Find out the impact of the US healthcare system and the health of Americans to our costs and lifespans. Watch and get the facts.
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00:00Hi, I'm Steve Ballmer.
00:02I spent 34 years growing Microsoft,
00:0510 years owning the L.A. Clippers basketball team.
00:08I love computers, data, and facts.
00:11That's why I started USAFacts,
00:14to help understand what our government is up to
00:17and what's going on in America.
00:19I'll share with you the facts and data,
00:22all from our government.
00:24You make up your own mind.
00:26In this episode of Just the Facts,
00:28health and healthcare.
00:31But first, a quick disclaimer.
00:33As I talk, I do a lot of rounding of numbers,
00:36but the data you see on screen will be more exact.
00:40Things might have changed since I recorded this in mid-June.
00:43I can't predict the future,
00:45but I'll be reading about it when it happens.
00:48So now, let's roll.
00:51I think we can all agree that good health
00:53is one of the most important things in life.
00:56This leads me to ask,
00:57how are Americans' physical and mental health?
01:00And how's our healthcare system working for us?
01:03We'll focus on the facts.
01:05You make your own prognosis.
01:07There's a lot to chew on.
01:12Let's start here.
01:13America's getting older.
01:15And thankfully, so am I.
01:17The median age in the U.S. was only 30 years old in 1980,
01:2235.3 in 2000,
01:25and 38.9 in 2022.
01:28In 2022, 3.28 million Americans died,
01:32about 1% of our total population.
01:35Nearly 3.67 million people were born.
01:39And here are the top causes of death per age bracket,
01:42as reported for 2022.
01:44Out of 69 million children ages 1 to 17,
01:48just over 16,000 died.
01:50About 4,900 of those were from accidents,
01:54unfortunately 2,100 by homicide,
01:57and 1,600 by suicide.
01:59Out of 120.5 million people ages 18 to 44,
02:04215,283 died.
02:0783,000 of those were from accidents,
02:11including accidental drug overdoses,
02:1422,000 by suicide,
02:1617,000 from heart disease,
02:19and 16,000 by homicide.
02:22Of roughly 82.5 million people ages 45 to 64,
02:27just over 600,000 people died.
02:30Around 138,000 people died from cancer,
02:34118,000 from heart disease,
02:3765,000 from accidents,
02:40and 34,000 from COVID.
02:43Among the 51.3 million people ages 65 to 84,
02:48just under 1.5 million died,
02:51around 350,000 of those from cancer,
02:54319,000 from heart disease,
02:57and 93,000 from COVID.
03:00And out of nearly 6.5 million Americans over 85,
03:05933,000 people died,
03:08around 249,000 of those from heart disease,
03:12102,000 from cancer,
03:15and 73,000 from Alzheimer's.
03:19The conclusion from all of this,
03:21accidents are the leading cause of death
03:24between age one and 44,
03:27then cancer takes over at 45,
03:29with heart disease a close second,
03:32and finally, at 85 plus,
03:35heart disease is number one.
03:37Let's dig into the leading causes of death.
03:40COVID emerged in 2020
03:42and reached its peak in early January 21,
03:45with almost 26,000 deaths per week.
03:49But as of July 2024,
03:51it's down to only 600 deaths per week.
03:55Now let's look at accidental deaths.
03:57Unfortunately, they have been increasing
03:59over the last decade,
04:01totaling over 227,000 in 2022,
04:05and accounting for 7% of total deaths.
04:09Accidental poisonings, which include drug overdoses,
04:12represent 45% of all accidental deaths.
04:18The leading causes of overdoses are fentanyl and meth,
04:21with fentanyl overdoses alone
04:24growing from just over 3,000 in 2010,
04:2774,000 in 2022.
04:31One category of accidental deaths
04:33has improved with time.
04:35In 1970, there were over 52,000 vehicle deaths.
04:39And even though the U.S. population
04:41has grown by 130 million people since then,
04:44and the number of miles driven has nearly tripled
04:48from about 1.1 trillion miles to 3.2 trillion,
04:52vehicle deaths actually dropped
04:55to just over 42,000 in 2022.
04:58Overall, Americans are living longer,
05:01which brings us to Alzheimer's.
05:03As of 2023, 6.7 million Americans over age 65
05:08had been diagnosed with it.
05:10We also hear a lot about firearm-related deaths,
05:13and there were 48,000 of them in 2022,
05:16including gun accidents.
05:1855% of suicides were committed by gun,
05:22and 79% of homicides were by gun.
05:26What about active shooter incidents,
05:28defined by the FBI as one or more individuals
05:31actively engaged in killing or attempting to kill
05:35people in a populated area?
05:37This includes mass shooting,
05:39and account for just 100 of the total
05:4148,000 gun deaths in 2022.
05:45This does not include gang violence
05:47or drug-related violence.
05:49Firearm deaths accounted for 1.2% of all deaths in 1999
05:55and grew to 1.5% in 2022.
05:58Let's shift gears.
06:00Let's look at key health risk factors,
06:03smoking, drinking, obesity.
06:06First, smoking, which causes strokes,
06:08heart disease, and lung cancer.
06:11In fact, it's connected with about 90%
06:14of all lung cancer deaths,
06:16the most common cancer type,
06:18and accounted for about 130,000 deaths in 2022.
06:23Fortunately, the share of adults smoking tobacco
06:26keeps declining,
06:28falling below 14% in 2022.
06:31Next up, drinking.
06:33Alcohol misuse,
06:35including repeated episodes of binge drinking,
06:38contributes to liver disease,
06:41as well as an increased risk of head, neck, esophageal,
06:46liver, breast, and colorectal cancers.
06:50In 2022, the government characterized
06:53almost 17% of adults as binge drinkers.
