Monday, February 18, 2008
Without insurance cancer often found later
By Yvonne S. Lee
CNN Medical Producer

The late stages of cancer are brutal. I remember an ugly tangle of tubes around my grandmother's body, her desperate, humiliating struggle for each breath, her body slumped over as sweaty white skin hung off the emaciated body of this once-mighty woman.

She was the family matriarch, a woman who had fed three hungry children and a half-dozen nieces and nephews through the worst days of the Korean War. She started smoking because she was hungry. She got her first cigarettes from American soldiers stationed in Korea during the war. She said they helped her feel less ravenous.

Doctors weren't able to save her. Advanced lung cancer was hard to detect and just wasn't curable in the late 1970s. It still isn't. Only 16 percent of cases in the United States are detected in Stage 1, when tumors are still confined to the lung.

It turns out that thousands of patients in the U.S. have to endure what my grandmother did - trying to survive after their cancer is diagnosed at a late stage. But many of those people find out they have advanced cancer because they do not have health insurance - something my grandmother did have - and therefore have limited access to health care and early cancer screening.

A new American Cancer Society study published in the journal Lancet looked at 3.7 million cancer patients - the largest study of its kind - and found that uninsured and underinsured patients are twice as likely to learn about their cancer in its late stages of cancer as people who have private insurance.

When I read this, I thought about all the people who have to watch their loved ones die of cancers that could have been successfully treated had the disease been caught earlier. It seems tragic that if they'd had insurance, perhaps they would have gotten pre-screened for breast, colon and other cancers. Catching these cancers early means you're much more likely to live longer.

If colon cancer is diagnosed in Stage 1, you have a 93 percent chance of surviving five years. This drops to 8 percent if it's found at Stage 4. According to the study, uninsured people were twice as likely get their diagnosis at an advanced stage of colon cancer versus an early stage.

The statistics weren't any better for breast cancer. Women without insurance were nearly three times as likely to learn they have cancer at a later stage rather than an earlier stage. If breast cancer is diagnosed late, your chance of surviving five years goes down by 80 percent.

These are scary numbers when you consider that 47 million Americans don't have health insurance. That's 47 million people who are taking a chance, whether by circumstance or because they have no choice, that they won't become seriously ill; 47 million who may have to rely on emergency rooms if they do; 47 million who don't have the luxury of calling their family doctor to ask about a pain in their chest, or a lump in their breast. They just have to grin and bear it, or hope that it's nothing.

I think about having five more years with my grandmother. I would have asked her what it was like to live during the Japanese colonization of Korea, when she escaped with her family to China, or how she was able to feed her children during the Korean War, with only a sack of rice to get through most weeks.

For me, health insurance is not a political issue, it's a moral issue. Poverty shouldn't mean that you are more likely to die from diseases that we can treat effectively if caught early. It shouldn't mean you get less time with your kids, or grandkids - not in the richest country in the world.

Are you uninsured or on Medicaid? Was your cancer diagnosed at a later stage because you didn't have insurance? Tell us your story.


Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

Another message from this article is to not smoke and then probably won't get lung cancer. It is a highly incurable disease whether you have insurance or not. The bigger message here is to stop smoking.
It's a tear-jerker story, with the family matriarch struggling for each breath. No one deserves this, to be sure, but the way in which it is written - that she was forced to turn to cigarettes to fight off hunger? The fact that we are the richest country in the world doesn't relieve people of responsibility for their own health.
The medical care that I have been given by the Veterans Administration in San Diego, La Jolla has given me fifteen years of life from 4 kinds of cancer. I am now 85, almost 86 and I have spent my extended life span of 5 years and fifteen years from the time it was first discovered. We are all in God's Hands and care. Cancer is the scourge. It must be wiped out. Radiation, surgery, chemotherapy, early detection are temporary and not permanent solutions. Cancer must be stopped before it starts.
This article is so true. My mother lost her health care once my dad died of a bout of lung cancer. She was a stay at home mom, and would have to pay astronomical amounts for good health care. She felt a lump in her breast but ignored it and tried to avoid the costs of a doctor's visit. She did not see a doctor until it became very painful and she could not lift her arm. She had advanced breast cancer and had to have a full mastectomy. Although she went into remission it came back and metastasized. She ended her bout with cancer and life in July of 2000. I feel she could have still been here if it weren't for her fear of health care expenses. We need to do something about this. This country can not go on like this. Innocent people are not getting good care because of their economic status, and it is just not right!!!!!
I am very sorry to hear about any person who gets cancer. It is a truly terrible way to die.

