If you haven’t heard about problems with the health care crisis in the US, you haven’t been paying attention. The US spends over four times as much on health care as it does on defense spending!

Health insurance and cost for medical treatment are escalating faster than any other segment of the economy. It has everyone worried: employers, employees, retirees, and politicians.

Who Provides Health Insurance?

The Government

If you work for the government, including as a member of the military, you’re covered, along with 39 million others who depend on the government for health care. It is sometimes easy to forget that someone does pay for all that care. Remember that government has only two sources of income: (1) taxpayers and (2) loans that put the country further in debt. Each Congressman has seven of his or her very own lobbyists from the pharmaceutical industry and medical providers’ lobbies like the AMA. Basically, it’s the lobbyists’ job to keep prices high and to prevent the passage of universal health care—or even improvements in the current systems. (Of course, members of the Congress are government employees. They have full-coverage insurance for themselves and their families that continues even after they leave office.

Employers

Health insurance is cited as one of the biggest worries for businesses large and small. Even though employees usually pay a portion of the premium through payroll deduction, the portion that employers pay is many times that. We’ve said that health insurance costs are rising—but that’s a bit of an understatement. In 2006 alone, small employers’ premiums rose by 8.8 percent, and companies with less than 24 employees saw an increase of over 10%.

Many, though by no means all, private employers offer health insurance to employees. The problem is that not everyone can afford to pay the premium, usually several hundred dollars a month. The average annual premium charged by insurers for family coverage averaged $11,500 in 2006. Employees paid out almost $3,000 of that, amounting to 10 percent more than in the previous year. A full-time, minimum-wage employee makes just over $10,000 a year, meaning that the total premium for health insurance coverage was more than the worker’s annual wage. According to the National Coalition on Health Care, employee's insurance premiums increased by 73% from 2000-2005. Inflation over that same period was 14%. Wages rose 15%. Premiums are skyrocketing to the point that they’re close to going into orbit! Then there are annual deductibles and co-pays, amounts that employees pay when they seek care. Employers choose higher-deductible plans for their employees to cut the premium cost—sort of like increasing the deductible for your collision and comprehensive coverage on your auto insurance to lower the premium.

It’s easy to find yourself in a medical-expense bind even if you have health insurance. You have to really understand how your policy works, and it seems that insurers keep changing things without warning. First you need a Primary Care Physician, then you don’t. You didn’t used to need a referral to see a specialist, but now you do. You’ve got to stay in the network of providers, or you won’t be covered. Hospital stays must be pre-approved—so let’s hope the ambulance driver can find your insurance card in your wallet or purse in case you’re unconscious. There are tales of people who took a loved one to the hospital in an emergency, only to be denied coverage because the hospital wasn’t in the network.

Then there are “the uninsured.”

As of October, 2006, over 46 million Americans were uninsured. We’re not talking about deadbeats, either. The vast majority of the uninsured are working people with families. They may not be offered insurance through their employer, or they cannot afford the premiums. Many self-employed people are uninsured, and the astronomical premiums for individual insurance put them off the playing field all together—or pre-existing conditions prevent them from getting insurance that will cover them for the very conditions they will most likely need care for.

When the uninsured do see a doctor, it is usually due to a life-threatening emergency or because something like a cold or the flu has spiraled into pneumonia or bronchitis so bad that they have no choice. For the most part, uninsured people who get sick simply hope they will get better. If they don’t, they finally go to the emergency room, where bills are so high it seems there must be a mistake. (A thousand dollars to stitch up a cut? You must be kidding!) If you can’t pay, the hospital will continue to hound you to collect. It could affect your credit rating if you don’t make a stab at paying off the bill.

What You Can Do