40 Alarming Statistics on American Health Insurance

Did you know that the United States is the only advanced industrialized country in OECD (also known as Organization for Economic Cooperation and Development) that does not operate under a universal healthcare system? As premium cost escalates each year, you may wonder if your annual insurance premium truly put towards patient care. Here are 40 alarming statistics on American Health Insurance you may want to know.

1. In 2016, 292.3 million individuals in the United States have subscription a form of health insurance:
   1. 5% of the population are subscribing to private health insurance
   2. 3% of the population are subscribing to public health care insurance (e.g. Medicare and Medicaid)
   3. 7% of the population are covered by employer-based insurance (Centers for Disease Control and Prevention)
2. Of the 37.3% of population subscribing to public health care insurance:
   1. 4% are subscribing to Medicaid
   2. 7% are subscribing to Medicare
   3. 2% are subscribing to open Marketplace direct-purchase plans
   4. 6% are covered by military plans

(United States Census Bureau)

3. 35% of Americans do not realize that Obamacare and Affordable Care Act (ACA) are the same. (New York Times)
4. Before the initiation of ACA (a.k.a. Obamacare), there were 57 million Americans who do not have health insurance coverage. After the initiation of ACA, by the end of 2016, there were only 27 million of Americans without health insurance (8.8% of the population). This is the lowest rate ever witness in history of the United States. (United States Census Bureau)
5. As of 2017, there were 28 million Americans without coverage resulting from government policy changes and insurance companies increasing the premium costs. (Henry J. Kaiser Family Foundation Research)
6. As of 2016, Medicare spent $646 billion and Medicaid spent $545 billion on American individuals who subscribe to public health care insurance aid. (Agency for Healthcare Research and Quality)
7. According to the statistics of American spending in 2016, $164 billion dollars were spent on paying premium fees. (United States Census Bureau)
8. In 2017, 43% of the American population cannot afford health care even if they have subscription to public insurance coverage. (Washington Post)
9. The average American has 4 doctor visits per year. The number is much lower compared to other OECD countries:

Rank	Country	Average Annual Doctor Visit Frequency
1	Korea	16.000
2	Japan	12.700
3	Hungary	11.800
4	Slovak Republic	11.400
5	Czech Republic	11.100
6	Germany	10.000
7	Turkey	8.400
8	Netherlands	8.200
9	Canada	7.700
10	Australia	7.600
11	Spain	7.600
12	Poland	7.400
13	Belgium	6.800
14	Italy	6.800
15	Slovenia	6.800
16	Austria	6.600
17	Estonia	6.400
18	France	6.300
19	Iceland	5.900
20	Latvia	5.900
21	Ireland	5.800
22	Latvia	5.900
23	Ireland	5.800
24	Luxembourg	5.800
25	Denmark	4.300
26	Finland	4.300
27	Norway	4.300
28	United States	4.100
29	Chile	3.400
30	Sweden	2.900
31	Mexico	2.700

(OECD)

10. In 2017, 4.4% of the population failed to receive medical care due to high medical cost. (National Center for Health Statistics)
11. The average American couple who retire at age 65 can anticipate to pay an average of $260,000 out of pocket healthcare fees in their retirement years.
12. 20% of the annual medical-related bankruptcy filings are composed of individuals aged 55 and over. (debt.org)
13. 40% of American adults do not have enough immediate funding to cover an emergency medical expense of $400. (Board of Governors of the Federal Reserve System)
14. In 2017, more than 25% of American adults skipped their annual medical examination because they cannot afford it. (Washington Post)
15. Every year in the United States, healthcare expenses is the #1 cause of bankruptcy filing. More than 1 million individuals file for bankruptcy due to inability to pay for their medical bills in 2017. (Henry J. Kaiser Family Foundation Research)
16. Survey studies have shown that insured individuals have a slight higher frequency of declaring medical-related bankruptcy (3%) than uninsured individuals (1%). (Henry J. Kaiser Family Foundation Research)
17. 1% of the American population do not have any health insurance. (Henry J. Kaiser Family Foundation Research)
18. 4 million individuals are ineligible for coverage due to immigration status. (Henry J. Kaiser Family Foundation Research)
19. Of the population without insurance, 4.4% of the population cannot obtain any coverage due to high cost of premium. (National Center for Health Statistics)
20. 5 million individuals across America are ineligible for financial assistance due to ESI offer such as employment state insurance. (Henry J. Kaiser Family Foundation Research)
21. 3 million individuals in the United States are ineligible to qualify for Medicaid yet they earn too little to qualify for ACA subsidies. (Henry J. Kaiser Family Foundation Research)
22. Within the population that do that have any type of health insurance:

