How We Pay For Health Care

by | Apr 18, 2012 | Federal law, Health, insurance, Medicaid, medical care, Medicare

Health care is a complicated and politically charged topic in our country.  Health care is one of the biggest challenges we face.  The cost of health care threatens to bankrupt our country and prevents many from obtaining the care they need.   

Many developed countries provide health insurance to all their citizens and finance it through taxes.

In the U.S., the government covers about a third of the population through Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and programs for veterans. About half of Americans are covered by private insurance, either through an employer or purchased individually. About 50 million people are uninsured.


Medicare and Medicaid are among the largest government programs outside of defense.  Medicare insures about 47 million Americans.  As most know, Medicare provides health insurance for people over 65.  Medicare also provide benefits for people who are disabled (i.e., unable to engage in substantial employment activities) and have enough quarters of work credit to qualify for benefits. We recently posted an article on Medicare discussing the eligibility requirements for disabled individuals.  

Medicaid is a joint federal-state program that pays for medical care for individuals with limited financial resources. Medicaid insures more than 50 million Americans.  Its enrollees include disabled individuals with limited financial resources.  Check out our recent post on Medicaid eligibility for disabled individuals.


Most Americans under 65 (about 157 million) get health insurance through their employers.  These are typically group plans.  Many employers purchase group plans to cover their employees and their families.  An important benefit of coverage through an employer provided group plan is that coverage and premiums are not dependant on medical history or age.  Pre-existing conditions are typically covered.  


Some 14 million Americans under the age of 65 buy insurance on their own and many more try.  The premium you pay and the coverage you get depends on your health status.  If you’re healthy, and especially if you’re young, insurers want you because you’ll be paying premiums but probably not using much health care. But if you’re old, sick, or both, and especially if you have a few pre-existing, chronic conditions, your choice is almost always more limited. Insurers might reject you or accept you at a price several times higher than what a healthy person would pay. 

The inability to obtain coverage for pre-existing conditions can be a serious problem.  Consider the following.  You have group health insurance through your employer.  You are in an accident or develop a serious illness and are unable to work.  Your employer will likely fire you if you can’t work for an extended period, which means you will lose your group health coverage.  You may be able to obtain COBRA coverage, but this coverage is temporary and very expensive.  After your COBRA expires, you will likely be denied an individual policy because of your pre-existing condition, or the coverage will to expensive for you to afford.  You are effectively uninsurable because of your pre-existing condition.  

This scenario leads many into bankruptcy.  A study found that 62 percent of persons declaring bankruptcy in 2007 had unpaid medical expenses of $1000 or more, and in 92% of these cases the medical debts exceeded $5000.  Even if you have health coverage, the deductible, co-pays, and coverage limits lead many into financial troubles.    

The cost of health care is also threatening the financial health of our country.  The Medicare and Medicaid programs were estimated to soon account for 50 percent of all national health spending.  These factors and many others fueled interest in an overhaul of the health care system in the United States. 

Heath insurance is critically important for hurt truckers, and anyone else who has been injured.  In coming posts, we will discuss common types and provisions of health insurance as well as changes signed into law as part of the Patient Protection Affordable Care Act. 

We don’t just handle our client’s personal injury and workers’ compensation lawsuits.  We make sure our hurt trucker clients are informed about all of the options available to pay their bills and get medical care while their lawsuit is pending.  

If you have been injured, we would be happy to speak with you about your case free of charge. You can contact us at 855-448-7887 (855-448-7887) or email us at [email protected] or contact us on Facebook or Twitter.