The ACS study is amazing. It is self-evident that people without medical insurance will die more often from cancer than those with it. More important is what does the ACS want done about this horrible problem? I read their response at http://www.cancer.org/docroot/subsite/accesstocare/content/Were_Taking_Action.asp
and do not see anything that will change the current situation. Unfortunately the ACS is part of the problem and not part of the solution. This organization is too entangled with the current medical establishment to offer real change. If you look at http://www.charitynavigator.org/index.cfm?bay=search.summary&orgid=6495
you will see that ACS is ineffective charity.
The current state of health care is as follows:

life expectantcy goes down, health care costs go up, coverage from health insurance goes down.


Who can fix it?
My story is one of similar woes. My father, a 61 year old man, was diagnosed with Stage 4 cancer just four months ago, and died, three months later. The problem with this is that he did have insurance. He worked as a High School Janitor for the State of Oregon. He didn't get the proper screening, and eventually had to quit his job due to his health. He thought it was the chemicals he used in the job that made him feel ill, and his doctors told him as much, yet it was likely the cancer. The government sanctioned system totally failed my father and he died because of it.

Health insurance shouldn't be a political issue, but it is. Your side makes it one by tagging it as a moral issue. It isn't a moral issue. It's not my fault if you or your grandmother didn't have insurance. It's the sick reliance on a bloated bureaucracy that should be feared and abhorred. Why do so many people not recognize the true criminals in this matter? It is the socialists trying to sell us some utopian dream that is just a prettied up version of indentured servitude.
What if instead, you grandmother had an HSA (Health Savings Account) coupled with some insurance that only kicks in at bills priced at $1500 or higher. Employers could do matching funds with employees and this fund would add up over time. This fund would be 100% tax free and would be allotted for health care spending only. The government makes a much better watch dog than a health care provider. The government needs to get itself out of the business of becoming our keeper, and become the one who makes sure we don’t get short changed on our care. But we should also remember that too much regulation will jack up the price. It needs to be a balance. In countries where people don’t have to worry about the price of health care, they still die of cancer because they’re not able to get treatment due to long waiting times.
Put health care in the hands of private citizens and give them the opportunity to shop, and competition in the market will drive the prices down. And to make sure that the treatments being promised are being delivered, have a Better Healthcare Bureau (like the BBB) which reports on bad healthcare practices. This would help to keep people honest.
Wow. Way to fan the flames. Soooo...if I read that article correctly, if you don't have health insurance, your going to die a horrible death by cancer?
I mean, that's basically what you wrote, right?
It is important to emphasize it is not just the uninsured but those on medicaid, supposedly medical insurance for poor people, that also don't get the same treatment as those with regular health insurance. This distinction is important because in the era of managed health care, we allowed insurance companies to structure what kind of health care we receive based on how much money we have. This is a tiered system that no longer places any value whatsoever on human life, only the bottom dollar. If you are a good producer of money, then you reap the benefits of good health care. If you are not a good producer of money, then you get what you deserve--to die from illnesses that would be otherwise treatable. Your value or worth as an individual comes not because you are a human being, but from how much income you produce. Until we address the dark underbelly of the new policies of trickle-down economics (the ultimate source for this twisted view of the value of human life), the disparities in who receives what kind of health care will only continue to erode.
Very thoughtful article and it touches important issues. For better or worse here in Europe we do not yet have to worry so much about insurance, but still these matters are not different between people who are rich and others who are poor. It is indeed a moral issue.
I have no health insurance. I'm self employed and business has been difficult in the last few months. I'm also concerned about some symptoms that I've been having... night sweats, pain in or around some of my organs, etc. The thing is, I choose not to go to the doctor. If I did, I'd be treated, because doctors don't refuse treatment to patients. I have ACCESS. I just don't have FREE access. The bottom line is, I have to make a decision based on where I'm at financially right now, and while I have some concerns, I have to choose to deal with it alone right now.

