Medical expense

“ To build a proper hospital for the sick poor, to supply it with properly qualified nurses, and sufficiently paid medical officers, one must incur initial expense, which is in the end constantly overpaid by eventual economies. My late brother constantly predicted that the changes which he counselled would relieve the rates in the end, and his prediction was constantly verified. The reader will find these facts illustrated in the pages which follow. A genuine reform is a sensible saving. ”

“ Diseases of the heart and blood vessels afflict some thirty million Americans. Each year cardiovascular disorders claim nearly one million lives and cost our economy nearly forty-eight billion dollars in lost wages, lost productivity, and medical expenses. ”

“ Half of all personal bankruptcies are caused in part by medical expenses. By significantly increasing health insurance coverage, the requirement, together with the other provisions of this Act, will improve financial security for families. ”

“ The current concern about the cost of medical care and resorting to government-run insurance programs and regulations will do little or nothing to reverse the trend to more and more sickness that costs more and more to treat. ”

“ The system of prepaid medical care which I have recommended is expected eventually to require amounts equivalent to 4 percent of earnings up to $3,600 a year, which is about the average of present expenditures by individuals for medical care. The pooling of medical costs, under a plan which permits each individual to make a free choice of doctor and hospital, would assure that individuals receive adequate treatment and hospitalization when they are faced with emergencies for which they cannot budget individually. ”

“ In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. ”

“ Like many of you, I've been appalled by tragic and repeated stories of men and women fighting for their lives and, at the same time, forced to fight insurance companies focused not on getting them the medical care they need but on cutting costs even if it denies that medical care. ”

“ It should be accompanied by a system of government insurance, whereby all classes who desire to be thrifty may pay a small annual premium in the days of health, and secure adequate hospital treatment and care when ill. Provided that pay wings were added to the existing voluntary and municipal hospitals, it should be found that the relatively small annual premium of £3 per annum should enable the policyholders to defray the cost of medical treatment in a pay ward or at a consultation department of a great hospital as a matter of business. ”

“ And it is hardly just the currently sick or injured among the uninsured who prompt elevation of the price of health care and health insurance. Insurance companies and health- [p594] care providers know that some percentage of healthy, uninsured people will suffer sickness or injury each year and will receive medical care despite their inability to pay. In anticipation of this uncompensated care, health-care companies raise their prices, and insurers their premiums. ”

“ In the absence of the requirement, some individuals would make an economic and financial decision to forego health insurance coverage and attempt to self-insure, which increases financial risks to households and medical providers. (B) Health insurance and health care services are a significant part of the national economy. National health spending is projected to increase from $2,500,000,000,000, or 17.6 percent of the economy, in 2009 to $4,700,000,000,000 in 2019. ”

“ The rich should be able to obtain the best medical and surgical services only in or from the hospitals, and should be charged in proportion to their means, the fee going to the hospital, not to the physician, who should have a fixed salary. ”

“ See id., at 115 (Table 34) (In 2009 alone, 64% of adults made two or more visits to a doctor's office.) .
When individuals make those visits, they face another reality of the current market for medical care: its high cost. In 2010, on average, an individual in the United States incurred over $7,000 in health-care expenses. Dept. of Health and Human Services, Centers for Medicare and Medicaid Services, Historic National Health Expenditure Data, National Health Expenditures: Selected Calendar Years 1960– 2010 (Table 1) . Over a lifetime, costs mount to hundreds of thousands of dollars. ”

“ It is true that in recent years there has been a rapid development, in some of the larger cities, of medical insurance clubs conducted by private companies, with dues of ten cents weekly. They give medical care in ordinary cases, but require extra payments for surgical treatment and for medical supplies. ”

“ It is estimated that the American people pay $2 billion per year in medical bills directly attributable to the treatment and diagnosis of asthma and allergic diseases and another $2 billion per year as a result of the indirect social costs of such illnesses. ”

“ More than half a million of those who have a heart attack will die this year, and the economic cost to the Nation in direct medical costs, lost work days, and lost production is estimated to be in excess of ten billion dollars annually. ”

“ In cases coming under Number 1 there is given free medical treatment; sick money—that is, money during period of sickness with which to obtain medicine, nourishment, etc.—or, if desired, free treatment in a hospital and support for the family; and money, in case of death, is supplied the family. The fund is furnished by employers and employed—the former paying one-third, the latter two-thirds. In cases of accident insurance the parties receive support during convalescence, from the fourteenth week after the accident happens. ”

“ If we had only a limited number of patients, we should be obliged to make the charges commensurate with our expenses; but our practice having become very extensive, and the income being correspondingly large, we are enabled to make the rates at the Invalids' Hotel and Surgical Institute so moderate that all who desire can avail themselves of its medical, surgical, and hygienic advantages. ”

“ As a consequence, medical-care providers deliver significant amounts of care to the uninsured for which the providers receive no payment. In 2008, for example, hospitals, physicians, and other health-care professionals received no compensation for $43 billion worth of the $116 billion in care they administered to those without insurance. ”

“ One out of every four dollars we spend on health care is swallowed up by administrative costs - on needless paperwork and antiquated record-keeping that belongs in the last century. This failure to update the way our doctors and hospitals store and share information also leads to costly errors. Each year, 100,000 Americans die due to medical errors and we lose $100 billion because of prescription drug errors alone. ”

