health care

Facts

Health care reform fell out of fashion after the Clintons' push to create a national health care system went down in flames in the 90's. But reform efforts are making a comeback. Everyone agrees on the two big problems: high costs and a high number of uninsured. Costs continue to soar and show little sign of letting up. For Americans who don't get insurance through their job, health care remains either a burden or, at times, a luxury to do without. Employers offering insurance to their workers, meanwhile, are beginning to buckle under the rising premiums.

While the problems are clear, the solutions are not - so we won't try to provide any. We do try, however, to lay out the big picture on how much we're spending, what on, and how our current insurance “system” works. For a great primer on the debate to bring costs down - and for any other info on health care, for that matter - see Kaiseredu.org.

Costs

How much the nation spends on health care (2005)

  • Total: $2 trillion (16% of the Gross Domestic Product)

  • Per person: $6,697

Over the years: Total health spending as % of GDP

source: HHS (pdf)

Who pays. How much is paid by (CDC):

  • The federal government : $454 billion (24% of all federal spending);

  • States and localities: $192 billion (15% of state and local spending) (According to the National Governors' Association, 31% of state spending goes to health care costs, with 22% going to Medicaid);

  • Private money (includes private insurance and out-of-pocket payments): $778 billion (55%).

What the money is spent on (2003)

source: KFF

Quality

Sorry - no quick and easy facts here, but you may want to check out the fed's

National Healthcare Quality Report 2005
to see how the quality of care has been improving over the years (sneak preview: not as fast as the cost of care). See also its partner study, National Healthcare Disparities Report, on the - slowly diminishing - gaps in quality of care.

Health Insurance

  • Percentage of Americans who are uninsured (2006) CDC:

    • 14.8%

  • Percentage of children (under the age of 18) who are uninsured (2006) CDC:

    • 9.3%

Over the years: % of Americans who are uninsured

source: Census (87-96), CDC (97-06)

Note: Although the Census is the most widely sited source, other studies of the Census data say that number may be overstated and that fewer folk may be uninsured: so while the Census said in 2003 there were 45 million uninsuerd, three other estimates were 19 million, 36 million and 41 million uninsured (Kaiser).

How folks are covered (non-elderly)

source: KFF

How many Americans have Health Savings Accounts (WP):

  • 3 million (as of February 2006)

Premiums for job related insurance (2004)

  • average yearly premium for an individual KFF:

    • $3,695 (employee contributes $564 of total on average)

  • average monthly premium for family coverage KFF:

    • $9,950 (employee contributes $2,664 of total on average)

The Government Role

The federal government shouldered 43.8% of all health care costs in 2003 (KFF), and provided insurance for 26.6% of Americans (Census). Here's a look at the two main forms of government insurance--Medicare and Medicaid.

Medicare

What it is: Medicare was established in 1965 to provide federally funded health insurance for the elderly. There are two parts to Medicare, Part A helps pay for hospital care while Part B helps pay for regular doctor care and other medical services (CMS).

Who receives it: Every one age 65 or older , certain disabled people under 65 , and people with permanent kidney failure are eligible for Medicare (CMS). In 2003 13.7% of all Americans and 96.0% of those 65 and older received Medicare (Census).

How much it costs: There is no premium for Part A health care because it is paid for throughout one's life with a health care tax on income (CMS). Individuals pay 1.45% of their income in Medicare tax and their employers also pay that amount in the tax (IRS). Part B has a premium of $78.20 per month (CMS). In 2005 the federal government spent $331.3 billion on Medicare (HHS).

Medicaid

What it is: Medicaid was established along with Medicare in 1965. It provides health insurance to low-income individuals and families. Medicaid is jointly funded by the federal government and the individual states, however, it is administered solely by the states (CMS).

Who receives it: Since Medicaid is administered by the individual states, eligibility requirements are different throughout the country. The federal government sets a bare minimum set of requirements, which states must adhere to, but may expand upon. In 2003 12.4% of Americans received Medicaid (Census).

Cost: Medicaid premiums differ from state to state ranging from as low as $105 a month in Michigan to as high as $209 a month in North Dakota. In 2001 the average premium was $150.60 per month (KFF). In 2005 the federal government spent $183.2 billion on Medicaid (HHS).

The rising costs of Medicare and Medicaid - compared to other costs in the federal budget

Medicare and government workers' funding shortfall

  • Predicted shortfall in federal government's funding to pay for Medicare:

    • $33 trillion, according to USAT

  • Shortfall in future liabilities for government workers' health care plans (USAT) :

    • $1 trillion for state and city workers

    • $2.3 trillion for federal workers

Medical malpractice

  • How much is spent addressing malpractice suits:

    • Less than 2% of all health care costs (CBO)

  • How much doctors spend on medical malpractice insurance:

    • $6.3 billion (HHS) (does not include how much hospitals and nurses spend)

  • How much is spent on "defensive medicine" - unnecessary test and procedures doctors perform to protect against law suits:

    • $60 - $100 billion (HHS)

See also our medical malpractice issue guide.

Where the facts are from:

Random selection of other possibly useful sources

Updated July, 2007

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