The sorry state of health care in the U.S.
As I See It
There is a common misconception afloat, being trumpeted by the health industry and politicians who are in league with the health industry, that we have the best health-care system in the world. In truth, we are No. 1 in only one item — the cost of our health care: nearly $8,000 per person and 18 percent of our Gross Domestic Product (both about twice the cost in all other industrialized nations).
In the U.S., brain CT scans cost two to seven times, appendectomies two and half to 13 times, and coronary bypasses one and two-thirds to seven times the cost in other developed countries. The World Health Organization rates the U.S. 15th in overall quality of health care, but just 37th in the quality of our system of providing health care. The U.S. ranks 50th in the rate of infant mortality, largely due to the inequality of distribution of health care. Many countries, such as Australia, Canada, France, Germany, Italy, Japan, Netherlands, Spain and Taiwan, have better availability of same-day appointments and lower rates of death from delayed access to health care than the U.S.; and Taiwan’s health-care system is rated as the world’s most efficient.
Why isn’t the world’s most expensive health-care system not the best? What makes health care in the U.S. so expensive? The answer is a mob of leeches sucking the lifeblood out of the system: the health-insurance and pharmaceutical industries, hospital equipment manufacturers, hospitals, and medical malpractice attorneys — all made possible by a complicit Congress.
The multi-billion dollar health-insurance industry adds 25 percent to our medical costs to support its multi-million dollar executive salaries, generous stockholder dividends, and the huge bureaucracies it employs to service claims from a multitude of separate employer and individual health plans and to sustain a high level of profitability by denying claims and terminating policies. Prescription medications cost twice as much in this country as they do anywhere else in the world, and medical equipment manufacturers sell their products to hospitals and clinics at prices up to four times the cost of production.
So-called nonprofit hospitals are also in the game. They spend down their large operating surpluses by paying high executive salaries, making luxurious capital expenditures, and purchasing high-cost items of medical equipment, regardless of how much they are needed. But if they buy them, they will be overprescribed, and paid off within 1-2 years. And the reason for that is that doctors are fearful of being sued by the medical malpractice lawyers if they don’t prescribe every test in the book, regardless of whether it is really necessary or of any value. As a result, the number of CT scans has quadrupled in recent decades. Another unnecessary expense is providing emergency-room health care for the uninsured, which costs as much as $100 billion a year — many times what preventive care would cost.
The U.S. ranks low in equality of access to health care. Those who can afford it can buy the very best health care that medical science can provide, but until very recently, 48 million Americans were without health insurance, and millions more had poor coverage. Obamacare is projected to insure an additional 30 million people, still leaving nearly 20 million uninsured. Sixty percent of personal bankruptcies, often causing loss of homes, are the result of medical emergencies (accidents or surgeries) with costs greatly exceeding insurance coverage and ability to pay.
So what are we to do? The system we have depended on for years is broken, and the rising cost is killing us. Obamacare is a monstrosity cobbled together by Congress to close some of the coverage gaps while at the same time protecting all of the special interests that have been getting rich off the old system. We need to start over, look at what all of the other industrialized nations have done, and adopt an efficient single-payer universal coverage plan along the lines of Medicare, which includes tort reform. The processing cost of Medicare is below 1 percent compared with that of insurance companies, which generally exceeds 20 percent. A Medicare-type plan would also relieve employers of the heavy financial burden of providing health care for their employees, which currently is discouraging them from hiring more full-time employees.
As Winston Churchill observed, “Americans will do the right thing …. after they’ve exhausted all the alternatives.” It is time to scrap our flawed health-care system, and do the right thing for the American people.
“As I See It” appears on the first and third Thursdays of the month. Hal Sundin lives in Glenwood Springs and is a retired environmental and structural engineer. Contact him at firstname.lastname@example.org.
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