As for the idea that the government should provide me with health care (even in the richest country in the world), what's the difference between that and asking my neighbors to pay for my trip to the doctor? There is none. If I'm not paying, someone else is. And if people perceive it as free, they'll use it when they don't need it.

Being in my position is tough, but living in a country that offers me this much opportunity also comes with some temporary discomfort... like not being able to afford the service that a doctor provides.
My mother-in-law, Pam, died March 2nd, 2007 from ovarian cancer. She was 63 years old and uninsured most of her life. She and her husband worked hard in the hospitality industry for over 45 years and raised 3 wonderful children. As parents, they had to choose between putting food on the table over purchasing health insurance. A ridiculous situation, that seems all too tragically common today.

Pam's quick story...
Over two years ago, Pam complained of some pains in her side and shortness of breath. We took her to emergency and found out that she had Stage 4 ovarian cancer. The family was devastated. The Drs. were sorry but if it was caught earlier they would have had a good chance at treating her and extending her life. Caught so late in the disease, her outlook was grim. She died almost a year later.

I am outraged at the American anti-Health Industry. Money should simply not be an obstacle to receiving basic health care. Not only is health care utterly unaffordable in the US for the low-middle class but the social safety nets in place to catch those that are in need are over-burdened. The current health care programs are designed to be re-active rather than pro-active. I do not blame the health care professionals - they want to help people. It is big business and gov't that is the road block to universal health care.

I am from Canada and have lived in the US for almost 12 years now. In Canada, Pam would have had regular medical/gynocology appts that would have detected her cancer in its early stages. She would definitely still be with us today.

I am not suggesting that the Canadian health care system is perfect - they all have flaws. BUT it does provide BASIC health care to every citizen. Growing up Canadian, you NEVER thought about not going to the doctor because of the cost. Take a moment to think about how not worrying about paying for health care could impact so many other areas of your life.

And for those that think Canadians pay a lot more taxes for this, you are simply wrong. I pay more taxes in the US than I would pay in Canada. The difference, in Canada I have something to show for my tax dollars. In the US, my tax dollars are used to support an untenable war and fund an un-representative government.

I still have to pay for my private health insurance on top of the taxes I pay. Something that I feel very fortunate to be able to afford here in the US. I would happily pay more taxes to make sure the every US citizen had health insurance.

The US citizenry must simply DEMAND health care - not ask - not hope for - but DEMAND it.
It is for many reasons good to find cancer early. Some problems exist though. Many screenings detect tumors that might not be cancer but said to be such! The other problem is that if you find REAL cancer early, the number of years of survival is of course higher than if you discover it later - even if you have NO effective treatment! Thus, unfortunatelly lung cancer screening has NOT decreased MORTALITY in lung cancer. There is still no effective treatment.
It isn't just the un or underinsured that are not diagnosed early. In many ways, these populations have more access than the highly educated and well-insured... it is a matter of balancing time and money. It takes time to get into a drs office, have routine screening done and further testing completed. This is often very difficult for people who are working and raising families... the last to be taken care of are those of us who are well incured.
Without health insurance, my husband and I have to put off all of our usual annual exams and testing until we have saved up enough for each exam. Even then, we are surprised by 'extras' that are thrown in, that we haven't budgeted for! I have learned that by calling each physician or dentist BEFORE making an appointment, I can receive discounts for payment at time of service, and on one occasion we even filled out a 'charity case' application for my husband to have an MRI. Our application was accepted by a major hospital, thank God, but it was humbling to be put in that position just to take care of one aspect of our health. Good health and good healthcare insurance will keep us in the job market and on this earth to contribute to humanity.
What Lee wrote about is a Class A example of why Stem Cell Research should be funded. Regardless of whether an embryo is a life or not, the question is for Conservatives:

