Doctor’s Tip: We need to fix our expensive, broken health care system
A better term than health care system would be disease management system — we wait until diseases occur, and then we spend a lot of effort and money trying to manage them ($3.2 trillion in 2016). Not only is our health care system expensive, it’s also deadly — complications and errors in our health care system are the third cause of death in America, following heart attacks and cancer.
The PNHP (Physicians for a National Health Plan) organization notes that:
• “The USA spends twice as much per person on health care as other industrialized nations, yet we rank near the bottom in nearly all health indicators (including life expectancy and infant and maternal mortality).”
• “Each year, one trillion of our health care dollars go to administrative costs (31 percent).” Although counterintuitive for some people, the administrative costs for government programs such as Medicare are only a fraction of the costs for private programs.
• “Our prescription drug prices are the highest in the world. Congress prohibited Medicare from negotiating drug prices.” (Due to the power Big Pharma has in Washington).
• “Thirty million Americans still have no health insurance, and another 40 million are underinsured.”
• “Most U.S. household bankruptcies are due mainly to medical bills — and most of those households had health insurance.”
The book “An American Sickness, How Healthcare Became Big Business and How You Can Take It Back” was written by Elisabeth Rosenthal, M.D., a physician and journalist. She talks about “the transformation of American medicine in a little over a quarter century from a caring endeavor to the most profitable industry in the United States — what many experts refer to as a medical-industrial complex.” Following are Dr. Rosenthal’s “economic rules of the dysfunctional medical market.”
1) “More treatment is always better. Default to the most expensive option.”
2) “A lifetime of treatment is preferable to a cure.”
3) “Amenities and marketing matter more than good care.”
4) “As technologies age, prices can rise rather than fall.”
5) “There is no free choice. Patients are stuck. And they’re stuck buying American.”
6) “More competitors vying for business doesn’t mean better prices; it can drive prices up, not down.”
7) “Economies of scale don’t translate to lower prices. With their market power, big providers can simply demand more.”
8) “There is no such thing as a fixed price for a procedure or test. And the uninsured pay the highest prices of all.”
9) “There are no standards for billing. There’s money to be made in billing for anything and everything.”
10) “Prices will rise to whatever the market will bear.”
Why do we Americans struggle to do what so many other developed countries have done — develop a medical system that covers all our citizens, that is reasonably priced, and that has better outcomes? The answer is at least in part what Dr. Robert Pearl calls the legacy players, in his book “Mistreated, Why We Think We’re Getting Good Health Care — and Why We’re Usually Wrong.” The legacy players are hospitals, medical insurance companies, the pharmaceutical and medical device industry, and specialty medical societies — all of which resist change because they are deriving huge profits from the current, broken system.
Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and other medical issues. Call 970-379-5718 for an appointment. For questions about his columns, email him at firstname.lastname@example.org.
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