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Rising health care costs are challenging the major payers, that is, the private and public health insurance systems. Private health insurance costs may well double, from $706 billion in 2005 to $1.39 trillion in 2015. Private health coverage companies responded to these increasing costs by implementing several new strategies. Most of these shifted more of the responsibility to their patients and providers. They changed their management of high-cost patients; introduced wellness, disease management, and medical technology information programs; reduced payments to providers; and implemented higher cost sharing.

Public health insurance costs will also rise, from $914.6 billion in 2005 to $1.93 trillion in 2015. Several attempts at curbing these costs slowed but did not stop the spending growth. Reform of Medicare (a federal program for those over the age of 65, certain disabled people under age 65, and those with permanent kidney failure treated with dialysis or a transplant) slowed some of the growth by cutting back payments to providers and shifting enrollees to managed care, both of which restricted benefits. However, the addition of a drug benefit in 2006 increased Medicare costs. Medicaid, a state-funded health program for the poor, greatly burdens the states, and states may respond by further restricting eligibility.

With this current climate of curbing costs, individuals must accept more and more of the financial burdens of the health care system. Two thirds of insured adults reported that their insurance premiums increased in the past 5 years. Copayments and deductibles are also rising for the majority of insured people, and for many individuals, high medical costs can have a huge impact on their lives.

Not only are rising medical costs a major stressor; they can also create significant barriers to health care. In the past year, almost one quarter of Americans had problems paying health care bills. Most of the unpaid bills were for physician services, lab fees, and prescription drugs. In a given year, almost 30 percent of adults report that they or a member of their household skipped medical treatment or either did not complete or cut the dosage of a drug prescription because of high costs. Individuals in disadvantaged social positions experience even greater access problems because of rising costs. Poor people, women, and individuals with chronic illnesses all report delaying or not getting necessary health care because of costs.

Bibliography:

1) Administration on Aging. 2005. "A Profile of Older Americans: 2005." Washington, DC: Administration on Aging.

2) Centers for Medicare and Medicaid Services. 2007. "National Health Expenditures Projections: 2006-2016." Washington, DC: Centers for Medicare and Medicaid Services.

3) Heffler, Stephen, Sheila Smith, Sean Keehan, Christine Borger, M. Kent Clemens, and Christopher Truffer. 2005. "U.S. Health Spending Projections for 2004-2014." Health Affairs Web Exclusive, February 23.

4) Kaiser Family Foundation. 2005. "Health Care Costs Survey." Washington, DC: Kaiser Family Foundation.

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