Employers are also feeling the pinch and more companies are dropping medical cover or reducing the benefits packages, and introducing wellness programs with teeth. This combination is placing a growing burden on taxpayers who fund Medicaid and the Children’s Health Insurance Program. Why is this happening? Well, let’s come down to a short list. The economy is not in great shape. The population is ageing and, as people get older, more goes wrong with their bodies. New technology is producing new treatments but that is often more expensive.

The pharmaceutical industry keeps raising prices to maintain its profitability. Put all the causes together and you have a broken system. The real problems start with the “entitlement” trap. Because people pay their insurance premiums out of their own pockets, they feel they’re entitled to get all the medical care they like. This leads to a significant amount of waste as health providers supply expensive services on demand regardless whether those services are needed. Mostly, the providers are driven by the need to make profits to keep their investors happy, and not by the patients’ needs. This makes general medical care unaffordable and shifts ever more of the costs on to the insurance companies and the tax payers. Health insurance premiums therefore go up. The Republican approach is to reduce taxes which makes funding public health provision more difficult. If people are uninsured, they wait longer to see a physician or go to an emergency room when their conditions have worsened. What could have been treated early on for less money suddenly becomes a bigger bill as costs are higher in emergency rooms. Why are costs higher? Because a significant proportion of patients cannot pay. The hospitals costs therefore have to be recovered from those who have the money or still carry health insurance. The moral of this story is for political parties to have the will to fix the problems.

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