Despite such high spending, millions of Americans do not receive the care we need. Unlike every other wealthy industrialized democracy, ours does not guarantee health insurance or health care. According to the United States Census Bureau, more than 45 million Americans lack coverage, excluding Medicare insurance.
The 59 percent of Americans with employer-provided insurance (or not Medicare coverage) have watched our coverage diminish even as our costs continue to rise. The 18 million or so of us who buy medical coverage on the private market often find ourselves in a running battle with insurers over medical claims–assuming we even find affordable plans, which is unlikely for those with a preexisting condition.
Small businesses struggle to provide health coverage for their workers, lacking the ability to spread insurance risk as effectively as large employers can. Medical bills are a leading influence in more than half the country’s personal bankruptcies, research shows. The United States ranks 31st in the world for life expectancy and 37th for infant mortality, according to data from the World Health Organization.
The country’s fiscal dilemma–the CBO projects the federal public debt will reach $20 trillion, 90 percent of gross domestic product, by 2020–are rooted above all in the burgeoning costs of Medicare and Medicaid, with the baby-boomer retirement wave still to come. The rising cost of insurance adds to the stagnation of our wages. Every dollar that goes into health care means less to spend on education, infrastructure, and renewable energy.