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When Illinois’ Central Management Services announced that the state’s 140,000 public employee retirees and teachers would have the insurance carrier switched from United Health Care to Aetna starting January 1st, is was a surprise and a concern.
As I have noted, there was very little input.
It may not matter to some of us in the state. Others are concerned about whether their current health care professionals will be in network.
Dig down and we find that the root of the constant stress about medical care is our system of privatization of healthcare, which is unique in the industrialized world.
100 million people in America, including 41% of adults, live with a health care system that is systematically pushing patients into debt on a mass scale, according to Kaiser Family Health.
Medical debt is piling additional hardships on people with cancer and other chronic illnesses. Debt levels in U.S. counties with the highest rates of disease can be three or four times what they are in the healthiest counties, according to an Urban Institute analysis.
The debt is also deepening racial disparities.
And it is preventing Americans from saving for retirement, investing in their children’s educations, or laying the traditional building blocks for a secure future, such as borrowing for college or buying a home. Debt from health care is nearly twice as common for adults under 30 as for those 65 and older, the KFF poll found.
Perhaps most perversely, medical debt is blocking patients from care.
In another survey The Commonwealth Fund also finds 72 million people have medical bill problems or are paying off medical debt, up from 34 percent in 2005. If you add in the 7 million elderly adults who are also dealing with these issues, a total of 79 million Americans have medical bill or debt problems.
The problem has not gotten better, since the Affordable Care Act.
Nearly two-thirds of U.S. adults under age 65, or 116 million people, had medical bill problems or debt, went without needed care because of the cost of whatever coverage they had was not providing adequate protection from high medical expenses.
The Affordable Care Act expanded insurance coverage to tens of millions of Americans.
Ironically it also created ginormous profits for the medical industry.
Hospitals recorded their most profitable year on record in 2019.
While the private hospital/Insurance complex thrived even during the pandemic, the law, while providing expanded coverage to some, failed to live up to its promise of more affordable care. Instead, many face thousands of dollars in bills as health insurers shifted costs onto patients through higher deductibles.
Now, a highly lucrative industry is capitalizing on patients’ inability to pay. Hospitals and other medical providers are pushing millions into credit cards and other loans, reports Kaiser.
They stick patients with high interest rates while generating profits for the lenders that top 29%, according to research firm IBISWorld.
Patient debt is also sustaining a shadowy collections business fed by hospitals ― including public university systems and nonprofits granted tax breaks to serve their communities ― that sell debt in private deals to collections companies that, in turn, pursue patients.
Even with Medicare and Illinois Medicare Advantage, the first question I get when I visit a doctor at Northwestern Memorial or anywhere else is about my unpaid balance.
My answer is always the same.
“It’s in dispute.”