SALTER: After the election, health care looms as the same irresistible force, immovable object

By: Sid Salter

When the electioneering bandwagons roll back into the barn and our new leaders assume their duties – regardless of the party in power – health care remains as the immense force on the nation’s political horizon.

With a growing, aging U.S. population living longer and a health care system struggling under a century of temporary programmatic fixes, there are no magic wand solutions.

In April, the Peter G. Peterson Foundation explained why the growth of health care costs is a certainty because of the growth of Medicare: “The number of Medicare enrollees is expected to increase from 60 million in 2018 to 75 million by 2028. That expansion in enrollment is expected to significantly increase the cost of Medicare over time. In fact, the Congressional Budget Office projects that Medicare spending will double over the next 30 years relative to the size of the economy — growing from 3 percent of GDP in 2019 to 6 percent by 2049.”

Since 2011, every single day, more than 10,000 Baby Boomers reached age 65 – and that growth will continue each day until the end of 2030. All 78 million Boomers in the U.S. are legally entitled to Social Security and Medicare.

American population growth and our entitlements are only one concern. Health care prices are a significant piece of the healthcare puzzle as well.

Johns Hopkins Bloomberg School of Public Health researchers published in the journal Health Affairs in 2019 that “that the U.S. remains an outlier in terms of per capita health care spending, which was $9,892 in 2016. That amount was about 25 percent higher than second-place Switzerland’s $7,919. It was also 108 percent higher than Canada’s $4,753 and 145 percent higher than the Organization for Economic Cooperation and Development (OECD) median of $4,033. And it was more than double the $4,559 the U.S. spent per capita on health care in 2000—the year whose data the researchers analyzed for a 2003 study.”

But population growth, entitlements, and health care prices don’t tell the whole story, either. Health care management is an incredibly volatile.

Relying on data from the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey Household Component (MEPS-HC), researchers found that just 5 percent of the population accounted for over half (50.1 percent) of total healthcare spending in 2017.

What does that mean? Gerald F. Kominski, director of UCLA’s Center for Health Policy Research, told journalist John Donovan that so-called “super-users” in two categories significantly drive up the overall cost of health care delivery. 

The first group comprises those who develop an acute illness like an emergency appendectomy or suffer an accident that requires hospitalization and acute care. Still, those illnesses or accidents are basically once-in-a-lifetime occurrences.

But the second group – those with chronic diseases like cancer, diabetes, and heart disease – who need regular physician, hospital, and emergency room care, expensive medicines, and treatment – really consume health care expenses.

Experts say systemic changes in health care management could stave off much of the ER, hospital care, and interventional treatments if those patients had better management of their treatments.

The availability of health care in rural locales is a problem with which Mississippians are all too familiar. Poor people in places with Hill-Burton hospitals – where the percentages of either private pay or government-reimbursed care are severely impacted – put those facilities’ future at dire risk.

Bottom line? The future is more patients scrambling for fewer resources in a health care system, not particularly equipped to handle the influx. 

Those are bipartisan challenges that will hit us all close to home. Social Security, Medicare, Hill-burton, Medicaid, the Affordable Care Act, none of those fixes have fixed the American health care system. The next shift of government leaders – federal, state, and local – have one long row to hoe on this single issue