The cost of US medical costs - Financial stress has a health cost itself

Throughout the holiday season, the public health machine continues to grind away.  If ever there was something to be grateful for in Canada, perhaps it is appropriate to sing platitudes to the Canadian health system.   We can easily find shortcomings in anything so complex, but let us look at one of the major reasons why the system exists – to provide universality and comprehensive care to everyone irrespective of their personal circumstances.  This becomes ever so obvious by comparing to others southern relatives. 

Out of the Robert Wood Johnson Foundation http://www.rwjf.org/  which funds the Centre for Studying Health System Change Centre for US study of health system  are reports on the challenging state of US personal costs borne for health services.  The sobering statistics contained in  medical bill problems for US families:

• ·         The number of uninsured Americans has increased nearly 25% from pre-recession and now stands at 51.7 Million
• ·         One in five American families are having problems paying medical bills, up one-third. 
• ·         Utilization is being reduced with fewer visits to doctors, which some people might suggest could explain an increase in the health of some families too.
• ·        Persons with medical debt have much higher unmet health needs than those without, presumably through decisions to not seek care when needed.

There is a good analysis of the potential beneficial impact of the first steps in expanding US medical insurance beginning in 2013 by demonstrating the added value provided to persons in the working poor income range. 

The good news for those living south of the border is the major impact on health care utilization was in the first half of the last decade.  Through the recession years there has been a relative flattening of some of the indicators. 

This blog touched on the issue of health care spending in Canada Canadian health spending November 8, 2011. One of the issues not discussed was that only about 70% of health care expenditures are covered by government programs in Canada, fortunately the ones that are most likely to be major financial burdens – however many costs are borne by Canadians.  This proportion of “insured” benefits is slowly being whittled.  The best example is the failure to insure needed prescription medications, and the active choice of some marginalized families to not fill prescriptions.  The work by the Canada Health Council referenced in the comment posted by Nonstop GO speaks to specific financial barriers in the subpopulation of those with chronic illness, worth the read and a focus of a future blog. 

As the US implements repairs to a crumbling foundation, Canada needs to consider a few renovations to protect the benefits that we currently enjoy.