Would you rather someone who is very real to you, like a family member or friend, die, or watch an embryo go.

Also, would Conservatives rather see the 'death' of something that's status as a living thing is not definite or a dying patient, WHO IS DEFINITELY ALIVE.
Although it is sad that this happens "universal health care" is not the answer. I agree that we need to take care of the sick people that do not have insurance. If I want to opt out of that program and stay with my private insurance then I should be able to do that. There should be no forced medical examinations. Examinations should be made availble for those that need it. I would like to have my health care left up to me and not have the government force their medical treatment on me.
I have to ask, has the government gotten more or less involved in health care in the past 25 years? I'm going to go out on a limb and say more. They've done wonders for it haven't they? And haven't costs come down? Hmmmm....NO and NO. So let's get them more involved? Good GOD people wake up!!!! Obama is not going to reduce health care costs. Nancy Peolosi is not going to reduce health care costs. People shopping for the best price for health care along with competition will reduce health care cost. The problem is people shop for insurance, not the underlying product.
I own my own business, but can't afford both insurance and all the other bills. I like the idea of living in Canada because they give health care to everyone. I guess we'll all just have to wait until God's Kingdom to set everything straight.
It's important to mention that in the field of molecular biochemistry and epigenetics, great strides have been made in the understanding of the mechanisms of cancer and diseases.
The new keyword in cancer research is "prevention", not "cure". Special compounds in the so called "superfoods" inhibit DNA methyltransferase (mutations) and angiogenesis (the growth of blood vessels in tumors).
Cancer and disease prevention are hinged on proper DNA/mRNA "nutrition", that utilize the protective/corrective epigenetic phytochemistry. In short, it's important to educate the public that it's more important to implement early "prevention" instead of focusing on "detection".
Our current health care system has evolved to the point where there are now state-of-the-art prevention, detection, and treatment protocols available for many diseases. Unfortunately only the well-insured in affluent communities actually have access to the best medical care. The dilemma is that it will be too costly to provide the best care to everyone all the time. Are we going to give everyone calcium heart scans along with detailed anlysis and appropriate prevention regimens at a cost of $1200 per patient as the standard of care? Probably not but many people in affluent neighborhoods are getting these today. I recently waited two days to get an MRI for my daughter's minor head problem in a facility that was less than a mile from home. Will this be the norm for everyone? Probably not. I am very fortunate in that I have insurance and live in a great community. Everyone deserves the best health care but everyone can't have it because it will be too costly. This is a tough nut to swallow and is seldom discussed. A "good" level of health care will have to be provided to all and then above the good level, people should pay out of their own pocket and that demand for additional services should not diminish the good level of care provided to all by reducing access to resources (MRI machines, etc.). If I have to wait three weeks and drive 50 miles for an MRI I should have the option of paying for faster, closer care as long as I don't impact anyone else's healthcare. Said another way, if everyone gets the same healthcare standard it be at a lower level for a significant portion of the population. This will not be viable for reasons too numerous to discuss here.
The BEST healthcare I've ever received was when I paid cash because I had insurance. I was clearly told what was happening, why each test was needed, and was explicitly asked whether I wanted each test performed. I got out of the doctor's office, despite being extremely ill and needing two bags of IV fluid, for less than $100.

This is in STARK contrast to the horrible treatment I get now that I'm in the "free" military healthcare system. No one ever tells me what is going on, they don't ask if I want a drug or a treatment, they just treat me like a piece of meat.

