Despite Obamacare, health care costs in the United States are still astronomically high

us healthcare costs

My latest rant is about the rising US healthcare costs, and its effects on consumers. I was sorely reminded of this recently when I read about the Canadian woman who happened to go into labor while visiting the U.S. and ended up almost a million dollars in debt to the United States health care system.

Visitors to the U.S. from Canada must purchase health insurance before traveling to the States, so Jennifer Huculak and her husband purchased a travel policy from Blue Cross. They found out too late that it would not cover the premature birth of her baby in Hawaii because of their unsubstantiated claim she had a pre-existing condition of a high-risk pregnancy. The couple is now facing bankruptcy, because there is no way they can pay this unreasonable and unfair cost. There has even been a GoFundMe page started which has generated a few thousand dollars so far to help them, but it’s got a long ways to go to cover the exorbitant bill they are facing.

U.S. health care costs are blown so far out of proportion that it should be illegal. Take older citizens, for one example, who have paid into Social Security and Medicare their entire lives, and then once dependent on their benefits with an income much lower than they had been receiving while working, they still have to pay an average of $4000 per year on medical expenses that Medicare doesn’t cover. How do some of these people come up with this if their benefits are only $12,000 a year, or even much less? They are already paying over $100 a month for their Medicare premiums out of their monthly checks, and yet they are still liable for up to 20 percent of their health care costs.

As well, all health care insurance premiums have skyrocketed. In the decade beginning in 1999, the cost for a family of four increased by 131 percent according to the Centers for Medicare and Medicaid Services which prompted legislative action in 2010 with the Affordable Health Care Act of 2010.

Since I’m talking about “affordable” health care, then you likely know that it recently became law for U.S. citizens to pay for their own health care. You may not be aware, however, that for those who aren’t able or willing to pay will be fined either 2% of their income or $325 per person in 2015, according to the website. The penalty increases each year, so in 2016 it becomes 2.5% of one’s wages or $696 per person, and so on.

Think about this a minute, and I’ll break it down for you. Let’s say you are an unmarried person, working full-time for minimum wage ($7.25 per hour.) Your gross income is a mere $15, 080 annually, which breaks down to $1256 per month. Let’s be generous and say that after taxes you have $900 to live on each month. Now you have to pay rent, utilities, food costs, transportation, clothing, and personal necessities. Can you spare a few hundred dollars to pay for your health care?

Likely you’ll have to budget carefully just to buy some cold medicine at your local pharmacy, and you’ll avoid going to the doctor unless you’ve broken a bone or are bleeding profusely. Now think about it, what if you were married with children, and one of you had to stay home with the kids, and the other was only earning minimum wage? Now you have childcare costs, extra food, clothing, school supplies, and a bigger apartment to try to juggle with your $900 per month. Not gonna happen, is it?

us healthcare costsI have to ask several questions when I see these figures. First, where the hell does the U.S. government think a person can come up with money to spend on health care insurance, let alone the mandatory fines if they can’t? Why should health insurance be mandatory for adults? For children, yes, I think that if people are going to choose to have children, then they should be obligated to provide the necessary medical care that children require. But for individuals and married couples with no kids, they should have a choice as to whether to cover themselves or not.

I know, I know. Your comeback is that if they don’t carry their own insurance, then everyone else ends up paying for their health care costs. I will address this in a moment after I finish questioning (blasting) the system.

How can insurance companies possibly think that the average citizen can pay hundreds of dollars per month to carry a policy that may or may not cover all of their necessary health care? What is the purpose of having such high policy premiums? I won’t even go into the gender discrimination issues when it comes to the cost of the premiums (even though Obamacare makes some types of this discrimination illegal) because I would inevitably say something to set more people off on their own tangents.

So now I’m down to the crux of the whole issue. The health care profession itself is the problem. Medical providers, institutions, and pharmaceutical companies are charging out of this world prices for their products and services. Capitalism at its finest.

Journalist Steven Brill wrote in a Time Magazine article that after seven months of intense investigation, he found that health care costs are essentially arbitrary, inflated, and unfair. Reader’s Digest did their own research, and in their September 2012 article showed some of the ludicrous costs that hospitals charge, such as Tylenol for $15 a pill, a box of Kleenex (sometimes called a “mucus recovery system”) for $8, $10 for the little plastic cup they bring your medicine in, $23 per alcohol swab and – get this – $53 for a pair of non-sterile gloves! I hate to even imagine what they charge for sterile gloves.

