How Do We Pay for Health Care?
The sources for paying for care in 1960 were primarily personal, out of pocket or private insurance; Medicare and Medicaid did not yet exist until 1965. It is obvious that they now make over 50% of health care expenditures possible— coverage shifted from the private sector to the public sector and is presently shifting back to the private sector. Technology has exploded, the costs of health
Table 8–4 Costs for Hospitalizations with Procedures: 1999 and 2006
Amount in Millions (2006 dollars)
Procedure 1999 2006
Respiratory intubation and mechanical ventilation 10,687 15,729 Percutaneous transluminal coronary angioplasty (PTCA)
6,407 13,327
Cardiac pacemaker, cardioverter, or defibrillator 3,518 8,693 Coronary artery bypass graft (CABG) 8,344 8,085 Knee arthroplasty (knee replacement) 3,573 7,920 Spinal fusion 2,651 7,670
Source: U.S. Department of Health and Human Services. (2009). National Center for Health Statistics. Health, United States, 2009: With Special Feature on Medical Technology. Hyattsville, MD. 2010: Author. Retrieved from www.cdc.gov/nchs/data/hus/hus09.pdf 2011, December 18, 2011, pp. 102–104.
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care have soared, and many of the health care-related programs are seen as “entitlements.” The costs of services are blindly covered and quite often it is impossible for a patient to get an itemized bill, yet, when people get them, they are astonished at the costs but state, “My insurance covers it and it costs me nothing.” However, for more and more people the costs of heath care have become so high that their health insurance companies either disallow desired procedures or stop payments after a certain amount is reached. Families are left bankrupt in many instances or finding it necessary to choose between care or financial insolvency.
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