wife works for a local hospital group and has relatively good coverage. As you say, others do not, and the consequences are real.
Since he can no longer work, he is applying for SSDI (social security disability insurance) but I’m a bit worried how long it might take, and if it will even be available in the future. Of course, my biggest worry is his health.
https://www.ssa.gov/ssa-performance/disability-processing-time
I am so sorry, Lena. 😔
I am very sorry to hear. Keep you in my thoughts.
My best wishes.
Lena, I am so angry that you had to go without health insurance.
Over the past 20 years my doctors discovered and excised two developing skin cancers — only because my employer-provided insurance allowed me to have a doctor visit every year or so. The doctors noticed things that I wouldn’t have thought twice about — until it likely would have been too late.
I hope that your medicine continues to ease your suffering and that you can access it for as long as you need to.
Lena, as someone who fought through a blood cancer chemo therapy for several years, successfully, even my excellent health insurance failed to cover more than 70% of the expense. Cancers, generally, force patients out of the work place and bills accumulate rapidly. (Chemo therapy induces debilitating, extended recovery periods.) Please don’t succumb to the induced ennui!
Stay strong and engaged. Every day is important. Best to you!
Lena,
My thoughts and prayers are with you. Hope you keep on enjoying Music. Here is a set you might like:
https://www.youtube.com/watch?v=eEaHxhRpgCg
So very sorry Lena.
I can only express how sorry I am to read this and hope that you stay engaged with us here as long as possible, I have always enjoyed your thoughts on so much.
I can only hope that someday, somewhere in this universe, there is a reckoning for the evil souls that perpetuate this system.
Be well
Thank you all for your kind words.
I’m deeply sorry to hear this Lena – I always look forward to reading your btl contributions here. I very much hope you have the love and support you deserve around you.
California ballot initiative to “make it harder” for heath insurers to deny health care. Is that a version of “we’re fighting for you”?
Naming it for The Saint is such a terrible idea no matter how much we appreciate Luigi’s efforts. It makes the entire initiative politically radioactive. Like the “Defund the Police” slogan which only ensured that demilitarizing police (the real goal for most activists) was never going to happen.
Since I trust the Ds about as far as I can bowl them, this feels like active sabotage while getting likes and shares on social media.
That sure looks like the plan: divide, distract and polarize the public on the emotionally-charged issue to continue the illusion of democratic choice. Meanwhile, the health extortion racket gets more expensive, and “access” worsens.
https://www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022
Not familiar with California?
I doubt this will make it radioactive; if anything it may make it stronger as the Trump administration scores an own goal on the criminal case. To be clear, it may be an actually horrible bill. But I doubt the name association will be an issue.
People are family blog fed up and especially in CA which has some of the highest costs of living in the world.
I know many people who are registered Ds in California who don’t approve of Mangione’s actions at all. (I am 4th generation NorCal) I believe the title is polarizing and signifies the hollow PR stunt. It would take much legislation from Congress and an exec who had half a brain to bring any significant improvement. Alas, that ain’t the case.
“It would take much legislation from Congress and an exec who had half a brain to bring any significant improvement.” That did recently happen once. Obama. Except he no intention of change in our favor.
Obama was groomed by The Chicago Machine to become the charlatan he is.
And I have the opposite experience when talking to people in CA.
In any case, are you trying to tell me that if the bill is actually useful and gets real healthcare to people who need it, they would vote against it because of a name? That seems beyond petty.
> The one below is from the Legatum Prosperity Index 2023:
They honestly believe that Uzbekistan (49), Turkmenistan (54), Tajikistan (75) and Kyrgyzstan (76), all the Stans somehow have better healthcare than Russia (84)? Okay…
Russia is a big country, and the medical system is poor in rural areas far from big cities like Moscow. It’s rather surprising that China, which should have similar problems, is quite high on the list.
Some of the stans are quite large and rural themselves. So I agree the Russian rating is suspect propaganda.
“While there have been significant improvements in the past 15 years under the Affordable Care Act,”
To what specifically — outcomes or inflated private profit?
I think the “Act” in the Affordable Care Act has been shown to be a stage definition at this point.
“Unique to America, our health care system is designed not to make people well, but to make CEOs & wealthy stockholders incredibly rich.” yes – very true Mr Sanders. So how about would you like to change this legislative outcome, or, if you prefer, this dynamic? Might I suggest that the Democratic party intoduce actual progressive legislation and, thereby recognize the deficiencies in it’s own legislative history, whence therefrom, propose legislation in the name of both national defence and “defending democracy” (f*&^%ng ridiculous)-
((((( “conduct that bears a hostile attitude toward U.S. citizens or U.S. culture (including government, institutions, or founding principles).”)))– sorry I had to add that bit of writen hogwashery))))) as what the Trump and the Biden do and did are all on the same path-despite the congressional theatrics. They are both hostile toward U.S. citizens and founding principals, government, culture, (supporting genocide, private prisons, defeating bankruptcy provisions, torture, culture wars, endless wars…..)
to the effect by instituting universal healthcare, limit private profit from the fruits of public research(The Bayh–Dole Act or Patent and Trademark Law Amendments Act (Pub. L. 96-517, December 12, 1980), bring back student debt into the realm of constitutional bankruptcy (Bankruptcy Abuse Prevention and Consumer Protection Act)-thanks clinton/biden- Speaking of Clinton lifts John McCain from the grave so, lets not forget campaign finance reform once spoken by John McCain which, brings up speculation in properties and the McCain/Clinton nexus again, so, propose the re-institution of Glass-Steagal that was repealed in 1999 Gramm–Leach–Bliley Act (GLBA) add legislation that imposes highest taxes for those speculators of preditory practices and other ‘Legal Gambling’ “Our lawmakers will do well, therefore, to pay less attention to the rate on incomes, and more to the source from whence they are drawn.”
Written around 1925
It is to be hoped, however, that there will never be another boom. The crash of the boom of 1923 was due to the same causes that wrecked the wall street stock market. People sold what they did not own. They made a payment down in the hope of getting the property off their hands before it began to burn. Real estate fell into the hands of sharp-shooting gamblers who had no interest in land. To them it was just a pile of blue chips on a roulette wheel.
Recognize that the economic interests of a few men do not make consent by the majority
Anyone ever have this experience: MRI with insurance ~ $4000 price, MRI no insurance for $450 cash price? I did, twice. No, didn’t say I was poor. I did say “I don’t need no stinkin’ insurance cards!” like that bandito in The Treasure of Sierra Madre.
Regularly. I bought two pair of prescription eyeglasses from my favorite web vendor. Some $40. I submitted a reimbursement form only to be refused. I never considered that the vendor would be “out of network.”
This year i decided to treat myself. One pair of Ray Bans with all the trimmings from a listed vendor. $350. I never saw the paperwork and have $150 left to spend this year. Maybe a pair of fancy readers.
I’ve heard stories simiilar to yours from my PCP. Even she’s been scammed.
I’ve said it before, but it bears repeatimg; we live in a time of deceit.
We haven’t tried that one yet, but we have run into the provider is in or out of network (i.e. covered or not covered) depending on the office that does the billing. Or the time we got a bill because we both had jobs and the insurance companies got in an argument about who should cover the cost of rabies shots (which were $22K per person).
What a crazy dumb system.
I pay for all of my imaging and labs out of pocket and then submit for reimbursement to greatly lower my co-pay.