Yet another example of highly inflated costs was mentioned in a Los Angeles Times article in 2011. A mother of a son with Crohn’s disease is billed for $38,000 for his medicine, although the hospital only pays $6300 per dose. OK, even the hospital’s price is utterly asinine. Where do these pharmaceutical companies get off on charging these kinds of prices?

Medscape published a report in 2013 showing the average income of U.S. physicians, with Orthopedic doctors earning over $350,000 a year, while cardiologists and urologists were close behind at $348,000 per year. I know that attorneys and athletes earn this much and more annually, but that’s another serious gripe for another post I will probably never write.

There are 33 developed countries on this planet, and 32 of these provide Universal Health Care. The United States is not one of them.

Dan Mundo wrote in his article for Forbes that the U.S. excels in many areas, but population health is not one of those areas. He shares the results of The Commonwealth Fund’s report in 2014 on overall health care, where they rated 11 countries on their overall health care and the U.S. ranked last. The report found that, more often than not, people in the U.S. go without needed health care because of costs – one-third or more lower-income adults went without needed care because of cost in 2013.

The U.S. also rated a poor performance on measures of national health expenditures and administrative costs compared to the other ten countries, each of which have universal health care. A poor score was also given for the overall health of people in the U.S. when viewing the mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60.

Back to the dilemma of people not paying their own health care costs and the rest of society having to shoulder these costs? If voters would get their heads out of their [bleeps] and fight these grossly inflated costs medical providers and insurance companies are getting away with now, we could potentially and realistically see more people being able to cover their own expenses.

Medical providers and insurance companies target the wealthy, leaving the poor and the common folk – who make up the largest percentage of Americans – to suffer needlessly both in their own health care needs as well as in their finances.

I have not written this post in order to persuade anyone of how crucial it is that the U.S. adopt a universal health care system (although it should,) nor am I advocating that pharmaceutical companies stop their research and development. I have to unashamedly state my opinion that physicians and surgeons are charging outrageously and downright offensively for their services, especially when they can demand, for instance, $225 and up for a 5-minute face-to-face in an exam room, and much more if they stop in to speak to you for a few minutes at the hospital.

I’m simply sharing facts here. It’s up to you, the reader, to figure out just how often and how seriously you’re being raped by the entire health care industry, and it’s up to you to decide what you are going to do now that it’s out in the open.


  1. Reading through the Affordable Care Act when it was first signed, I remember the gradual rollout of program components. One part that impressed me was that sometime late 2015 or early 2016 physicians and healthcare facilities would be limited in what the charge. I understood it was being delayed as an appeasement to the insurance companies who are really being jerked around by the sudden influx of sick people they are now bound to cover.

      • the content doesn’t really change the initial statement. Obamacare has several new taxes rolled into it that will cause health care costs to continue to go up at an accelerated rate. also blaming capitalism for the problems is just absurd. the problem is people are too lazy to look over their hospital bill and go “wtf, why am i paying $20 for a Kleenex?”. far too many people have just become accustomed to charging it to insurance without thinking about the costs or comparing prices. the only thing that is wrong with the capitalist system is that it requires consumer responsibility, and when people delegate that responsibility or ignore it the system goes to shit. that is the problem.

        • You are right when you say “…the content doesn’t really change the initial statement.” The article was written to appeal to a certain demographic – those who believe Obamacare is the answer to the U.S. health care system crisis. I also agree with you about people delegating the responsibility and/or ignoring it, which is why I wrote about American’s getting off their asses and doing something about it.

          But it IS capitalism, despite your disagreement. The meaning of capitalism is “an economic and political system in which a country’s trade and industry are controlled by private owners for profit,” and that is exactly what is happening in the health care industry when corporations and individuals are getting away with charging preposterous fees for products and services rendered.

          The point of the article is to try to reach those who have been suckered into believing (mainly through the media which is another industry run by the wealthy and powerful) that Obamacare is the Be-All and End-All to the health care situation in America. Too many people believe what they are told without question following along with what’s presented to them, akin to a bunch of sheep going to the slaughterhouse.

          • Per your statement that the cost of insurance premiums for a family of four has risen 131% over the past five years, I checked your source (Centers for Medicare and Medicaid Services) and did not find what you apparently found. It is an article from 2011 and actually states that “since 1999”—and I assume that means the period of time between 1999 and either 2010 or 2011—the premium charges for a family of four had risen 131%.

            Not over “the past five years alone,” but between the years 1999 and 2010/2011. If I read that right, your comment per the Affordable Care Act’s meaning of the word “affordable” would not be properly based. Especially given that policies derivative of the ACA were not even active prior to, as I recall, January of this year (2014).

