The ink on the 2011 debt deal is barely dry, and Congress may have averted a credit rating downgrade for U.S. debt. But people who get health care in the U.S. continue to face rising health costs and self-ration due to those costs.
Deloitte‘s 2011 Survey of Health Care Consumers in the United States: Key Findings, Strategic Implications found that this self-rationing behavior dramatically increased in the past two years. In 2009, 35% of U.S. adults said they decided not to see a doctor when they were sick or hurt because the cost was too high. By 2011, 49% responded this way — an increase of 40%.
While 8 in 10 U.S. adults have a primary care provider, 2 in 10 do not. Among these 20% of health citizens without a medical home, 35% said they could not pay for primary care services, and 26% said they did not have insurance that covered primary care.
Cost also plays the most important role in people choosing their health plan: the #1 criterion in selecting a plan is “what I have to pay to buy the insurance” – that is, how much the premium costs, cited by 82% of U.S. adults — up from 73% in 2009. In addition, the co-pay required for a doctor visit was cited by 81% of people as a health plan selection driver.
Health Populi’s Hot Points: The most grace-filled moment of the House vote on August 1, 2011, was witnessing Gabby Giffords rise up on the floor of Congress in response to the standing ovation given her by her colleagues in the House of Representatives. She returned to the Hill to vote for the debt deal, standing as strongly as she could, in a miraculous health outcome celebrated by colleagues on all ‘three’ sides of the aisle – Democrat, Republican, Tea Party.
Would that all Americans have the same quality and intensity of health care afforded to our elected officials.
The one certainty a health forecaster like me can cite — regardless of what happens today, next week, or next year in the re-imagining of the U.S. Health System — is that we are all health consumers now, concerned about how we will pay for health care whether we are young, middle-aged, or older Americans. The global economy continues to have landmines underneath the surface — from Italy’s debt to Main Street’s lack of job generation in American’s hometowns — which will set a context for health reform “compromises” in the next few years.
We will all need to save more money, to live, to buy food (with prices escalating in 2012), to fill our gas tanks, and to pay for health care. The Employee Benefit Research Institute found the “new normal” in 2011 is low confidence in one’s ability to retire. As of December 2010, a woman looking to retire whose employer would not subsidize health care in retirement would need to have saved $240,000 to cover her post-retirement health costs.
The phrase “debt limit” has a very personal implication in this light for every American. We are all health consumers now.