Sincehealth care spending has grown at an average annual rate of 9.
For example, in andtwo of the largest health care systems in southeastern Michigan i. These closures result in additional strains on remaining hospitals, creating even greater stresses for an already fragile system.
While hospital closings and mergers create many issues and concerns, both the declining number of beds and the declining number of admissions is related to a significant decline in the number of in-patient surgeries.
Bythe respective percentages of in-patient and out-patient surgeries were 42 percent and 58 percent. While the cost savings to insurers is real, although difficult to calculate, the impact on formal and informal after-care services and in home health care is equally difficult to estimate.
Now many more patients return home on the same day of their surgeries.
For individuals with familial and social supports this reality may not be as challenging as for patients who live alone and have little if any family or social network on which to depend. It is calculated by the Institute for the Future that 40 percent of sickness is related to life style and health behavior choices.
Clearly education and early case finding are paramount. Prevention has proven effective for individuals or families who have made life style and health behavior changes. However, for many patients, changing to a managed care program, or switching between managed care programs, changes and limits the choices of providers to those on preferred panels.
In many plans, if a patient wants to see a provider with whom he or she is familiar, but who is not included as a provider in their "new" plan, an option may exist for obtaining "out of network" services, but it almost always comes with a significantly higher out-of pocket co-pay.
Some employers are covering fewer persons. Some are passing the increases on to employees and requiring higher levels of employee contribution. And some employers are just doing away with health care benefits all together.
While reductions in the "value" of an existing plan adversely impact employees, the ability to contain insurance costs helps for more people to at least remain covered in some fashion—even if their coverage is only for very serious illnesses. The number of people in the population without health care has increased.
Currently it is estimated that 42 million people, or 16 percent of the population, is without any form of health care insurance. The Institute for the Future projected that the number of uninsured will reach 48 billion by While this statistic usually rises during times of recession and decreases in times of expansion, the number of uninsured has increased even during the expansion of the late s and early s.
The Institute for the Future also reported that the number of non-elderly persons covered by employment related health insurance dropped from In Michigan, for example, the Access to Health Care Coalition reported that between and the percent of residents without health insurance decreased from However, given the relationship between the economy and the availability of health insurance, this decrease appears temporary.
An increase is expected in the number of uninsured, especially in light of the economic downturn of While not all eligible children have been enrolled in these programs, a considerable number are not eligible based on family income exceeding a percentage of the Federal Poverty Level FPL.
Mirroring national trends, Michigan is struggling with rising unemployment, a budget deficit, and growing demands for health services and insurance coverage. Often the underinsured and uninsured use the emergency room, the most expensive form of health care service, for any illness.
Weiss and Lonnquist reported that uninsured emergency room care visits totaled 93 million in In approximately half of the cases, urgent care was not needed, nor did the individuals seeking care have a regular physician or other option for gaining access to health care services.
Their observations are summarized below: The first group represents 38 percent of the population. It consists of empowered consumers with considerable discretionary income, who are well educated and use technology, including the Internet, to get information about their health.EPA's peer-reviewed study found that under the primary estimate, every dollar invested in ozone layer protection provides $20 of societal health benefits in the United States, and that after accounting for uncertainties, the benefits still far outweigh the costs.
To recognize its expanding quarantine duties, in , Congress changed the service's name to the Public Health and Marine Hospital Service and, in , to the Public Health Service. In , PHS' support of state and local public health activities began with a small grant to study rural health (35).
In , the United States devoted 16% of the economy to health care, an increase of almost one-quarter since (when 13% of the economy was spent on health care), yet much of that spending did not translate into better outcomes for patients.
The health care system also fell short on quality of care, too often failing to keep patients.
Health care in America is markedly different now than when President Lyndon B. Johnson signed Medicare and Medicaid into law on July 30, Since that time, the government has poured billions.
This background paper examines health care spending and the impact on the economy of the United States. In brief, the findings reported in this paper are: Households In the latest available data (), the average household spent $2, a year, or percent of its income, on health care.
For example, states could facilitate legal and clinical reforms such as changes in clinical practice of medicine rules that would enable new organizations to enter the health care delivery system.