            Given that your statement about policy increases does factor into your discussion in a major way, it might be helpful to check that source again.

            I don’t in any way think the ACA is a Be-All or End-All and don’t really know many people who do—indeed, I agreed with Brill’s insinuation that Medicare-for-all or another type of single-payer system is obviously the most effective and efficient context for healthcare delivery in the U.S.—but the ACA is certainly better than the unsustainable system we had and is, at least, a first step toward a system that makes sense.

            I do disagree, as does Brill, with your implication that physicians in general are raiding the vault. It is not physicians who have primarily benefited from the rise in healthcare costs. It is Big Pharma, the “medical device” industry, the public and private “non-profits,” and the Beancounters/Executives who run those public and private “non-profits.” In fact, as Brill notes, one of the problems with which we will eventually have to deal is the drop in the number of physicians available—physician compensation has not kept up with much of the healthcare industry and, given the debt some med students leave school with, it has become a less glamorous way to go.

            It is interesting that Brill says the two primary issues that would have to be dealt with if the U.S. moved to a Medicare-for-all model are (1) some type of pool of funding that insures adequate compensation for physicians and (2) incentivizing continued medical research at the highest level.

            • Sorry to continue my conversation about policy premium costs, but the erroneous statement that premiums for a family of four had gone up 131% “over the past five years” primed my mental pump.

              First, your own source noted the September, 2011 implementation of an ACA rule/regulation which required that “insurers seeking rate increases of 10 percent or more for non-grandfathered plans…are required to publicly disclose the proposed increases and the justification for them.”

              Second, that same source noted that “state-specific” increase “thresholds,” developed in conjunction with HHS, would work to develop those thresholds. States that have “effective” rate-review committees will work—and, already are working—to review premium proposals as to coverage and cost. These have proven to be primarily “blue” states. “Red” states—primarily the states that have not accepted the Medicaid expansion—have no developed rate-review committees and premium proposal reviews thus fall under the aegis of HHS. The differential in premium costs in states with their own rate-review committees is manifestly lower than in states without them; cf. the report on comparables between adjoining counties along the Minnesota and Wisconsin state line.

              Third, premium increases for 2015 have actually come in measurably lower than initially projected, though consumers who do their due diligence will be rewarded for it. Of those who are typically part of the annual churn, 16% of those on the individual market will end up paying 3% less for premiums in 2015. Volatility in rates is high, so checking about is significant. Kaiser found that the same premium for a 40 year-old non-smoker in Birmingham, Alabama rose by 2.5% for 2015, decreased by 10% in Phoenix, Arizona, rose by 28.$% in Anchorage, Alaska and decreased y 25.5% in Jackson, Mississippi.

              Taken together, however, premium increases on average will be between 4.5% and 8% for 2015 on the exchanges, which is far lower than the pre-ACA annual increases.

              As to the last five years, Kaiser reports that the annual family-plan premium “went up 3% from 2013-2014” and that “premiums increased more slowly over the past five years than the preceding five years (26% vs. 34%) and well below the annual double-digit increases recorded in the late 1990’s and early 2000’s.”

              With the myriad visions of apocalyptic happenings in the insurance markets relative to the ACA, I simply thought a more sober and factual running of the numbers might be in order. Again, I have innumerable problems with the ACA and see real problems with the deductibles—which have been on the rise for far longer than the ACA has been with us. But it is a step in the right direction.

              As to healthcare costs themselves, we both know the problem—healthcare-related interests spent, uh, how much on lobbying in 2014 relative to consumer groups? And, have you noted the resistance to the ACA and/or especially the notion of a single-payer plan among the sheep who make up the herd annually sheared by the the GOP and elements of the American Right? Do we seriously think they can be convinced of the fleecing they are taking? They will be a necessary part of any citizen/consumer movement against the healthcare industry in its present iteration. At present, out of a combination of ignorance, laziness and ideological bitterness, they are some of its loudest proponents—for goodness’ sake, they are blaming Obama and we “socialists” for the fact that, without their wool coats, they are cold this winter.

              • The oversight has been corrected and the post edited, Rusty. This does not change my overall thinking about the costs associated with health care. Although the yearly increases to the end consumer have been shown to be rising at a much lower rate since 2010, the fact is that the costs are still going up. Even the 4.5%-8% in 2015 (figures you quoted) is money out of the American public’s wallet.

                As far as the medical providers themselves, I still believe they are overcharging patients. High education debts are no excuse, many people have higher education debts they must struggle to pay, but they don’t have the luxury of a $350K income to reduce them.

                The argument in the article is simply demonstrating how the medical profession and health care industry at large is raking in profits at the expense of the American public.