“ On health care reform, we still have much work ahead of us. I applaud the House of Representatives for passing a prescription drug benefit for seniors, and for its efforts to fix the nation's badly broken medical liability system, which is driving up the cost of medicine and driving good doctors out of the profession. ”

“ Because of crushing health care costs and the fact that they drag down our economy, bankrupt our families, and represent the fastest-growing part of our budget, we must make it a priority to give every single American quality, affordable health care. That's why this budget builds on what we have already done over the last month to expand coverage for millions more children, to computerize health records to cut waste and reduce medical errors, which save, by the way, not only tax dollars, but lives. ”

“ While sickness, like taxes, visits every family no matter where it lives, we have found that we actually have less need of medical care living in the sticks than we did in town. Also the charges for competent care by both doctors and dentists are lower. ”

“ Bishop Harman, an ophthalmic surgeon, and a member of the Council of the British Medical Association, says:
“In my out-patient clinic 60% of the patients are insured persons who attend for treatment that is essential to their industrial efficiency.... A scheme of medical benefit which does not provide for specialist service and for institutional treatment is no scheme, it is poorer in status than the Poor Law provision which does all these things.” ”

“ Plans should be evolved to improve protection against the costs of prolonged or severe illness. These measures will help reduce the dollar barrier between many Americans and the benefits of modern medical care. ”

“ On cross-appeals from the decision of the Tax Court, the Court of Appeals held, by a divided vote, that the full rental payments were deductible as expenses for 'medical care' within the meaning of § 213. ”

“ The economic drain on our resources in the form of direct medical costs and lost wages and production will exceed $60 billion.
Since 1948, the United States Public Health Service and a private voluntary organization, the American Heart Association, have joined in a concerted effort to combat cardiovascular diseases. ”

“ Right now, two out of every ten patients account for more than eighty percent of all health care costs. These are patients with serious illnesses like cancer or heart disease who require the most expensive surgeries and treatments. Insurance companies end up spending a lion's share of their expenses on these patients, and not surprisingly, they pass those expenses on to the rest of us in the form of higher premiums. ”

“ EVALUATION- For 2011 and periodically thereafter, the Secretary shall evaluate and revise the risk adjustment system under this subparagraph in order to, as accurately as possible, account for higher medical and care coordination costs associated with frailty, individuals with multiple, comorbid chronic conditions, and individuals with a diagnosis of mental illness, and also to account for costs that may be associated with higher concentrations of beneficiaries with those conditions. ”

“ Howarth, Medical Officer of Health of the City of London, and Dr. B. A. Richmond, Secretary of the London Panel Committee, affirm “the limitation of medical benefit to insured persons alone cannot continue. Another service has been added to the many competing classes of state treatment”; and they bring out the fact that personal contributions of insured persons are swallowed up in supplying the sickness and disablement benefit, and contribute nothing to the cost of the sanatorium benefit, maternity benefit, or medical benefit. ”

“ The term ``health benefits ́ ́ means medical, surgical, hospital, prescription drug, and such other benefits as shall be determined by the Secretary, whether self-funded or delivered through the purchase of insurance or otherwise. ”

“ The medical profession is a belated profession. We cannot collect a fee by statute under certain conditions—as when the call comes from a third party. We must have money. What is there left to do? Graft! Or ‘commercialize.’ That’s a nicer name for it. Let’s see now just what the public brings on its own head.
“There’s a man who thinks it is necessary that his leg comes off. He has nerved himself for the operation and has announced his willingness to pay, say $250. A conscientious surgeon examines the leg and saves it without the use of a knife and the man recovers the use of it. ”

“ But when we consider, on the other hand, that sickness deprives men of the means of acquiring money; that it increases all the expenses of living; and that high charges often drive patients from regular-bred physicians to quacks ”

“ And tonight I propose that individuals who buy catastrophic health care coverage, as part of our new health savings accounts, be allowed to deduct 100 percent of the premiums from their taxes.
A government-run health care system is the wrong prescription. By keeping costs under control, expanding access, and helping more Americans afford coverage, we will preserve the system of private medicine that makes America's health care the best in the world.
We are living in a time of great change - in our world, in our economy, and in science and medicine. ”

“ And I ask tonight for record expenditures for the program that helps children born into want move into excellence, Head Start.
Step six, we must reform our health care system. For this, too, bears on whether or not we can compete in the world. American health costs have been exploding. This year America will spend over $800 billion on health, and that is expected to grow to 1.6 trillion by the end of the decade. We simply cannot afford this. The cost of health care shows up not only in your family budget but in the price of everything we buy and everything we sell. ”

“ Funding.—The costs to fiscal intermediaries or medicare administrative contractors conducting the medical necessity reviews under paragraph (1) shall be funded from the aggregate overpayments recouped by the Secretary of Health and Human Services from long-term care hospitals due to medically unnecessary admissions and continued stays. The Secretary may use an amount not in excess of 40 percent of the overpayments recouped under this paragraph to compensate the fiscal intermediaries or Medicare administrative contractors for the costs of services performed. ”

“ In 1883 sickness insurance was organized, being made compulsory for all persons with incomes under $500; the expense is borne one-third by the workers and two-thirds by employers, the main purpose being to secure a sufficient relief—amounting to one-half the wage—for a period of thirteen weeks. ”