According to the Kaiser Family Foundation in 1970, the average American spent $353 a year on health care.By 2023, that figure had exploded to $14,570 per person. Even adjusting for inflation, that means spending grew from $2,151 in 1970 dollars (adjusted to 2023) to $14,570 an increase of almos t sevenfold. Put another way, in 1960 health-care spending accounted for roughly 5% of GDP. Today, that figure is 20% — which means $1 of every $5 in the U.S. economy is spent on healthcare. That figure keeps growing, and it’s unsustainable. Medical expenses have always outpaced inflation, but over time that disparity has exploded. Even though the United States spends far more than every other nation on health care, we have little to show for it. At 79.3 years, we rank 55th in life expectancy, far below other industrialized countries like Japan (84.7), South Korea (84.3), Italy (83.7), United Arab Emirates (82.9), Canada (82.6), New Zealand (82.1), the UK (81.3), Chile (81.2), and even Albania (79.6). Our system of health insurance is badly fragmented. Poor people get their insurance from Medicaid. Most people over 65 get covered by Medicare. Many working people have some coverage (of widely varying cost and quality) through their employer. Still others buy insurance in the private marketplace. The most recent data from 2024 shows 8.2% of Americans — roughly 27 million people — have no health insurance at all. And that number is sure to grow if premiums jump. The net result of this inefficient patchwork system is that we pay far more than the rest of the developed world with worse outcomes and tens of millions of people getting no preventative care at all. That means problems that could have been detected and treated early on are left undiagnosed until the person ends up acutely sick in an emergency room. There, the prognosis is much worse and the cost of treatment is exponentially greater. This month, Congress is debating whether to extend COVID-era health insurance subsidies. Trump’s “Big Beautiful Bill” ended those subsidies. Democrats want to extend them for three more years. The next few weeks will determine what, if anything, is done to prevent more than 20 million Americans from getting walloped with higher premiums, co-pays and deductibles. But extending the COVID era subsidies is literally just putting a band-aid on a gaping wound. The real solution, universal health care, is politically impossible. Bernie Sanders has tilted at this windmill for many years, and it simply is not happening. When Obama got the Affordable Care Act passed in 2010, he could not get enough Democratic votes (and no Republican votes) to adopt a public option. This compromise proposal would have allowed Americans to choose between keeping their existing insurance plan or opting into Medicare, where their premiums would be based on their income.  A public option has existed for ages in higher education. Students can go to a public college (like the University of Utah) or pay more money to go to a private college. Similarly, parents can choose to send their elementary or secondary school age children to a private school or their local public school. Both the public and private options coexist quite well. A public option allowing people to enroll in Medicare could be phased in over time. For example, we can start with people aged 55-64, then a year or two later 44-54, and so on, until that option eventually was made available to everyone regardless of age. Medicare is more efficient than private insurance. No money is wasted on shareholder dividends/profits, big CEO salaries, advertising, fancy offices, etc. Overhead costs are minimal. Most Medicare dollars go to hospitals, doctors, pharmacists and other providers. Providers rarely have to wait and refile to get claims paid. The system functions smoothly. Medigap insurance (also known as Medicare supplements) is readily available and quite reasonably priced, and consumers could purchase them to cover the 20% of costs that Medicare doesn’t cover. In the long term, extending ACA subsidies is at best a stopgap measure and not a real solution. Lawmakers need to look at a Medicare public option to help ensure that eventually all Americans have basic health care coverage at a price they can afford. The other huge cost driver — RX drug prices — will be the subject of another piece. In the meantime, let’s hope our elected representatives don’t put a huge lump of coal in our Christmas stocking. Gene DeSantis is a Kamas resident. The post The health insurance debacle appeared first on Park Record. ...read more read less