The United States spends a lot of money on health care.According to the Centers for Medicare and Medicaid Services (CMS), total US healthcare spending is $4.3 trillion by 2021. What do we get for what we pay for? Life expectancy at birth is not that long compared to other wealthy countries. Life expectancy in the US in 2020 was 77 years. I was 80 years old in England. Australians are expected to live to the age of 83. In Japan, the average life expectancy has reached 85 years.
If we spend the most on health care than any other country on the planet, but we don’t have the best outcomes, where does the money go? It’s going into the vaults of private health insurance companies in America. UnitedHealth Group, America’s largest insurance company, 2022 profit of $20.6 billion. This is a 16.4% increase from 2021. The six largest U.S. health insurers had net profits of $41.5 billion in 2022.
Those gains come at the expense of patients and providers, adversely affect health care outcomes, and undermine the quality of America’s healthcare system as a whole. It’s a common misconception that only the uninsured in America suffer from medical debt. According to a 2022 Kaiser Family Foundation study, 44% of insured adults have medical debt A further 17% have had medical debt in the last five years.
what treatments are there Health insurance company denies coverageWe do everything from pre-approved heart surgery, to newborn neonatal care, to emergency room care.?a Kaiser Family Foundation Survey found that “nearly 17 percent of claims in the network were denied in 2021.” UnitedHealth, the largest health insurer in the United States, is now making a reversal attempt to grow its revenue. About to implement life-saving preventive cancer screenings Delayed pre-approval.Ann American Medical Association Survey Ninety-four percent of surveyed physicians said prior authorization would lead to treatment delays, and 80% said that prior authorization could lead to treatment abandonment.
Not only do health insurers impose medical debt on patients by refusing to cover a wide range of essential treatments, they also accept payment for the medical care provided to already stretched health care providers. left unattended.Anthem Blue Cross Blue Shield consistently By underpaying reimbursement or inappropriately denying insurance coverage, hospitals end up paying for their patients themselves. In 2021, 53% $2.5 billion of Anthem’s medical expenses were outstanding in the second quarter.
Hospitals close their doors when their calculations go wrong. in Arizona, 18% of rural hospitals are at risk of closing. This means that Arizonans have less access to care and have to travel far for the treatment they need (assuming their health insurance company covers it from the start).
Left unchecked, health insurers will put ever-increasing profits ahead of patients and providers in the American healthcare system. The Affordable Care Act (ACA) sought to advance a voracious restraint on health insurance by forcing insurance companies to spend 80% of every dollar directly on health care. Unfortunately, health insurers have responded by raising costs to keep making huge profits.
If Congress and states are looking for easy outcomes to curb abuse in the health insurance industry, they should reconsider the ACA’s health loss rate rule to limit insurer profit levels in addition to profit margins. be. If we are going to spend trillions of dollars on health care, we should not pay bonuses or dividends to private health insurers and do everything we can to get it spent on health care.
Oscar de los Santos is Democratic Assistant to the Leader of the Arizona House of Representatives. He represents District 11, which includes Southern Phoenix, Lavigne, and Guadalupe.
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