Book : Catastrophic Care Why Everything We Think We Know...

-Titulo Original : Catastrophic Care Why Everything We Think We Know About Health Care Is Wrong

-Fabricante :

Vintage

-Descripcion Original:

Excerpt. © Reprinted by permission. All rights reserved. Introduction How American Health Care Killed My Father Becky is a twenty--six--year--old who’s worked in my company’s marketing department for three years. It’s her first job out of school, and she’s done very well. She’s smart, ambitious, and poised, and her future is promising.Becky describes herself as a “bit hypochondriacal,” so she sees two primary care physicians a year. But she’s generally healthy and has no major health care needs. With the insurance plan she’s chosen, she can see any doctor she wants, but the annual deductible doubles, from $250 to $500, when she goes out of network. Most of the treatments she uses count as preventive care, which now has no cost sharing. So with her share of the company’s insurance premiums and her out--of--pocket expenses, health care will cost Becky just about $2,500 a year. That may be a bit more than she would like, but all things considered, it’s not terrible for someone just starting out, right?Wrong.Becky will actually contribute over $10,000 to America’s health care system this year--most of it through payments she’s not aware of. That’s right: health care will consume just under a quarter of Becky’s true compensation, not the 7 percent she believes. I’ll be providing a detailed breakdown of these additional--I call them deliberately disguised--costs in chapter 2. For now, what you urgently need to understand is that beginning on the first day of her working career, the cost of health care will be the major constraint on Becky’s standard of living matching--much less, surpassing-that of her parents.And it will only get worse for Becky as she settles down and starts a family. Because, as I’ll show you, even if we somehow eliminate the explosive growth in health care costs--literally reduce growth to zero--our current system already ensures that Becky will pay well more than $1.2 million into it over her lifetime. If Becky’s hoping the new Affordable Care Act will somehow reduce her cost, then she’s unaware that the administration’s own projections show per capita health costs rising by 5 percent per year over the next ten years (which would mean her lifetime contribution to the system will be $1.8 million, even assuming that after those ten years health costs don’t grow at all). All this assumes she never has a major illness, in which case she will almost certainly pay much more.None of this is on Becky’s radar screen today. Although she’s probably spending more this year on health care than on anything else (except maybe big--city apartment rent), and while she describes herself as a “true bargain shopper,” Becky has no awareness at all of what health care is really costing her. She thinks about her health care benefits, not about her health care costs.Becky hopes to be successful, perhaps someday earning “several hundred thousand” a year. That would put her in the top 1 percent of earners in America. When I ask her how much she would need over her lifetime to pay for health care, she mentions the possibility of dealing with cancer or other major issues and says “millions.” There is “no way” she could afford to pay for her care on her own. But then I ask her how a society can afford health care for anyone if even people in the top 1 percent don’t have the resources to cover their care. Where would the money come from? She’s a bit embarrassed: “I’m sorry, that doesn’t make any sense. I haven’t really given this any thought.” I assure her there’s no reason to be embarrassed: almost no one seems to have given this much thought.I started thinking about health care because of a personal tragedy: almost five years ago, my father died from a hospital--borne infection he acquired in the intensive care unit of a well--regarded New York hospital. Dad had just turned eighty--three and had a variety of the ailments common to men of his age. But he was still working the day he walked into the hospital with pneumonia. Within thir