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- Medicaid and Medicare each cover about 50 million Americans
- As of January 1, 3.9 M people have signed up for Medicaid and 2.1 M for private coverage through the exchanges.
- 54.9% of Americans had employment-based insurance in 2012, down from 64.2% in 2000.
- About 80% of the uninsured are US citizens; 20% are noncitizens both lawfully present and undocumented.
- 57% of Americans and 80% of the uninsured reported delaying or foregoing healthcare in 2012 because of cost.
- 54% of people with insurance coverage likewise delayed or skipped health care due to cost.
- States’ rejection of Medicaid expansion will result in 7,100- 17,000 deaths annually.
- High deductibles reduce emergency room visit rate but raise subsequent rate of hospitalizations.
- In 2012 50% of national income went to the top 10%, 20% to the top 1%.
- In 2014 US healthcare spending will be $3.1 trillion, $9697 per capita, 18.3% of GDP.
- Administrative costs for both government and private sector insurance are expected to jump 13% due to the complexity of the ACA model.
- In 2013 employer-sponsored health insurance coverage rose 4% to $16,351 family, $5884 individual (1/3 from employee, 2/3 from employer).
- In 2013 average total cost of health care for family will be $22,030. Average family income was $52,100.
- Large employers (75%) are shifting workers to high deductible plans and health exchanges; many are dropping part-time workers, family coverage, pre-65 retirees and COBRA recipients.
- United Healthcare, is dropping up to 20% of physicians on their Medicare Advantage panels to avoid expensive care for the sickest clients.
- Medicare patients in fair or poor health spend 2x out-of-pocket compared to those in good or excellent health.
- Enrollment in Medicare Advantage tripled in 2013 to 14.4 million. These plans cherry pick and lemon drop Medicare Advantage costs US $34 billion more than traditional Medicare.
- There 12 new proton beam therapy centers in the US, 20 planned, each $230 million, minimal population benefit.
- Entrepreneurs game freestanding dialysis centers and emergency room centers, nursing homes.
- Big Pharma abuses continue with fines of billions of dollars. Companies treat fines as line items, pay the fine and keep on speeding.
- A wave of hospital mergers make doctors into assembly-line workers.
- 2006 Massachusetts ACA-style reforms are failing. Premiums up 9.7% from 2009-2011, value of coverage down 5%, deductibles up 40%, overhead up 20% per year.
Michael C. Huntington M.D. email@example.com 541-745-5635 March 7, 2014