What's the Future of U S Healthcare? What Should You Do?

Summary:

Predicting the future of healthcare is tricky. We can’t know the unknowns, but, we can look at where we are, at current trends, and at expectations to forecast what might happen.

Where is global medical care? Where it is likely to go? How could it affect us? We’ll look at the key factors of the American system. From those premises, we’ll project what is likely for US care? What's the likely impact on you? And, what should you do about it?

Where Is Global Healthcare Now?

Most of the developed world utilizes socialized medicine systems that involve centralized control by a governmental agency. Globally, there are four basic systems in play:

• Socialized Medicine – a government owned and operated system that covers everyone (such as the British system);

• Socialized Insurance – a single payer system that covers everyone, with government insurance paying private service providers (as in Canada);

• Mandatory Insurance – government controlled, covers everyone through required participation, with multiple public or private service providers and with payment by multiple funds or insurance carriers (as in Germany);

• Voluntary Insurance – Optional coverage and optional participation that does not cover everyone, with many service providers and many funds or insurance carriers in a nearly free market format (as in the US);

The characteristics of socialized medicine systems are that they cover everyone with basic, but limited, “free” services. The demand for such free services invariably exceeds supply. Of course, these free services are paid by taxpayers, so they are in no way free.

To control costs, governmental bureaucrats usually rely on rationing access to services and on limiting services to established treatments and drugs that have lower cost. This results in long wait times for service and in limited or no access to the latest “miracle” cures.

What’s The Likely Future For Global Healthcare?

Andersen Consulting held a conference of authorities to tackle this question. They determined that the global marketplace, the information age and developing Asian nations would drive healthcare to major changes in coming years. They settled on these most likely system scenarios:

• Socialized Medicine Combined With Managed Care – socialized systems are desperate to accommodate growth but limit costs. Managed care is a program that has been a disappointment in the US;

• Mandatory System With Managed Care – mandatory insurance plans have the same cost control problems as socialized medicine. This combination hopes for the same questionable solutions as above;

• Personal Responsibility System – incorporates mandatory participation but seeks to control costs through personal responsibility and use of required health savings plans;

• Multi-Tiered Health Service – A three-tiered combination of a private fee for service top tier, a managed care social insurance funded middle tier and a basic service government funded lower tier;

Where Is US Care Now?

The US system is an assemblage of several formats described above.

• The Veterans Administration and Military Healthcare are limited Socialized Medicine;

• Medicare is Socialized Insurance;

• SCHIP and Medicaid are limited Socialized Medicine;

• With the March, 2010, enactment of the Healthcare Reform measure, also known as ObamaCare, the whole of the US is being put on track to a healthcare system that might be described as a combination of three systems mentioned above - Mandatory Insurance, Multi-Tiered Health Service and Limited Socialized Medicine. The final form that the US healthcare system will take is not yet known, because it is still evolving and subject to change.

What Is The Likely Future For US Care?

ObamaCare is currently the Law of the Land, but it is hardly a settled issue.

America is split with less than 40 percent in favor of ObamaCare and almost 60 percent opposed to it. Polls reveal that a greater percentage is against having a government controlled universal medical system. See National Health Insurance.

The role of the US government is likely to increase under ObamaCare with the pressure from Obama supporters for universal coverage and their clamor for “free” medical care for the Uninsured. With universal care, costs will rise beyond imagination. The projected cost for the Medicare Part A program for 1990 was $9 Billion. The actual cost was $67 Billion.

The costs for ObamaCare were officially projected at less than One Trillion dollars over the first ten years. However, after passage of the bill, subsequent estimates project costs to be at least three times the original estimate.

When such cost overruns hit, as they are bound to do when services are "free", government bureaucrats will resort to their usual cost-cutting measures of restricting or delaying access to services and of opting for less expensive, lower tech treatments and drugs. We have seen this as a continuing problem in the government systems of Canada and the UK.

Restrictions, delays and lower tech treatment have not been a major problem in Medicare yet, but the program is clearly headed that way. Much of the funding for ObamaCare was accomplished by assuming reductions in the Medicare budget going forward. The Medicare budget will now be far too small to handle the baby boomer surge that is just beginning. Many doctors are already opting out of Medicare because fees are too low and the administrative burden is too high.

The recourse for patients who can not get access to service will be the same as for the Canadians and British. They must secure private services themselves on their own effort, at their own expense.

As the US implements the major components of its nationalized care system in 2014, expect the same conditions for the same reasons. You must be prepared to take charge of your healthcare for yourself and your family. For Medicare patients, that reality will come sooner than later, as more doctors withdraw as providers.

What Is The Likely Impact On You?

Many people have assumed that the move by the US toward a government controlled medical system will decrease personal responsibility. It will do just the opposite. The personal burden you will bear for managing the healthcare business for yourself and your family will dramatically increase. You must be ready, willing and able to . . . .

• conduct your medical affairs within whatever medical system and government system that evolve;

• take advantage of any tax, savings and financial benefits that are available to you;

• participate in and benefit from preventive and fitness programs; and,

• go outside any government affiliated service to get independent private services at your own expense if and when necessary for the sake of your lifestyle or your life.

Unable to get needed care at home, citizens of the UK and Canada have found it necessary to travel to other countries for medical procedures. Such travel, called medical tourism, has grown significantly.

Many Canadians have sought relief in the US because of its proximity. However, high US medical costs have driven numerous Canadians, Brits and uninsured Americans to Asia and Latin America for treatment or surgery. Medical tourism hospitals in non-US locations often compare quite well with US standards.

US healthcare consumers do not yet have a great need for medical tourism. Some could be interested if they need a lower-cost remedy for an uninsured pre-existing condition or if they are willing to risk a treatment or procedure that is not approved in the US.

However, private medical services outside of government controls could be outlawed in the US. That is so in Canada. It would have been a provision of Hillary-Care in the Clinton era. If such restrictions are enacted here, medical tourism will be a welcomed option. It might be your only alternative.

What Should You Do?

You should pursue a protocol that puts you in charge of your healthcare and gives you

• Affordable health insurance;

• A fitness plan that focuses on good physical conditioning, prevention and nutrition;

• An assistance plan that will help you conduct your healthcare system affairs;

• An advocacy program to navigate you through whatever government regulations that evolve;

• Assistance with the tax, savings and financial benefits that are available to you;

• Assistance with caregiver issues that may arise; and,

• Help to seek medical tourism if necessary for the sake of your lifestyle, or your life.