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Middle Class Death Watch -- 33 Frightening Economic Developments

Downward mobility, homelessness spreading to the middle class, 200,000 public employees laid off? Here are some frightening trends to keep an eye on.

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“To paint an accurate picture of how health care cost growth is affecting the finances of a typical American family, RAND Health researchers combined data from multiple sources to depict the effects of rising health care costs on a median-income married couple with two children covered by employer-sponsored insurance. The analysis compared the family’s health care cost burden in 1999 with that incurred in 2009. The take-away message: Although family income grew throughout the decade, the financial benefits that the family might have realized were largely consumed by health care cost growth…. Had health care costs tracked the rise in the Consumer Price Index, rather than outpacing it, an average American family would have had an additional $450 per month — more than $5,000 per year — to spend on other priorities.”

“It may be a little tough to see but there are four lines, showing long-term spending, as a percentage of GDP, on health care, Social Security, discretionary spending, and other mandatory spending. That blue line that shows the sharp increase? That’s health care. As Sarah Kliff noted in response, “Even as someone who spends a lot of time writing about health policy, this new chart … is still one that gives me a bit of pause.” This should matter in the context of the debate in Washington, because if policymakers want to address long-term debt issues, they should at least realize, to borrow Willie Sutton’s line, where the money is.”

“Though as many as 25 million uninsured Americans have pre-existing medical conditions like heart disease and diabetes, a year-old program to insure them has only 21,000 enrollees…. The Government Accountability Office reported that the government has so far spent just 2 percent of the $5 billion allocated by the health care reform law for the program, which launched last summer as the Pre-Existing Condition Insurance Plan. Administration officials initially said as many as 375,000 people would sign up in 2010 alone. The PCIP offers market-rate monthly premiums and caps out-of-pocket costs for any U.S. citizen who has a pre-existing condition and has been without “creditable” health insurance for at least six months. The GAO found that the six-month requirement is the biggest obstacle to higher enrollment in the program.”

“America’s health-care system differs from its counterparts in other affluent nations in a number of ways: greater fragmentation among payers and price-setters, stronger incentives for overuse of advanced diagnostic and treatment technology, higher administrative costs, less access to care for some. We might therefore expect it to perform less efficiently to achieve poorer health outcomes for a given amount of expenditure…. The chart plots life expectancy at birth by per capita health expenditures as of 2007. Twenty affluent nations are included. Among these countries the U.S. spends by far the most money on health care and yet has the lowest life expectancy.”

“Several days ago, I wrote about the ordeal I have been going through trying to move my health insurance from Kentucky to Maryland. Because I had a health insurance policy with Anthem Blue Cross in Kentucky, the local Blue Cross was obligated to offer me what is called a guarantee issue conversion policy that does not require underwriting (a good thing since I have several pre-existing conditions that would otherwise make it difficult for me to obtain health insurance). As I reported earlier, the Maryland conversion policy was almost no insurance at all so one of the options I wanted to explore was what kind of policy CareFirst (the Blue Cross company that serves the Washington, DC metro area, including the Virginia and Maryland suburbs) would offer me if I lived in the District instead of in Maryland. I asked CareFirst to send me the information and when it arrived it was a stunner. We are talking about maybe a 15-mile difference in location and the same company. But the policies were radically different, which CareFirst attributes to insurance laws which vary by location.”