Rant

Is there a healthcare problem? Or a fix?

Posted 33 months ago|10 comments|952 views

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Health care , Healthcare , USA

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Written by

Jack H Remington

The USA is admired around the world for its great achievements. Providing fair and equitable health care to all is not one of those achievements.

According to "Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care", cited at left, -

"Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. [...] Compared with five other nations—Australia, Canada, Germany, New Zealand, the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes."

"The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance."

Some might suppose that the economies of scale of a great nation like the USA would make it's healthcare more efficient.

However, according to the report, each citizen of the USA spends *TWICE* as much for their healthcare on average as the citizens of the other first-world countries studied. Yet, the average American gets *WORSE* healthcare than the citizens of any of those nations.

It would be bad enough for Americans to pay twice as much to get the *SAME* outcome. Paying twice as much for worse outcomes suggests that the USA is being consistently ripped off. Cui bono? Someone is feeding off the public teat, at the cost of American health.

The American citizen's healthcare spending is going into someone's pockets, but it is mostly not going to providing healthcare.

Accordingly, in many countries that are great friends of the USA, terms like "American standards of health care" are synonyms for "nightmare" and "disaster", and are flung about as insults - much like "Chinese standards of free speech".

There are a lot of Rants and Raves on this site about President Obama's health care proposals. I'm not looking to migrate that specific debate into this rant, so much as to get people's views on the issue of whether there is a problem with American healthcare, and if there is a solution, not limited to the current Democrat proposals.

So, having set this premise, I would like to provide a forum for RantRavers to state their views on these questions.

Q1. Is there a problem with the current American system?

Q2. Should Americans aspire to have healthcare that is as good and equitable as healthcare in other first-world countries?

Q3. Where is all the public's money going, if not to providing healthcare?

Q4. Can the system be improved so that Americans get the standards they deserve? How?

To start the ball rolling, here are my preliminary views.

Q1. Yes.
Q2. Yes.
Q3. I don't know. I presume that a lot of it that is supposed to being acheiving health outcomes is going to achieving something else.
Q4. I don't know. But I think that if there is a solution it will result in putting less public and private money into the pockets of the people who are currently profiting and more into providing outcomes. Those who currently benefit won't like it, and they will fight it as hard as they possibly can.

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Altruist
Eugene, OR

33 months ago: Good Post!
1. Yes the American system is fatally flawed and it can't be fixed by putting band aids on it. The only way to bring costs down and to insure the 49 million uninsured and the 150 million underinsured is to set up a single payer system.
2. The rich and those with good employer paid insurance are probably satisfied, but the uninsured, the under insured need something different than what we have. Businesses small and large would also benefit greatly with a decent system. They can't be competitive when they spend 20% on health care. That is one of the reasons Chrysler and GM went belly up. The World Health Organization declared access to health care a basic right. Don't let the Republicants deny the basic rights of the poor.
3.Most of the excess money goes to overhead. The insurance industry has 30% overhead compared to Medicare with 3% because they hire a bunch of paper pushers to deny claims. If seeing a doc is expensive how about more call-a-nurse programs, local clinics and housecalls with screening from paramedics and nurses to see if a patient really needs a doc or just have a cold. Drug costs are outrageous. It only costs a nickle for a drug that costs hundreds of dollars, and they only spend a fraction of their advertising budget on research and development. Why do they have to advertise to the general public? Only the doctors should determine drug use.
4. There are no shortages of successful models in any other developed country. We should pick the best parts of all of them. We should at the very least have basic care for everyone, and then if people are concerned about socialized medicine, or the wait let them buy supplemental insurance.

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Harshaw

33 months ago: 1> That 47 million number really needs to be looked at. Some of the numbers very a little depending on where you look, but most research I have looked at consistently proves that the 47 million is myth.
http://www.factcheck.org/politics/the_real_uninsured.html

2> Altruist, Chrysler and GM went belly-up because their health care costs and union salaries were so out of whack that it was unsustainable. Compare what us workers in a Toyota Plant get for salary and benefits compared to what GM workers were getting. And Polls show that 80% of Americans are either very satisfied, or satisfied with their current health care plans.

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Harshaw

33 months ago: 3> I will agree that the out of pocket cost is really starting to get high. And I do not know how to fix that completely. I do think it would help if you were allowed to purchase plans out of state. For example. I had Blue Cross of MA. I paid 167.00 a week for a family plan. I was just laid off from my job so we had to switch to my wifes plan. She works in RI. Her company offers Blue Cross of RI. For a better plan with no deductible for hospital stays, lower prescription co-pays and Doctors visit co-pays, we pay I think 10 dollars less. She works for a smaller company, and where my company was a 60/40 split (I paid 40) hers is a 50/50. SO I say make them compete!

4> Some other things I don't agree with which relates to access money. All of the free samples of the latest drugs that get handed out to doctors offices. Sure, the antibiotics are nice, but a free 7 day trial of viagra? Come on! Not to mention did you know that Drug Companies get subsidized by the government to advertise their drugs on television!

5> Obamas main selling point at the moment is creating a public option that the private companies have to compete with. I say we can make them compete with each other without having to fork over tax payer money to fund the competition. Especially when you do your research and see that the 47 million number does not hold much weight.

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Out Of The Box

Moderator

33 months ago: Altruist
You would be a lot more credible if you would stop using verbatim the same talking points we hear every day from the left media. It's starting to sound like a mindless chant.
The name calling and uncivil manner of referring to your opponents is demeaning to you. Republicants, dumbocrats, all the rest.

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Jack H Remington

33 months ago: Out Of The Box, do you have opinions on the 4 questions?

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Out Of The Box

Moderator

33 months ago: 1. yes

2. no, we are not other countries. we do not need to model ourselves after them. we can do better.

3. the public's money they are spending on health care INSURANCE, (not health care) is going into a fund run by each insurer, out of which payments are made to medical facilities and doctors, who then pay their nurses and support staff. Whatever is left over after satisfying their obligations, is used to increase business with advertising, paying the staff of the insurer, and distributed amongst stockholders.

4. I would rather see people given the money for premiums from tax dollars, than to have this much control over our personal lives handed over to the government. I would definitely pay an extra tax for that.

On a side note, I feel like this is just part two of the saga that began with The Patriot Act, the first played on conservatives, the second on liberals, all part of the same power play, just a different cast to disperse suspicion.

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Mike Licht
Washington, DC

33 months ago: Obama's gonna kill Grandma?

See:

http://notionscapital.wordpress.com/2009/08/07/obama-wants-to-kill-your-grandma/

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Altruist
Eugene, OR

33 months ago: Harshaw, I agree that the 47 million number is a bit too high, but that is the number the census came up with and that is the number the CBO uses to figure out costs. Everyone will be pleasantly surprised to find that it is much cheaper to cover everyone than we are being told. I think that being able to shop in any state for insurance would bring down costs but that is the intent of the Public Option, paying into that would be the same as shopping around for the best and cheapest.
OOTB I suggested many ways to bring down health care costs in the following rant and not one of those ideas were in any of the media. http://www.rantrave.com/Rant/Getting-serious-about-cutting-costs.aspx
I agree that name calling detracts from civil discourse. Republicants is pretty minor though and is just shorthand for the fact that they are dedicated to opposing every Democratic proposal with no viable alternatives of their own. Would "the party of No" be preferable?

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