American Health Care 2021 - Now What? Discussion 3: Holistic Analysis

Monday, Nov 01 1584

Informed decision making is essential to sound policy making.

The current regulatory and oversight process has laudatory goals, but does not effectively engage the complexity and interactive phenomena of the health care system with the understanding and rigor required to actually achieve those goals.


Consider, for example the following examples of what might charitably be called unintended consequences of the well-intentioned current policy making process:

  • Between 2008 and 2016, Medicaid costs increased from $0.55 to $0.67 of every federal dollar going to states and local governments. The demand on state revenues increased as well and now claims about 20% of all state revenues collected. These increases affected state and local spending on other priorities including education and infrastructure. 
  • During roughly the same time period (i.e., 2008-2017), enrollments in Medicare and Medicaid increased 43%, adding more than 40 million people to the two programs. The provider infrastructure did not grow at the same rate, which created access problems for certain segments of the population (e.g., people living in rural areas).
  • In 2017, government health care programs spent $1.4 trillion dollars more than they brought in from premiums and other revenue sources. Approximately $240 billion of that deficit spending was added to the national debt, increasing the burden on future generations. The remaining $1.2 trillion deficit spending generated increases in premiums for the private sector large group and individual markets (i.e., cost-shifting). These increases, in turn, have led to major increases in out-of-pocket costs for individuals and families and contributed to the current widespread and spreading concerns about costs.

CAG is dedicated to enhancing public and policy maker ability to understand, evaluate and interact more effectively with decisions affecting the American healthcare system.



Last modified on Monday, 06 December 2021 21:47