Health Care System Crisis: Growing Challenges Point to Need for Fundamental Reform

Health Care System Crisis: Growing Challenges Point to Need for Fundamental Reform

HEALTH CARE SYSTEM CRISIS: Significant Challenges Point to Need for Fundamental Reform

Federal Fiscal Challenges: Changing Composition of the Federal Budget

Composition of federal spending by budget function

Selected Fiscal Exposures: Sources and Examples

Composition of federal spending as a share of GDP under baseline extended, assuming all tax cut provisions expire

Composition of federal spending as a share of GDP, assuming discretionary spending grows with GDP after 2004 and all expiring tax provisions are extended

Health Care System Challenges

Health Care System Challenges: Costs

National health expenditures nearly doubled from 1992-2002

Health expenditures will continue to absorb an increasing share of GDP

The United States exceeds other industrialized nations in total health spending as a percentage of GDP

Despite higher spending in the United States, resources devoted to health care are not always higher than in other countries

Growth in health care spending, 1992-2002

Composition of spending on personal health care services, selected years

Change in spending per enrollee, selected public and private purchasers, 1992-2002

The federal government acts through different tools

Estimated federal resources for health care by policy took, fiscal year 2004

Health care is the nation’s top tax expenditure in fiscal year 2004 (estimated)

Out-of-pocket spending has declined as a share of total health care spending

Spending on health insurance, as a share of average annual household spending on health care, has grown in the 1984-2002 period

Public program obligations, already burdensome, will be unsustainable for future generations of Americans

Medicare and Medicaid are projected to grow dramatically as a share of GDP

Workers per HI beneficiary are expected to decline

U.S. labor force growth will continue to decline

Growth in elderly population will strain Medicare and Medicaid in coming decades

Health Care System Challenges: Access

In 2002, 17 percent of the nonelderly population was uninsured

In recent years, roughly 40 million Americans have been uninsured

Significant gaps exist in health care access and coverage

Simplified view of access to and gaps in health care coverage

Chart notes

Simplified view of coverage gaps by payer and benefit type

Many states are planning to undertake Medicaid cost containment strategies in fiscal year 2004

Health insurance may be out of reach for many individuals in poor health

Health Care System Challenges: Quality

The U.S. continues to lag other industrialized nations in reducing infant mortality rates

The United States lags other industrialized nations in life expectancy at birth

The United States exceeds other industrialized nations in potential years of life lost

U.S. has fostered quality of care through investment and achievements in medical science

Deaths due to medical errors in hospitals are higher than certain other causes of death in the U.S.

Patients often do not receive recommended treatments and procedures

Patients often receive unnecessary treatments

Obstacles to Meeting Health Care System Challenges

Obstacles to meeting challenges: health insurance issues

Obstacles to meeting challenges: information gaps

Obstacles to meeting challenges: market imperfections

Evaluating Health Care System Reforms

Evaluating Health Care System Reforms cont'd

Framework for Evaluating Health Care System Reforms: Cost

Framework for Evaluating Health Care System Reforms: Access

Framework for Evaluating Health Care System Reforms: Quality

Framework for Evaluating Health Care System Reforms: Implementation

Health care system ideals: incentives, transparency, and accountability

Conclusion: