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Has America Reached The End Game In 
The For Profit Health Care Model?
By: Patrick Mansfield | U.S. Health Alerts


As we witness the downfall of the Affordable Care Act (ACA), the question that needs to be asked is whether the U.S. health care model currently in place is sustainable. We have created a for-profit system that now consumes 17.5% of Gross Domestic Product (GDP). Health care cost is bankrupting the private and public sector of the American economy. What are the causes of this crisis? 

The Cost Of Becoming A Doctor

The average four-year cost for medical school including books and tuition is $278,455 for private schools and $207,866 for public schools. Then you must add the loss of income that medical school students miss out on. For example, instead of being part of the workforce and earning money, medical school students are having to pay almost a quarter million dollars for tuition.

The Negative Effect Of The High Cost Of Medical School

The cost of medical school keeps many potential students from becoming Doctors. Due to a high debt load, and a limited supply of Doctors, A General Practitioner’s Salary in the United States is the highest in the World.

The Cost Of Receiving Health Care In The United States

If you become sick in the United States, the cost of treatment will far exceed the cost that other industrialized countries pay for treatment. Since we are the only industrialized country that mostly relies on health insurance for providing care, the United States lacks the bargaining power that all other industrialized countries can take advantage of. For example, because England has a universal health care model, they can bargain with companies the cost they are willing to pay for treatment.

How Health Insurance Contributes To The Cost Of Health Care In The United States

Because health insurance companies need to make a profit to stay in business, they need to monitor their risk for potential losses. This is the main reason why the Affordable Care Act is failing Americans. Most experts agree that the insurance companies that are in the Health Insurance marketplace are in the beginning stages of a death spiral (death spiral for an Insurance company happen when claims being paid exceed premiums being collected, which eventually leads to insolvency). To prevent a death spiral, an insurance company needs to raise premiums and deductibles to support this model. Eventually, people will refuse to pay the premiums and will leave the market.

Non-Punitive Mandatory Pre-Existing Coverage; The Elephant In The Room

The Insurance business model works only when risk is pooled so that any losses can be covered by the premiums collected in the pool are paid to cover the loss. The health insurance business model does not work when insurance companies are forced to accept pre-existing conditions without charging for the increased risk. For example, let’s say you are looking to buy a homeowner’s insurance policy and you tell the insurance company that your house will burn down after the coverage is in force. You would be denied coverage.

The Cost Of Health Care Has Exceeded The Affordability Level To Cover The Majority Of Americans

Because of the high cost of treatment, we are now realizing that the private health insurance is not working. If you remove the subsidies provided in the Affordable Care Act, most Americans would simply not be able to pay their premiums. But not only are we looking at higher premiums, but the deductibles are rising as well. So even if you have health insurance, you may not be able to afford to use the insurance.

The Fix

Health care is a very complicated public policy even without having health insurance as the main source of providing health care. As a country, we have created an unsustainable health care system. There is no easy fix, but we need to start thinking of alternative health care policy that removes health insurance as the main provider of health care in The United States. The fix needs to start from the root of the problem, the cost of medical school.

 The High Cost Of Medical School.

Fund Medical Schools With Government Grants So We Can Increase Enrollment.
Hold Medical Schools Accountable For The High Cost Of Tuition. If Medical Schools Accept Public Funding, Then The Government Should Put Caps On Tuition. One needs to ask; Where Does The Money Go?

 Invest In Artificial Intelligence (AI) For Providing Care.

AI technology Is At The Early Stages Of Providing Health Care. A Good Example Would Be A Symptom Checker That Incorporates Established Algorithms In Providing Responses.

Providing An Option For A Single Payer System (Universal Health Care).

Not All Americans Can Afford The Most Expensive Car, Our House. These Are The Natural Outcomes Of A Capitalist Model. We Need To Provide Health Care For Those That Are Priced Out Of The Health Insurance Market. 
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Americans Need To Have The Option Of Basic Health Care.
Increase The Medicare Tax To Fund A Single Payer System. Most Americans Would Be Better Off Paying 4% More in Medicare Tax, Than Paying $1200 Monthly Premiums For An Insurance Policy With A $12,000 Deductible.

The cost of health care is slowly bankrupting the United States. Both Republicans and Democrats need to come together to help fix this problem. If the endless debates continue we will slowly witness the death spiral of Health Insurance companies. Without a plan in place, many Americans will eventually be without Health Care.
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