                Thank you for your input, as it does provide additional information providing average citizens a chance to develop a deeper understanding of all of the implications.

                • I have no truck with your concern for the rise in costs associated with healthcare. And I am all too aware that the premium rises for 2015 represent real money coming from the pockets of real people. My point was simply to note that the rate of increase was lower—sad, isn’t it, that, in these times, we have begun to accept lower rates of increases as victories!

                  I do understand your concern per physicians overcharging patients but, again, your numbers beg for deeper examination. You mentioned orthopods and urologists and cardiologists averaging around $350K per year. My guess is that there are a lot of variables that get caught up in those very generalized numbers—not the least of which is the fact that PCP’s, etc. were not included those averages. But, there are other variables, too.

                  One of those variables is geographical location—my cardiologist niece wishes she was making $350K per year in her practice near Charleston, SC, but she’s not close (and, actually, she has a right thriving practice). Her pre-tax income for 2013 was $185K, while her sales rep husband—who seems more interested in playing video games than working (excuse the snark!) and whose responsibilities are in no way as serious as hers—had a pre-tax income of over $210K. Furthermore, I have a cousin—a good, solid dairy-farmer with whom, as a boy, I attached many a milker to many a cow in pre-dawn darkness—whose son is a PCP in a small, rural South Carolina town and is pulling down somewhere in the neighborhood of $120K per year (pre-tax). Now, neither my brother’s or my cousin’s progeny had student debt when they finished their studies. But they both tell horror stories of classmates who did. As, of course, Steven Brill does in the TIME article you referenced. I think you overrate the dollar-making abilities of the great majority of doctors and underrate the effect of student debt—if you read Brill’s article thoroughly, he is pretty clear in his substantiation of the way in which it has affected the number of students opting for a medical career. As I noted, there are thousands and thousands of doctors who don’t have the luxury of making $350K per year to pay off those loans. And, seriously, how many of them begin their medical careers making anything close to $350K per year (pre-tax)?

                  Doctors are an easy target, aren’t they? And some deserve to be targeted. But, according to studies by Brill and Kaiser, not most. We should be targeting Big Pharma, the “medical device” industry, the “non-profits,” and the executives who run the “non-profits.” And, of course, we should be targeting the legislators who have been bought by lobbyists for all of the above. It’s just that, excepting doctors, the above group isn’t as visible/identifiable and, thus, not as easy to shoot at. And we desperately want someone to shoot at.

                  The facts surrounding our healthcare delivery system are not inconsequential. This is a heated debate in our country and precise denotation of the numbers is a serious matter. Get them wrong and your argument will get dismissed in a hurry by those who oppose it. Heck, get them wrong and your argument will get dismissed in a hurry by those who support it.

          • fair enough, though you kind of reiterated my point about capitalism. in terms of pace of progress and incentive to be innovative capitalism is bar none to any other form of economic system. in fact, you can see a large push back against inflated healthcare costs in the form of prompt-care type services. while those places can’t take care of major health issues, they can deal with a bunch of smaller stuff at a fraction of the cost if you went to your doctor.

            As i said before, the problem is people aren’t holding businesses accountable, and that goes for a lot of businesses not just in health care. The down side to capitalism is that for it to work, it requires a lot of responsibility of the consumer to keep businesses in check. or even another business to do their best to drive down prices to appeal to a wider market.

            These days people are too quick to say “there ought to be a law” and to me that is a huge cop out. sure, reforming things through the market will be long and hard, but it didn’t get this bad in a day either. And wanting a quick fix through legislation is pretty cowardly as far as i am concerned.

            • While your reverence for pure market forces is admirable, it is naive to the max. In our time, pro-business legislation has rigged the market and it will take equally strong and terse pro-consumer legislation to undo the distortions. My suggestion to you: Read. Lose your blind faith in what you apparently think are pure market forces—those don’t exist anymore. And get back to us when you have concrete ideas on how to “reform” the market and, more importantly, who is going to do the “reforming.” My goodness!

              • amusing, however you seem to be excessively naive in your trust of government to get a job done without lining their pockets. the only long term real solution is from the pure market, and if we are incapable of doing it through such means we are undeserving of any kind of solution.

                in this age of information people are perfectly capable of finding out this type of information on a company. so if they do not take advantage of that excess of information and work to change their spending habits accordingly then any negative consequences that come as a result therein are squarely on the shoulders of the consumer whether they realize it or not.

                i have a length of concrete solutions that do not require nanny government coming to rescue us. however i have no need to discus them with you in a situation like this.

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