Every presidential candidate is talking about health care in one way or another. The Republican position is to repeal the Affordable Care Act; Hillary Clinton’s is to expand the ACA; and Bernie Sanders would replace the ACA with a “Medicare for all” program.
But, according to Kaiser Health News, none of them are talking about five issues that bring a lot of grief to a number of people, because of the challenges they present.
Out-of-pocket spending is out of control, if you ask most people; employers have been slowly (or not so slowly) and steadily shifting the increasing costs of health care coverage to employees, and it’s not as if people don’t feel the difference in their wallets. Premiums, deductibles, and the patients’ share of medical bills are all on the rise. Then there are the bills for out-of-network services that patients did not know were out of network when the services were provided.
Then there are drug issues. Martin Shkreli’s appearance before Congress about the 4,000 percent increase in Turing Pharmaceutical’s Daraprim may have been the most egregious example of the increases that patients have encountered when seeking treatment, but it’s far from the only massive drug price increase to hit the headlines.
The flip side of that is the length of time that drugs take to get to market. Patients desperate for a new option for treatment say that the approval process is too slow, but there are plenty of examples of drugs that were rushed to market only to make headlines a few years — or even months — later when they prove to be the cause of other serious health problems.
The cost of long-term care (LTC) is another issue that’s not getting enough attention. Medicare doesn’t pay for it, Medicaid will — but only if you’re a step away from indigent — and private LTC insurance can be prohibitively expensive. In addition, as costs for LTC rise, many insurers exit the market or raise premiums beyond people’s ability to pay.
The long-term health of another program — Medicare — is another issue candidates haven’t addressed much, either. While Medicare accounts for 14 percent of all federal spending, and costs look likely to climb as more and more boomers hit the age at which they start spending more on health care, Republicans are talking about privatizing the program that pays for all these medical expenses. That would put the onus on private insurers to handle any price increases in care. Other Medicare issues, while not so sweeping, also have an outsize effect on beneficiaries and providers.
And last but not least is dental care. People in this country are dying from lack of access to dental care; neglected dental issues can snowball into such conditions as heart disease, diabetes, and Alzheimer’s disease — not to mention infections that can begin in the mouth and spread to other parts of the body. Dental insurance is uncommon and doesn’t cover very much, leaving both children and adults without the protection that regular dental care could bring.
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