Marty
Makary, Opinion contributor Published 5:00 a.m. ET Sept.
16, 2019 | Updated 12:23 p.m. ET Sept. 16, 2019
Medicare for All is one of the most hotly
debated topics in the 2020 election. But what is it? And how will it work? We
explain. Just the FAQs, USA TODAY
Politicians make lots of promises on
health care. Maybe they should promise to get rid of waste.
As presidential hopefuls debate how much more
money to pour into our broken system, they should consider how much we already
spend.
In a new report out Monday, my Johns Hopkins
colleagues and I found that nearly half of our federal tax dollars are being
spent on health care. Bear with me because I know these are a lot of
numbers. But let’s add it up.
Start with the 27% of federal spending that
goes to Medicare, which covers
seniors and the disabled, and Medicaid, which covers
low-income Americans.
Next, include Social Security spending that
gets siphoned into health care, through Medicare co-pays and other expenses.
More than 1 in 5 federal dollars goes to Social Security. According to
a Kaiser Family Foundation study, seniors are spending nearly half of their Social Security payments for
medical expenses. That amounts to an additional 11% of the federal budget being
spent on health care through the Social Security program.
That’s not all.
The military health care system consumes more
than 1% of the federal budget, separate from spending on health care for
veterans, which is more than 4% of federal spending. And then another 1% is
spent on health benefits for
the 9 million federal employees, retirees and their family members.
Finally, we estimate that 3% of federal
spending goes toward interest on the
portion of our national debt attributable to health care spending.
The substantial price tag
All total, our Hopkins team estimated a grand
total of 48% of all federal spending going to the country’s medical-industrial
complex.
As if that weren’t enough, we haven’t even
included what’s spent on employer-sponsored health benefits. The average American spends $11,121 on
health insurance a year. Employers contribute an
additional $5,288 to your health care cost from a pool of money allocated for wages
and benefits — money that could otherwise go to your paycheck.
That’s a hefty tab!
No wonder Americans get ticked off when basic
medical care is not covered. American workers are spending 55% more on
insurance premiums than they were a decade ago. Over the same time, their
deductibles and co-pays are going up. Remarkably, on top of what people spend
on health care through taxes and insurance, the average American now spends approximately
$3,000 each year on services
that are not covered.
All this means that if you earn $52,000 a
year, you are contributing $22,474, nearly half of your allocated wages, on
health care.
Don't add more cash, cut the waste
What do we do about it? The answer is not
to throw more money into the system as most political candidates like to
propose in grandiose plans they parade around in an election cycle. As I
learned when I researched my new book, "The Price We Pay,"
we already spend enough money to provide every American with the best health
care on the planet. It’s time to cut the waste.
We need to examine health care’s overpriced
services, middlemen and the perverse incentive structure that promotes
unnecessary tests and procedures. The lack of transparency around the business
of medicine has created a fog that enables the price gouging and kickbacks that
profit some on the backs of everyday Americans.
Given the toll of health care on everyday Americans and businesses, and how our
astronomical spending threatens every other national priority, transparency’s
time has come.
We also need to change the way we talk about
health care spending. The next time you catch somebody saying their “health
insurance plan” or their “employer” or “Medicare” covered their health care
bills — correct them. You and them and all of us are paying the bills
through tax dollars and your insurance premiums.
Let’s change the lexicon in America to point
out what’s really happening — a shell game of taking money from everyday
Americans to enrich the medical industry.
Last year, health care became the largest
business in the United States. This boom has been good news for many large
hospitals and insurance companies, which are reporting their highest profit margins in history.
However, these impressive numbers obscure an ugly reality. An estimated 30% of
our bloated $3.5 trillion health care spending is
wasted on services that have nothing to do with improving health.
Politicians are great at finger-pointing and
piling on. They are even better at promising entitlement benefits without
showing how they would pay for them. Last year, health care’s special
interests spent half a billion dollars on lobbying. Every
stakeholder seems to have a powerful voice in Washington, except for one — the
patient.
Let’s also make our voices heard.
This White House is implementing a recent price and quality
transparency executive order. Speak up! Leave a public comment on the
department of Health & Human Services website. The swamp of Washington
lobbyists is going to share the same old special interest arguments on the
public comment website. Our voices as patients and health care workers should
also be heard. It’s time Washington stops talking about how to fund our broken
health care system, and start talking about how to fix it.
Dr. Marty Makary is a Johns Hopkins professor
and author of the new book "The Price We Pay: What Broke
American Health Care — and How to Fix It." Follow him on
Twitter: @MartyMakary
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