• non-Hispanic White people have the lowest rate at 6.3%.
• Hispanics have the highest rate at 16%.
• Blacks have uninsured rate of 10.5%.
• Asians have uninsured rate of 7.6%. (National Center for Health Statistics)

23. 114 million Americans do not have dental health care coverage. (National Association of Dental Plans)
24. Every year, an average of 738,000 Americans have to seek emergency care due to dental-related problems. (National Association of Dental Plans)
25. In the beginning of 2017, there are 41.9% of children between the age of 0 to 17 years old that seek public health coverage and 4.9% were uninsured. 54.6% were able to receive private health insurance coverage.
26. Texas has consistently rank as having the highest uninsured rate of 26.3% in adult Americans between age 18 to 64. Whereas New York has consistently rank as the lowest with only 7.2% of uninsured rate in 2017. (National Center for Health Statistics)
27. Even though Obamacare has drastically lower uninsured individuals rate, states that are heavily leaning towards Republic views have suffered the worst coverage gap problems due to states’ refusal to expand Medicaid. The top 10 states to face this problem are:
    1. Texas (1,046,430)
    2. Florida (763,890)
    3. Georgia (409,350)
    4. North Carolina (318,710)
    5. South Carolina (194,330)
    6. Missouri (193,420)
    7. Alabama (193,320)
    8. Virginia (190,840)
    9. Tennessee (161,650)
    10. Oklahoma (144,480)

(Kaiser Family Foundation Research)

28. In 2017, more than 25% of American adults skipped their annual medical examination because they cannot afford it. (Washington Post)
29. Medical correlation studies have shown that individuals without health insurance are 40% more likely to die than individuals who have subscriptions to private health insurance. (National Center for Health Statistics)
30. In 2017, 50 % of voters continues to support Obamacare. 31% of voters want Republicans to continue their effort in repealing ACA. 18% wants the government to move onto other more important issues. And 41% want the government to work to improve the existing Obamacare healthcare system instead. (Politico)
31. Only 5% of the American population account of half of the countries healthcare insurance claims and spending. These individuals tend to be in older age groups and suffer from more than 1 chronic health conditions such as diabetes, heart disease, high blood pressure, obesity, and lung disease. It has been estimated that $623 billion went towards paying for these individuals in the year of 2009. (The Atlantic)
32. Health insurance companies receive tax breaks under the federal law. Every year, the government is estimated to lose at least $260 billion by not taxing these companies. In 2016, insurance companies were required to pay approximately 35% corporate tax from their profits. But due to the new reform in Republican health 2017, the tax rate has been cut to only 20%. (Axios)
33. Health insurance companies have declared their spending of 87% of all premiums on patient care. The rest of the premium goes into customer service, administrative cost, and technology advancement. However, it has been found that the 6 largest providers are actually spending approximately 82% of the premium on patient care (ABC News)
34. It has been found that individual policy subscribers of private providers receive the least benefits (66 cents of every premium dollar) versus individuals who subscribe to group policies (average of 74 cents per premium dollar). (ABC News)
35. It has been estimated that health insurance companies make an average profit margin of 3.2% from the premium fees as the ACA Tax Provisions MLR guidelines demands all health insurance providers to use the majority of premium back on patient care. (Center for Economic and Policy Research studies)
36. Compared to insurance providers, other health sectors have a significantly large profit margins:
    1. Hospital care and service: 3.7%
    2. Medical equipment: 9.5%
    3. Medical supplies and instruments: 12.5%
    4. Drug manufacturers: 20.8%

(Vox)

37. It has been estimated that private insurance providers utilize between 12 – 18% of the total premium on administration costs. In comparison, Medicare only uses 2% on administrative costs. (Politifact)
38. Based on the Center for Economic and Policy Research studies, the average overhead spending of various forms of private insurance providers from 2010-2015 were:
    1. Private Insurance Providers: 18.8%
    2. Combined Private Providers: 13.1%
    3. Private Individual and Employer-based Providers: 12.3%

(Center for Economic and Policy Research Studies)

39. It has been estimated that when all forms of private insurance providers’ overhead combined, an average of $143 billion was wasted per year between 2010 – 2015 on administrative costs. (Center for Economic and Policy Research Studies)
40. If the United States were to switch to universal public healthcare system, the overhead spending would decline to $20 billion or less each year. This would save the country at least $100 billion annually. (Center for Economic and Policy Research Studies)

As the average annual health premium cost rose to $18,764 in 2017, it is truly a puzzle whether Americans are truly receiving the quality health care they deserve. Even though private health insurance providers are not totally forthcoming with their premium fee distribution and possibly taking in extra billions of dollars annually, the statistics of other healthcare sector margin profits highlight the great money pits in the United States healthcare system. Perhaps it is not the insurance sector that is gouging the pockets of Americans after all. Then what are the reasons for the outrageous expenses in the United States healthcare system?