U.S. health care system headed for perfect storm

Number of uninsured, rising costs, long term care and an aging population could force a major system overhaul, says leading health economist

“We are headed into a time when a confluence of changes are going to lead to a perfect storm, making us finally realize that our health care system needs a major overhaul,” says Timothy D. McBride, Ph.D., leading health economist and professor of social work at Washington University in St. Louis.

Timothy McBride discusses the factors contributing to a perfect storm for the U.S. health care system.

“As the elderly population doubles between now and about 2030, projections are that we will see at least a doubling of the costs of the federal and state health and retirement programs,” he says. “That will likely be when the perfect storm hits. But if we miss it then, we will likely have missed all the storm clouds for the foreseeable future.”

McBride is available to discuss the current state of health care in the U.S. as well as the presidential candidates’ health care plans. Washington University in St. Louis is the site of this year’s vice presidential debate.

Familiar trends associated with the current health care crisis are the high rate of uninsured Americans and rising health care costs. The number of ever-rising uninsured is 47 million or about 16% of the U.S. population. National health expenditures exceed $2 trillion, accounting for 16% of the U.S. economy — more than three times the share health care took in 1960.

“While attention focuses on these two major trends, other storm clouds are brewing,” McBride says. “A long term care crisis looms, grows, and receives little attention, despite problems with the affordability, quality and access to long term care. These problems will only become much worse as the aging population doubles by 2030.

“Much attention also has been paid to the problems of financing Social Security, but the financial problems of the Social Security program pale in comparison to the burden of the Medicare and Medicaid programs on our economy.”

According to McBride, the growth of the elderly population will heighten concerns about the workforce needs in health care. “There are already shortages of nurses, and open nursing positions are sometimes filled by the expensive practice of recruiting migrant nurses into communities,” he says. “Added to this problem now are reports of shortages of other health professionals, including therapists, social workers, health aides and even some categories of physicians.

“Overall, we continue to worry about the general quality of health care as well as the problems of health disparities, as the inequities of our economy and culture flow into the health care system.”


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