In 2016, US healthcare spending reached $3.3 trillion or $10,348 per person. That’s about 18% of US GDP. It’s also almost twice as much as what most other rich countries pay. This is a problem, especially for the health and financial wellbeing of the American people.

In one New York Times survey, almost half of the 10,000 respondents described basic medical care as an economic hardship.  Many of these respondents reported they or someone in their household had skipped or delayed care due to cost considerations. For instance: 

  • 24% had been less likely to see a doctor when they were sick or injured
  • 25% had not filled a prescription, cut pills in half, or skipped doses of medicine
  • 31% had gone without medical treatment they thought was needed

While the high cost of US healthcare hits the poor and uninsured especially hard,  middle-class and insured households increasingly report problems affording their premiums, deductibles, and co-pays. And Americans aren't just skimping on preventative care and treatment; in order to pay their medical bills they're cutting back on food, clothing, and basic household items.

If that weren't bad enough, the high cost of healthcare has suppressed US wage growth for decades. Check out "Health-Care Costs Ate Your Pay Raises" for more details.

We can't get to universal healthcare without tackling costs in a very serious way. And, no, "Medicare for all" won't do it: as noted in Part I of this series, Medicare spends about $11K a year per enrollee and the average Medicare enrollee pays over $3K a year for out-of-pocket costs. More than a quarter of Medicare beneficiaries pay more than 20% of their income on these costs.

Affordable universal healthcare can be accomplished via single-payer or multi-payer systems.  In the rest of this series, I'll be focusing on ways to bring down the cost of US healthcare regardless whether the government or private insurers are doing the paying. 

Next: Nurse Staffing Levels: Politics and Consequences