06:56The next risk factor is obesity,
06:59which can contribute to higher rates of cancer,
07:02heart disease, and diabetes.
07:04Obesity is defined for an adult
07:07as having a body mass index of 30 or higher.
07:11Take me, for example.
07:12I'm 5'11 and weigh 210 pounds,
07:16and my body mass index is 29.3.
07:20Unfortunately, obesity among American adults
07:24increased from 15.8% in 1995
07:29to 33.6%.
07:32Wow.
07:33How common is mental illness?
07:35Around 34% of young adults ages 18 to 25
07:41had a mental illness.
07:43For adults ages 26 to 49, it was 28%,
07:49and adults 50 or older, 15%.
07:52Now let's go through who's insured and who isn't,
07:55where does all the healthcare spending go,
07:58how much of it comes directly out of your pocket,
08:01and who picks up the rest of the tab.
08:03About 92% of Americans, or 304 million people,
08:08had health insurance in 2022.
08:11Private insurance covered over 216 million people,
08:1566% of the total.
08:17Public insurance covered 119 million people.
08:21That's 36% of the total.
08:23It adds up to more than 304 million
08:26because people can be on more than one insurance plan at a time.
08:30The uninsured rate dropped from 16% in 2010
08:34to 8% in 2022.
08:372010 was the year the Affordable Care Act,
08:40also known as Obamacare, passed,
08:42but there could be many factors explaining
08:45the decrease in the uninsured rate.
08:47In total, this leaves about 26 million people
08:50with no health insurance.
08:52Now let's turn to health spending.
08:54That accounts for 17.3% of America's gross domestic product,
09:00$4.5 trillion.
09:04On average, Medicare spends about $15,400
09:09for every enrollee,
09:11Medicaid, $9,200 per enrollee,
09:16and private health insurance, $6,600 per enrollee,
09:21and CHIP, which is a program for children, $3,400 per enrollee.
09:28Of the $4.5 trillion in health spending,
09:31$3.7 trillion was spent on personal health care,
09:36while $760 billion was spent on things like public health,
09:40health research, health care facilities,
09:43medical equipment,
09:45and the cost of running health insurance programs.
09:48Private health insurance accounted for 31%,
09:51or $1.2 trillion,
09:53of all the personal health care spending in the United States,
09:56followed by Medicare at 24%, or $870 billion,
10:01and Medicaid at 19%, or $710 billion.
10:06The last 13%, which is about $470 billion,
10:10was all paid by us out of our pocket.
10:13It includes our co-pays, deductibles,
10:16stuff we buy at drugstores.
10:18It does not include monthly premiums,
10:21which we'll talk about later.
10:22So where did all this money go?
10:25Hospitals accounted for 37%,
10:28physician and clinical services are 24%,
10:32and then prescription drugs were only 11%.
10:36The average amount spent on health care per person per year
10:41went from $3,000 plus in 1980
10:46to more than $11,000 in 2022.
10:50One factor, the 65-plus population,
10:53went from nearly 26 million people in 1980
10:57to over 57 million in 2022.
11:01This does not mean people are paying $11,000 a year.
11:06On average, just over $1,400 of that came out of our pockets,
11:11not accounting for the premium.
11:13Most of out-of-pocket spending
11:15is on what are called non-durable medical products at 24%.
11:20That's $339.
11:22It's up 180%.
11:24Next is physician and clinical expenditures out of our pockets,
11:29then dental services, prescription drugs,
11:33nursing care facilities, hospital care,
11:36and durable medical equipment like crutches.
11:39We are spending more than ever on prescription drugs,
11:42but individuals are paying a lower percentage of it
11:45out of our own pockets.
11:46Between 1980 and 2022,
11:49Americans went from spending $135 to $170
11:54out-of-pocket per person per year,
11:57and then insurance pays the rest.
11:59This really surprised me
12:01given all of the discussion of drug prices.
12:05Now let's talk about premiums.
12:07Americans shell out $760 billion in premiums each year
12:12to private and government insurance programs.
12:15Of this, employees paid around $300 billion in premiums.
12:20People who get insurance through the health exchanges
12:22established by the Affordable Care Act pay $70 billion.
12:26Americans pay into Medicare
12:28both while they're working through payroll taxes
12:32and also through premiums that you pay
12:35once you start receiving Medicare benefit.
12:38Combined, that amounts to $339 billion a year.
12:42And some people have additional forms
12:44of property and casualty insurance
12:46covering some health care costs
12:49amounting to nearly $43 billion.
12:52Add these premiums to the other out-of-pocket costs
12:56and American households pay $1.2 trillion
13:00into the health care system.
13:02That equals just under $3,700 per year,
13:07per person, for every person in the country.
13:10What about the insurers themselves?
13:12For this, let's look at the administration costs.
13:15The total administration and net costs
13:18of all insurance programs in 2022 was $334 billion.
13:23Medicare had the highest administrative costs,
13:26with Medicaid close behind,
13:28and private insurance was just $644.
13:32This really interested me,
13:34given how much discussion there is
13:37about how private insurance companies' profits and costs
13:41are driving health care costs.
13:43Let's do a fact check.
13:45Adding this all together,
13:47in 1987, households paid 37% of health care costs.
13:52Today, they pay 28%.
13:55Private companies paid 23%,
13:58but today pay 18%.
14:01State governments paid and still pay 15%.
14:05And the federal government
14:07went from 17% of the total in 1987
14:10to 33% today,
14:13the largest portion of the bill for health care.
14:17That's it for health and health care,
14:19very complicated topics that touch all of us
14:23in very real and very personal ways.
14:26I hope you agree,
14:28the more we know about health care,
14:30the better voters we can be.
14:33Just the facts.
14:35You decide what you believe.