I would gladly take a high deductible self-pay system if the military would give me the money they waste on the poor treatment I get now.
I am an apartment manager of an income and age restricted property. All of my residents are on Medicad/Gov. based health care. Not one of the residets get the care or medications they need; if they do, a PA will change it if it works! One resident was diganosed 8months ago with cancer and has yet to receive any treatment for it. His doctor cancelled his appointments, he has no medications at all. His case worker finally stepped in last week and he has new appiontments scheduled and new prescriptions called in. But it has been 8 months since the diagnossis! I agree, something needs to be done. These people have worked, paid taxes, contributed all of their lives, they deserve to be treated like everyone else! I really hope something can be done before too many more have to needlessly die for the message to get across!
Medicaid is Medical Insurance by the Government. If we mandate universal health insurance managed by the federal and state governements for all, we could look forward to the same wonderful coverage that those on medicaid have.
I don't have health insurance because I am a full time student and cannot afford it. my job does not offer insurance either. I worry about what would happen if I got sick all the time. If I got sick, I would be in serious trouble.
I will be 66 in July, I was found to have colin cancer stage 3 in May of 05. I had surgery, but decided against chemo or radiation. I had a barriam enema exray in 03 and they said I had diverticulitis. I waited to have the colonoscopy due to not having insurance and was paying the barriam exray on payments. Theysaid the cancer was back one year ago, I have insurance now but I have decided to just do natural healing. I really wish I had the colonlscopy 2 years sooner and it would have been much better for me. I am in excellent health otherwise and have been taking very good care of myself ever since surgery.
I'm glad someone is talking about this subject. I think about this issue every single day. Whenever I hear someone mention visiting their doctor or hear an ad that says "ask your doctor..." I feel a little worse. I do not have the luxury of insurance, because both of my jobs do not offer it to part time employees. Whenever I feel pain I just grin and bear it and hope that it's nothing serious. I figure I'm still young enough to live without medical care (26). Nobody should live this way. I'm sick of hearing "money can't buy happiness". Well it can buy health insurance! I think having peace of mind, knowing I'm healthy, would sure make me happy!
My wife, Maggie, was diagnosed with colon cancer when she was 31. Stage IV, livered consumed with tumors. We had insurance, thank goodness, but because we had just changed insurance, the insurance company launched an investigation on us trying to find reason to drop us. It was horrendous. Here we had just gotten out of the hospital, had received devastating news, and started chemo while trying to heal from having part of her colon removed and the insurance decides to send us a very scary letter declaring that they are investigating our application. Neither of us have ever had even a day’s lapse in insurance and, amazingly, we didn’t change companies, we just changed divisions – we went from group coverage to private coverage since she was in school and I was about to start school. Fortunately, after months of “investigation” I learned by them finally paying our bills that the investigation had been completed. They didn’t even bother to send us a note saying “ah, we discovered that you guys weren’t trying to defraud us.”
Cancer took my grandmother too, so i wholeheartedly agree with your blog and the position on early detection/more health insurance coverage. i've got no jokes here, only kudos. this may be the only time in history that's ever occurred.
Great conspiracy question: Do we want to find a cure for cancer? Do we make so much money "treating" cancer that we put off cures and vaccinations?
Somebody with cancer in stage 4 is less likely to survive 5 years than somebody with cancer in stage 1, health insurance or not.

The important question really is "Is somebody with health insurance will take longer to reach stage 4 than somebody without" and "will somebody in stage 4 with insurance will live longer than somebody without".

If we knew so much about cancer and how to treat it, then why are we talking about "5 years survival" instead of remission ?

After having seen so many people spending the last years of their lives receiving treatement until they die anyway, I thinking I myself would choose opt out of the treatments, even if I had insurance.

