Every January, The New Falcon Herald editorial team focuses on health care issues that affect a vast number of people. In the name of tradition, this month, we cover health-related topics such as food safety, salt vs. no salt, a unique chiropractic method and a personal review on the Fitbit. Also, Kathy Hareís book review this month is all about medicine: too much or too little. And Robin Widmar in her article for the Fire Protection District covers cancer in firefighters.We canít talk about health care without mentioning the system itself ó a system that is inarguably draining government and private pocketbooks. And weíve been talking about health care costs and access for decades!Reviews of the Affordable Care Act, otherwise known as Obamacare, have been mixed. The ACA was enacted in 2010 to provide subsidies to people who could not afford health care; at the same time, the act mandated that all citizens must be covered by insurance.A Gallup poll showed that in 2008, 14.6 percent of Americans did not have health insurance. In the third quarter of 2013, just before the ACA, 18 percent of Americans did not have coverage. By the first quarter of 2016, those without insurance declined to 11 percent, according to Gallup. Those who seem to have benefited the most under the ACA are middle-to-low income Americans, especially those with chronic diseases who were unable to get coverage prior to the ACA because of pre-existing conditions.There is a problem, however, when people who rely on employers for their insurance are experiencing substantial increases in their premiums, while getting less for their buck.Out-of-pocket costs this year will hit $350.1 billion, and are expected to rise to $555.8 billion during the next decade. Part of this is occurring because employers are shifting medical costs to employees through high deductible plans.According to the Kaiser Family Foundation, in 2008, high deductibles were not as high and not as common. In 2008, 18 percent of covered workers had deductibles of at least $1,000 (up from 10 percent in 2006). For small-business employees, 35 percent had deductibles of $1,000 or more (increased from 16 percent in 2006). In 2016, the high-deductible plan is standard: 51 percent of all covered workers and 65 percent of small-business workers incur deductibles of $1,000. For workers at firms with 200 or more employees, the average deductible is $1,238. Those working in small businesses pay an average deductible of $2,069.A PBS July 13 article published the latest statistics from the U.S. Department of Health and Human Services. National health expenditures will rise to $3.35 trillion this year, or $10,345 each for ìevery man, woman and child.î The per-person figure is on average, but the truth is that 5 percent of the population accounts for almost half of health care spending in any given year, according to the article. And about half the population has little to no health care expenses, accounting for only 3 percent of health care spending. Hospital care accounts for 32 percent of the $3.35 trillion.Baby boomers are expected to drive up Medicare and Medicaid costs; by 2025, government health care spending will be at 47 percent.Medical costs continue to outpace inflation, and many of us have experienced first-hand some of the reasons that medical costs are soaring.For example, medical providers are paid on a fee-for-service system that reimburses each test, procedure, etc. Many doctors tend to order unnecessary tests; and, depending on insurance plans, some doctors donít do enough preventive type testing. Our system does not reward efficiency.Chronic illnesses and obesity, combined with an aging population, contribute to burgeoning costs.We have no way of knowing the real costs behind treatment modalities. Once in a while, we hear something on the news mainly about the outrageous, growing prices for pharmaceuticals; which is a topic itself. A lack of overall transparency regarding medical treatment costs keeps consumers in the dark, allowing for willy nilly price gouging.Also, as insurance carriers consolidate, competition lessens among them ó many insurers are also leaving ACA markets.There is only one thing we can do. Take responsibility for our own health. The health care industry is like anything else: If we donít buy the products, they either go out of business or significantly decrease their prices. And if we donít buy or use the product, the insurance companies wonít have to pay as much; and just maybe our premiums will go down ó all in a perfect world, right?Hereís to your health in 2017!– Michelle
