Monday, November 28, 2011

Our Still Badly Broken Health Care System

Despite conservative boasts that America has the best health care system in the world or claims that no one really goes without needed medical care, the reality is something far different. Unlike "old Europe" - which admittedly has its share of problems - America still views a huge segment of its population as disposable. Moreover, those on the far right who wear their religion on their sleeves act in a manner diametrically opposed to the Gospel message on caring for the sick and the poor. It's one stunning example of how America is anything but exceptional - at least in a positive manner. A column in the Washington Post looks at this broken system where we continue to pay more than in other nations yet receive far less health care services. Here are some highlights:

Ultimately, the only way to control federal spending and deficits is to suppress the upward spiral of health costs. These are already the budget’s largest single expense (27 percent in 2010, compared with 20 percent for defense), and their continued rapid growth, combined with the scheduled introduction of Obamacare, will soon bring them to nearly one-third.

Americans know that expensive medical care is squeezing non-health government programs and, through higher employer insurance costs, take-home pay. But they console themselves that U.S. health care “is the best in the world.” Among experts, this view has long been debated, but a new study from the Organization for Economic Cooperation and Development (OECD) in Paris suggests that the debate is over: It’s not true.

U.S. health spending (about $7,960 per person in 2009) is in a league of its own. It’s 50 percent higher than Norway’s ($5,352), the next costliest. U.S. spending is more than double Britain’s ($3,487), France’s ($3,978) and the OECD average ($3,233). Despite this, Americans aren’t notably healthier than people in other advanced countries, the study reports.

[B]y some indicators, Americans get less medical care than do people in other advanced countries. The number of practicing U.S. doctors (2.4 per 1,000 population) is less than the OECD average (3.1 per 1,000), as is the number of annual doctor consultations (3.9 per capita in the United States versus 6.5 for the OECD average).

What propels U.S. health spending upward? The OECD’s answer comes in two parts: steep prices and abundant provision of some expensive services. . . . This is a devastating portrait. At times, the U.S. health care system delivers the worst of both worlds: pay more, get less. Unfortunately, the message isn’t new. America’s fragmented and overspecialized health system maximizes returns to providers — doctors, hospitals, drug companies — but not to society.

[T]he system needs a fundamental overhaul to deliver more value for money. There are essentially two ways to do this. One is a voucher system that, through tax credits and fixed Medicare premium subsidies, would allow patients to shop for the best health plan. Competition, the theory goes, would force hospitals and doctors to restructure the delivery system; health plans would compete on the basis of price and quality.

The other way is a government-run, single-payer system that would — somehow — include strict budget limits on doctors, hospitals and other providers. . . . . One way or another, if we don’t act, we’re surrendering our future to runaway health spending.

It's a bleak picture and unfortunately, I do not see our political leaders having the spine or desire to stand up to the powerful players in the health care industry who are just fine with the current disastrous system.

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