The U.S. health care system is not healthy and Americans are worried. In his State of the Union address last year, President Bush promised to provide Americans with “affordable health care.” Yet, while the United States continues to spend more than any other country on health care, nearly 47 million Americans—a record high—remain uninsured. With the cost of health care a top concern of the American public, the president will likely address the issue in this year’s State of the Union address. But rather than provide solutions that would extend affordable coverage to all Americans, Bush appears ready to re-hash his tired, unpopular proposals for expanding consumer-driven health care and continue his efforts to unravel the employer-based health care system by changing the tax treatment of some employer-sponsored health benefits.
- Americans are paying more and getting less when it comes to health care. Health care costs have skyrocketed 87 percent over the last five years, despite wages increasing just 20 percent. As a result, the number of Americans without health insurance has increased by 6.8 million—to nearly 47 million—under the Bush administration. At the same time, the quality of our care—and the quality of our health—continues to lag. Approximately 70 percent of deaths and health costs in the U.S. are attributable to chronic disease, some of which may be preventable. Yet only half of recommended preventive services are provided to adults.
- The president’s plan to expand health savings accounts (HSAs) will not solve the problem. Health savings accounts disproportionately benefit the wealthy, some of whom use them as tax shelters. The Government Accountability Office (GAO) found “that the average income of HSA users was $133,000 in 2004, compared to $51,000 for all non-elderly tax filers.” Most low-income individuals “do not face high enough tax liability to benefit in a significant way from tax deductions associated with HSAs” and multiple studies have shown that HSAs are likely to increase the number of uninsured and increase health care costs, all while costing taxpayers tens of billions of dollars.
- In the absence of federal action, states have been stepping in to fill the gap. While 2006 saw no movement toward universal health care by the Bush administration, the states made more progress and set off a national debate on health care. In 2006, Vermont and Massachusetts joined Maine in providing near universal coverage to their residents. This month, California Gov. Arnold Schwarzenegger (R-CA) proposed unveiled a $12 billion proposal to extend health coverage to the 6.5 million Californians who currently have no insurance. While some aspects of Schwarzenegger’s proposal raise concerns—particularly whether health care will be truly affordable for lower-income Californians—as a whole, the proposal represents a positive and exciting step in the national debate on health care reform. “I look forward to everyone now having those debates,” Schwarzenegger said.
Daily Talking Points is a product of the American Progress Action Fund.