America’s healthcare system has always operated on a fee-for-service basis. In an ideal marketplace, fees for medical services would be reasonable enough that patients could afford to pay for a broken leg, strep throat, childbirth, and other fairly routine procedures.
Paying for our own services seems like an independent, American thing to do. But, healthcare costs are so high that there is no way the average working American can afford to foot his or her entire bill. With dependents and higher deductibles, families feel the crush of medical bills even more.
Supporters of Barak Obama’s signature legislation, the Affordable Care Act, boast that the number of Americans covered by health insurance policies has increased under the ACA. But, they don’t mention the high individual costs of those policies. Before the ACA took effect, individual deductibles were often $1,000 annually or $2,000 for a family.
Now, the average American individual deductible is over $4,300 annually and just under $8,000 for a family. These figures don’t include monthly premiums and coinsurance costs, which is often the largest part of a medical bill.
As a mom and my kids’s primary caregiver, I have to weigh the estimated seriousness of my child’s injury against the cost of getting treatment. Urgent care centers are a great option for (more) affordable acute care, but their operating hours are limited and usually exclude Sundays altogether.
If my one-year-old falls off the back of the couch and hits his head on the edge of the rocking horse, I have to decide if I am five hundred dollars’ worth of worried about his injury, because admittance to the emergency room will cost a minimum of $500. Any medicines administered, including drugstore basics like ibuprofen, will be added to the bill at inflated prices.
Add an x-ray and a couple lab tests, and the total bill can easily exceed $1,500. And maybe the doctor discovers that nothing is actually broken or infected and sends him home with an admonition for me to “keep an eye on him.” Parents shouldn’t be faced with choosing between “better safe than sorry” and being able to buy groceries and pay rent.
We live in one of the most developed countries in the world, and parents are unsure if they can afford to take their kids to the doctor for common ailments.
Lab tests for strep throat and influenza can cost hundreds of dollars when paid for upfront. Families without health care coverage are sometimes tempted to try ineffective and/or unsafe at-home examinations and treatments when faced with the alternative of taking an expensive trip to the doctor. Parents are expected to provide financially for their children, which is fair and reasonable. But there is no conceivable way the average American family can pay for their family’s healthcare when the costs are unfair and unreasonable.
The healthcare system favors society’s highest and lowest earners. If a family makes enough money on one income (which is unlikely) or with both Mom and Dad working (which is more likely, but harder on the family dynamic), then they are more likely able to afford healthcare costs.
Families who live below the federal poverty line and struggle to afford basic necessities like food and rent receive completely free healthcare, but the quality of life at that price point is low enough to make that an unattractive long-term plan.