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Health Care Crisis: A broken system in need of true reform

Health Care Crisis: A broken system in need of true reform

It's no news that America is experiencing a health care crisis. Millions of people are going without care, billions of dollars are being wasted, and the majority of medical students are choosing to specialize rather than go into primary care. Recent health care legislation starts to address some of these problems, but the crisis is far from over and will require true reform at multiple levels in order to solve.

How did we get here? By using medical insurance - a system originally created to cover unplanned serious illnesses and crises - to manage our routine, everyday health needs.

Insurance is a critical element in the health care of Americans - for expensive, unusual, unpredictable events.  It creates significant problems when used as a payment system for everyday health care. The insurance infrastructure actually makes primary care more expensive and less effective.

Americans are paying more, but getting less for health insurance:

  • The costs of employer-based health insurance premiums have risen 114% since 2000.1
  • Americans are paying higher deductibles. The average family deductible increased from $1,034 in 2006 to $1,518 in 2010.1
  • American families aren't only paying higher deductibles, but higher copayments as well. In 2004, only one in five people with health insurance through an employer had a copayment of more than $25. In 2008, that number was one in three. In 2009, it was nearly one in two.2
  • A middle-income family with individual coverage spends an average 22% of household income on health care while a similar middle-income family with employer based coverage spends about 8% of their income on health care costs.3

Millions of Americans are going uninsiured or underinsured because of escalating health care costs, decreased access to health care and gaps in quality of care. 

  • 86.7 million Americans were uninsured at some point during 2007 and 2008.4
  • Working families make up 80% of the uninsured.5
  • Insured Americans are going without needed medical care due to expensive copayments and deductibles.6

 The solution: Direct Primary Care

1Kaiser Family Foundation. Employer Health Benefits Annual Survey 2010. http://ehbs.kff.org/pdf/2010/8085.pdf

2 American Health Insurance Plans Center for Policy and Research, Individual Health Insurance 2006-2007 and 2009: A Comprehensive Survey of Premiums, Availability, and Benefits. (Washington, DC: American Health Insurance Plans, 2007, 2009) http://www.ahipresearch.org/pdfs/Individual_Market_Survey_December_2007.pdf, www.ahipresearch.org/.../2009IndividualMarketSurveyFinalReport.pdf

3 Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2001-2006.

4The United States Census Bureau, "Income, Poverty and Health Insurance Coverage in the United States: 2009" http://www.census.gov/newsroom/releases/archives/income_wealth/cb10-144.html

5 Kaiser Family Foundation. The Uninsured: A Primer, Key Facts about Americans without Health Insurance. (Menlo Park, CA: Kaiser Family Foundation, December 2010). www.kff.org/uninsured/upload/7451-06.pdf

6 The Kaiser Commission on Medicaid and the Uninsured. Snapshots from the Kitchen Table: Family Budgets and Health Care. http://www.kff.org/uninsured/7849.cfm.

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Primary Care:

Essential to Good Health

Primary care includes disease prevention, health maintenance, patient education and counseling, diagnosis and treatment of acute and chronic illnesses. It spans preventive care (such as immunizations and check-ups), routine treatment of common injuries and complaints, and maintenance for ongoing health issues.

Primary care is the foundation of good health. It's the key to preventing debilitating and expensive problems. A health care solution that doesn't address primary care is no solution at all.