Rising costs and coming demographic changes threaten the quality and future of health care in the United States and other developed countries.
That was the stark warning from AHA president Raymond J. Gibbons, M.D., FAHA, during his presidential address Sunday afternoon.
?Our ability to reduce death and disability from cardiovascular disease and stroke is threatened by the growing crisis in health care delivery,? Dr. Gibbons said. ?The elephant must be led out of the corner to center stage. We must look beyond short-term concerns in the interest of long-term progress,? said Dr. Gibbons, professor of medicine and co-director of the Nuclear Cardiology Lab at the Mayo Clinic, Rochester, Minn.
The problems with health care are many, he continued. Health care spending continues to rise while research spending falls. Government reimbursement for services to the elderly and the poor have lagged behind cost increases, heading toward disaster.
Less Medicare and Medicaid reimbursement has prompted health care providers to shift costs to nongovernment patients, driving up costs and insurance premiums in the private sector. Higher premiums mean fewer employers are offering health coverage, boosting the number and the percentage of uninsured families and individuals. As the uninsured population rises, reimbursement falls, leading to more cost shifting.
According to Dr. Gibbons, the average family health premium in the U.S. now exceeds $11,500 annually. That is over 250 percent of the 1991 cost, far higher than inflationary increases, he added.
Most small businesses cannot afford to offer health coverage. While 67 percent of large firms offered retiree health benefits in 1988, just 33 percent offer them today, Dr. Gibbons noted. Despite this decline, business health expenditures will top corporate profits by 2008.
The prognosis is poor. Over the next 25 years, the number of Americans over the age of 65 will double. Starting in 2011, 10,000 Americans will turn 65 every day for the next 20 years.
?The time is long overdue for responsible members of the health care community to begin the public discussion that must take place before the public, our patients, our political leaders and we are willing to make the necessary and difficult decisions,? Dr. Gibbons said. ?Minor patches will not work. The required major fix will be painful.?