We did not get significant healthcare reform with the PPACA, or as it is pejoratively known by the Republicans—Obamacare. The ideas were generally good ones, but the law was fundamentally hamstrung from the beginning by the twin failures of not being able to gain control of the American Trial Lawyers Association and therefore of malpractice suits which resulted in defensive medicine as usual, and of not gaining any leverage against the financially rapacious big insurance companies; so, healthcare insurance premium costs for the majority of employed people went up very substantially; in many cases the costs tripled.
Politics notwithstanding, we cannot afford or sustain our present nonsystem of healthcare. Healthcare is 17.1% of the GDP and is the most important driving force of the national debt—the total amount of money the U.S. government has borrowed—and the national deficit—which is a measure of any single year’s federal financial shortfall, the difference between what the government takes in from taxes and other revenues, called receipts, and the amount of money it spends, called outlays. The items included in the deficit are considered either on-budget or off-budget, and debt is the accumulation of deficits over the years. Total debt also includes off-budget surpluses. The on-budget deficits require the U.S. Treasury to borrow money to raise cash needed to keep the government operating. It borrows the money by selling securities to the public, also borrows from lending institutions and nations. About 61% of the U.S. national debt is owned by China. The deficit hit a maximum of $1.41 trillion in 2009 during the Great Recession, due to a fall-off in tax revenues and an economic stimulus aimed at jump-starting the economy. It gradually declined somewhat, but still stayed at levels of more than $1 trillion in 2010, 2011 and 2012. The nonpartisan Congressional Budget Office said those years marked the largest budget deficits relative to the size of the economy since 1946. The projected national debt for 2016 will be $20.2 trillion, and the yearly interest required to maintain national solvency is expected to be $227 billion by the end of 2015, more than double to $480 billion by 2019, and more than triple to $722 billion by 2024. Medicare liability alone is $28.1 trillion. Suffice it, we are in an endless struggle to pay the interest on our debt; we make no effort whatever to pay down the ruinously high principle.
Average annual projected growth of healthcare costs of 6.2 percent per year is projected for 2015 (beginning at~$2.5 trillion) through 2022, largely as a result of the continued implementation of the ACA coverage expansions, faster projected economic growth, the aging of the population, and the end of the sequester. One of the worst aspects of this mountain of healthcare related debt is that a serious proportion of those costs are preventable without degrading the quality of care received by the consumers. In the next blogpost in this series, I will quote from my book, Another Whistleblower. The book is fiction, but I purposefully included a finishing section off nonfiction to let my readers know how real and how serious this particular debt problem is.