I might live 2 weeks less, but at least, I won't spend the last years of my life in hospital receiving treatments by folks who don't even know what they're dealing with, really.
My husband and I have been married for 32 years, a few times we each had insurance thru our employer. We sure could of used the extra money instead of insurance while we were raising our family. We were lead to believe it was like a lottery we were donating, hoping we never had to use it. We became self employed in 1997. We paid cobra while looking for an insurance company. We joined what we thought was a large group and bought a policy thru one of the largest health insurers of America, we also had thru many of our employers. It costs about $300.00. In 1999 I had a stroke and had to have aortal by-pass surgery. Remember when you're sick you aren't working. After the surgery they kept raising our insurance to over $1200.00 a month. Take that times 12 is $14,400 per year along with out-of-pocket and co-pays on medications. I made about $30,000 a year, working approximately 70 hours a week. Remember taxes also come out of the $30,000. Why are the insurance companies, thru the years claimed unbelievable profits and continually raising our premiums? This is wrong.
A trip to the doctor's office when we were first married cost $2.00 and medication was $2.00. Today we go to the doctor have simple procedure done and some labs and are charged more than most of us make in a week. I'm told we have better care. I am not sure about that at all. Insurance companies dictate what procedures they'll allow the doctors to do over the telephone. How good is that? Today many of us have seen insurance meeting in our companies. Young workers wonder why they have to pay for the older sick ones. Remember most of us were young and healthy once, I didn't know we were just donating profits for the insurance company.
Today I am a 5 foot 1 inch grandma driving a company tractor trailer cross country to reduce the cost of my health insurance. This is not our American dream.
Betty Seaba
"Those who don't know their history are destined to repeat it." If what you say is true, about putting health care in a free-market environment, which is what managed care is all about, and which we have been doing now for the past 25 years, then why have health insurance rates continued to spiral upwards entirely out of control leaving ever more people unable to afford aaccess to health care?
I think that this is a very complicated issue. Certainly, not having insurance leads to later stage diagnoses and that is both a political and a moral issue. But just like your grandmother, other things come into play as well. Simply giving people the facts isn’t always enough of an incentive to get them screened early. Let’s face it: cancer – regardless of its stage – is terrifying. It is the worst word you can ever hear. My view is that people need resources that not only educate them about the benefits of early detection but show them that life after cancer is possible and in many cases, even better than it was before the diagnosis. My mother went for 4 years without having her breast cancer diagnosed – not because she lacked insurance or did not believe what she had read about early detection. The truth of the matter was that she was terrified about dying from the treatment. Only after seeing me – her daughter – get through treatment for breast cancer did she confront her fear and see the doctor.
That experience, in large part was the inspiration for a site that I created called www.livingconversations.com where women share their experiences with life after breast cancer via videos and written text that give each other hope that they can get beyond the disease.
My friend Becky, a woman whose medical history already included a previous history of skin cancer, got melanoma while unemployed, yet no one would even look at the lesion (one dr told her it looked "OK" to her, the dr). And the only reason she was diagnosed in the first place was because she was a nurse and pointed, with not a small degree of anger, to the large, black lesion on her BARE leg !! When the clinic finally gave her the bad news it was invasive, she got bounced around till finally a dermatologist, not an oncologist, took it off. This woman, a member of the health profession herself, couldn've died, all because the clinic wouldn't pay for it, and she COULDN'T pay for it. Of course the uninsured are diagnosed later!! Who's gonna pay for it? Cheaper to bury a body than to treat it. Medicine is a sensitive subject rooted in science; sadly, so is economics.
I was diagnosed with StageIIIB cervical & uterine cancer and was not insured. In order to get treatment to save ny life I had to declare myself disabled to receive medicaid and social security benefits.This is a travesty in as great a country as the USA.
I am sorry to hear about your grandmother losing her life to this horrible cancer. All cancer is horrible. I know! I have cancer. I have sarcoma; and, when I was diagnosed, the cancer was in stage four. But thanks to the efforts of a great medical team, thanks to advances in medical science, thanks to God's will, and, most importantly, thanks to Canada's outstanding universal healthcare system, I am still here today. I feel no pain. My liver function is improving, and I am getting better. I am mobile, and I am able to resume a normal life. I am currently receiving these Eprex injections to boost my blood cell count. A one month supply of this drug costs about one thousand, seven hundred dollars - Canadian. I paid only two dollars. The government pays all the rest. I know about the horrible effects of advanced and terminal cancer. My cousin lost her husband to non-small lung cancer, which spread to his bones. In the end, he weighed only one hundred and thirty pounds. It was devastating. Expect for a steady but mild abdominal pain, excessive fatigue at times, I feel great. So far, I can say that I am one of the lucky ones. Cancer can be beaten. It's a horrible way to die, and it is a horrible way to live - but many of us do live with cancer. In today's world, cancer does not have to be a death sentence. I'm glad I live in this day and age, and I am glad I live in Ontario, Canada.
That's why life spans for the poor are lower than those with financial means. Those who cannot afford it put off maintenance health care and other care as well.
Shame on the person who says they wouldnt have got lung cancer had they not been smoking. There are many people out there who have never smoked and got lung cancer. If you have something that demeaning to say then you shouldnt post. Shame on you! I am uninsured and have had severe stomach problems but am unable to pay for it, but, I make too much money to get any assistance for this and other tests I have had to turn down because of the fact I cannot afford it. Thank God for PPA, this is the only way that I can get the medicine I need for my ulcer and my migraines.
I would just like to mention that my grandmother was a very healthy and health conscious. She ate healthy, walked every day and never smoked a day in her life. She still died of lung cancer. You don't have to smoke to get lung cancer.
I am so happy we are discussing this. My family is underinsured. We pay $400 a month and our deductible is $7,000. We, therefore, get no healthcare. We cannot afford $80 pediatrician visits.
When my son hurt his back, we did not go to the emergency room. An MRI for $3,000 would empty my son's college fund!
I want single payer health insurance now. Please check out the website of ethical doctors: http://www.pnhp.org/
who also support it. And please write your comments about it!
Wake up America!

