The results of a recent Harvard-backed study came to a surprising conclusion: in a reversal of historic trends, the wealthy now spend the most on health care (compared to the poor and middle class), despite being the healthiest group overall. Although spending on health slowed overall between 2004 and 2013, there was a massive realignment concerning which types of people spend large sums on health care. This is a critical study, because it suggests some important (and potentially concerning) trends about the way our healthcare system is set up in this country.
Like any responsible study, the Harvard research doesn’t attempt to draw any hard and fast conclusions from the data they unearthed. However, there are some correlations that can be made with confidence, particularly the suggestion that the high cost of deductibles is discouraging people from seeking health care. The study makes it fairly clear that the wealthy make use of the health care system the most, despite needing it the least. For the poor, however, the prohibitively high cost of deductibles can be a depressing financial hurdle to pass before receiving care. For many individuals below the poverty line, they may decide to just ignore their health problem in light of knowing that they can never afford the deductible.
This financial aspect of the United States’ healthcare system has real effects on real people. For example, men and women considered ‘poor’ by the study were respectively found to live 15 and 10 years less than their wealthy counterparts, on average. Simply put, there is a massive disconnect between need, expenditure, and health outcomes. This suggests a huge inefficiency in the way the country’s healthcare system is currently running, which could possibly have grave quality of life and fiscal implications in just a few short years.
While Obamacare has made it easier for the poor and lower middle class to gain access to health coverage, it has also entrenched the idea of high deductibles and co-pays as being part of life. For example, a medium-tier “silver” package on the health exchange commonly comes with a deductible in the $3,000 range. For something that is supposed to function as a mid-tier package, that is a huge sum of money. By the official government-backed health exchange codifying this kind of deductible into the fabric of our healthcare system, it is an implicit acknowledgement that these multi-thousand dollar sums are the entry requirement to being treated in this country.
With this framework in place, the wealthy (who can afford high deductibles) are pumping money into the system and are being treated despite having overall good health. Meanwhile, the poor are intimidated by these deductibles and not paying in, while the middle class feels a tremendous squeeze due to the price point.
One thing is clear — despite the best of intentions, there is still a ton of work to be done in order for this country’s healthcare system to effectively and compassionately treat citizens from all walks of life.