THE HEALTHCARE CRISIS IS NOT GETTING BETTER
Healthcare Policy Forum 2.15.2026
Rob Stone MD
Uninsured in the US
Source for data before 2010: Council of Economic Advisers, “Methodological Appendix: Methods Used to Construct a Consistent Historical Time Series of Health Insurance Coverage,” 2014, https://obamawhitehouse.archives.gov/sites/default/files/docs/longtermhealthinsuranceseriesmethodologyfinal.pdf.
Source for data from 2010 – 2021: Early Release Estimates from the National Health Interview Survey, multiple years. Available at: https://www.cdc.gov/nchs/data/nhis/earlyrelease.pdf. Note that there was a change in survey methodology in 2019.
Uninsured (percentage)
4.8 million are projected to lose coverage this year with the expiration of ACA premium subsidies. As the Medicaid cuts in the OBBB phase in, the CBO predicts over 14 million will lose coverage in the next 8 years
60,000 Hoosiers losing health insurance coverage is expected to lead to 75 preventable deaths per year in Indiana.
The inability to pay for healthcare in the U.S. has reached a new high, with more than one-third of Americans (35%), or an estimated 91 million people, reporting that they could not access quality healthcare if they needed it today, according to the latest West Health-Gallup Healthcare Affordability Index.
Rates were higher among Black and Hispanic Americans, with 46% and 52%, respectively, reporting that they would be unable to afford quality healthcare.
Growth of Physicians �and Administrators
Bureau of Labor Statistics; NCHS; Himmelstein/Woolhandler analysis of CPS
Managers shown as moving average of current year and two previous years
Growth since 1970
The average US physician’s practice spends $99,581 annually on billing and costs related to fighting with insurance companies
Medicare Means
Source: Day, Himmelstein, Broder, Woolhandler – Int. J Health Serv 2014
Updated data from firms’ SEC filings (Q12016)
Overhead = (Premium revenue – Medical Expenses) / Premium Revenues
2016 Medicare Trust Fund Report at https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/Downloads/TR2017.pdf
Insurance Overhead
Q1 2016
Stop Wasting Our Money on Bureaucracy
Elevance
Medicare Means Healthier Americans��
Institute of Medicine. Shorter Lives, Poorer Health 2013
Ranking of US mortality rates by age group among 17 peer countries: Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland, Netherlands, United Kingdom
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USA
Rank in World
1 |
3 |
5 |
7 |
9 |
11 |
13 |
15 |
17 |
0-1 | 1-4 | 5-9 | 10-14 | 15-19 | 20-24 | 25-29 | 30-34 | 35-39 | 40-44 | 45-49 | 50-54 | 55-59 | 60-64 | 65-69 | 70-74 | 75-79 | 80-84 | 85-89 | 90-94 | 95-99 |
Age
Men
Women
Age 65
The Grand Experiment – �Healthcare in the US and Canada
Sources: Statistics Canada, Canadian Inst. for Health Inf., and NCHS/Commerce Dept.
USA
Canada
Health costs
% of GDP
HMO Act Passed
Canadian Medicare Fully Implemented
The Grand Experiment – �Healthcare in the US and Canada
Compared to Americans, Canadians now
spend half as much,
have fewer unmet health needs,
and live 3 years longer.
Slide provided by the late Princeton University healthcare economist Uve Rheinhardt
“President Donald Trump has been channeling public anger over health care costs, pillorying “money sucking” insurers and alleging that “BIG, BAD Insurance Companies” have been “ripping off the public for years.””
�
Warren Buffet�at Berkshire Hathaway's annual meeting, May 6, 2017
Healthcare costs are “the tapeworm of American economic competitiveness”
Daviess Community Hospital in Washington
Memorial Hospital Logansport in Logansport
Community Hospital of Bremen Inc. in Bremen
Ascension St. Vincent Randolph in Winchester
Ascension St. Vincent Jennings in North Vernon
Ascension St. Vincent Clay in Brazil
Ascension St. Vincent Salem in Salem
IU Health Jay Hospital in Portland
Franciscan Health Rensselaer in Rensselaer
Sullivan County Community Hospital in Sullivan
Adams Memorial Hospital in Decatur
Harrison County Hospital in Corydon
https://dailyjournal.net/2026/02/06/johnson-memorial-health-to-close-maternity-unit-cut-about-48-jobs/
New York Times 7/21/25
The Big Bill’s trillion dollar Medicaid cuts have NOTHING to do with bringing down overall US healthcare spending. It only slices and dices who pays for what – called cost shifting, while increasing complexity, inefficiency, and overhead costs.
Single Payer Medicare for All�
Improve Medicare
Expand Medicare
Medicare is already paying for and taking care of the oldest, most complicated and expensive patients in our healthcare system, since 1966
Single Payer Medicare for All��Makes Economic Sense
http://www.pnhp.org/facts/single-payer-system-cost Accessed 2/25/2017
https://dignityandrights.org/2019/05/253-economists-sign-letter-backing-medicare-for-all/
20 of 22 studies:
The savings would
fund full coverage.
253 economists:
“The time is now for
Medicare for All.”
For context, the OBBB Trump tax cuts for the rich (The Epstien Class) will cost $3.3 trillion. And it increased the ICE budget by $70 billion.
November 14-17, 2025 survey of 1,207 US likely voters
Where Do We Start?
PNHP’s 2nd major anti-profiteering target:�
Medicaid Managed Care
More information at: medicareforallindiana.substack.com
Who knew that for-profit insurance giants like United Healthcare and Anthem/Elevance were profiting from Indiana’s Medicaid program?
The time is right to remove insurance companies from Medicaid.�But States Have “Other Options”
Deprivatize Medicaid
– or –
Reduce funding for other state programs
Cut services
Cut eligibility
Cut reimbursement rates
Raise state taxes
De-Privatization or Dis-Intermediation or Removing the Middleman
Removing insurance companies from Medicaid has �Over a Decade of Proven Success
https://www.connecticutifs.com
“The Insurance Capital of the World”
Deprivatization Reduces Spending
https://cthealthpolicy.org/medicaid-switch-from-mcos-saving-taxpayers-billions/ (average annual 2012 - 2020 propagated to 2025)
https://www.nber.org/system/files/working_papers/w33302/w33302.pdf
Connecticut (2012-2025)
- Christopher G. Donovan,
CT House Speaker, 2009-2013
CT Medicaid Spending
per member per month
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$750 |
$700 |
$650 |
$600 |
$550 |
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2012 | 2014 | 2016 | 2018 |
2019
2012-2024 tiny Connecticut
saved $4 Billion
https://pnhp.org/removing-the-middlemen-from-medicaid/
Most states would each save hundreds of millions of dollars per year.
All state savings combined: up to $34 billion in 2023.
Federal savings: up to $43 billion in 2023.
All states + federal savings: up to $77 billion in 2023.
Indiana:
Can save up to
$340 million
per year this way
PNHP.ORG
MedicareForAllIndiana@gmail.com
MedicareForAllIndiana.substack.com
Prescription for Healthcare – WFHB Bloomington Community Radio WFHB.ORG and Apple Podcasts