Current healthcare system simply can not survive. Here is the fact: Projected national healthcare expense is $4.277 TRILLION in 2017. This is according to US Dept of Health & Human Services (www.cms.hhs.gov/NationalHealthExpendData/Downloads/proj2007.pd f ).

It means, a family if 4 will need to spend $52,400/- a year in 2017 on healthcare alone. Absolutely, it is mind-boggling and certainly not sustainable.

Why such a large sum is required here in US compared to only half of it is spent in other western countries even after providing care to everyone. Simple reason is 'HEALTH INSURANCE COMPANIES' do not exist elsewhere.

What happens in our current system? Too many people are involved. Patients and doctors would be enough to provide care. But, health insurance is involved in every aspect of our health. Result: Complexity. It means more law suits & lawyers. It means more cost to doctors (by way increased malpractice insurance premium); and doctors resort to what is called 'defensive medicine' involving more unnecessary tests. Not just that, 30-35% of the total dollars in healthcare is spent as ADMINISTRATIVE EXPENSES. Result: PROHIBITIVELY EXPENSIVE healthcare for the patients.

So..what is possible? SIMPLIFY the system. Here is a possible solution:
1) Separate catastrophic illness (like cancer) from 'all other' procedures.
2) Employers spend tens of thousands of dollars for every employee (& dependents) every year. Let them direct 50% (or so) of these funds to the employees Health Savings Account and the rest to a 'federal catastrophic coverage pool'.
3) The individuals will pay directly to the doctors from their own HSAs for 'all other' procedures.
4) Catastrophic coverage will be provided by the federal pool with some individual copays.

Why it will work? It is simple. For most services, it involves only the patients and doctors. It means less law suits, less defensive medicine and far less administrative expenses.

jack
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