The Des Moines Register
5/10/2004
U.S. has the best? Think again
We’re tops in health-care costs, but not in quality
By Register Editorial Board
Most Americans know this country spends more money per person on health
care than any other country in the world. The United States spends twice as much as Australia, England and Canada. Yet Americans seem to think this spending is OK. After all, we have the best health care in the world, right? Don’t you get what you pay for?
No.
And no.
In fact, Americans are not getting what they pay for when it comes to health care because a poorly constructed system yields poor results.
Consider three studies that made the news last week.
The Robert Wood Johnson Foundation reminded everyone what a mess the U.S.
system of health care is when its study concluded about 20 million U.S. workers are uninsured. In a few states, one in five working adults doesn’t have coverage. The United States has a system that irrationally ties health care to employment, making a job the source of coverage for millions of Americans. But apparently even having a job doesn’t guarantee health insurance.
A study published in Health Affairs, a policy journal, looked at five countries and found the quality of care in the United States is no better, even though this country spends far more money. A fragmented system was given as one of the reasons for the higher costs, and the study found the United States had the worst five-year survival rates after kidney transplants of the nations examined.
Then there was the especially troubling study conducted by Rand Corp. This took the most comprehensive look yet at the quality of health care in this country. What did researchers find? Patients get about half the care recommended for conditions from heart disease to diabetes, regardless of where in the United States they live.
Imagine that. This country spends more than $1 trillion a year on health care, and patients are only getting half the care they need. Americans ought to feel like a shopper who pays too much for a product that turns out to be a lemon. But the U.S. system isn’t just a waste money; it costs people their lives.
How does the United States fix the system?
It doesn’t need to spend more. It needs to spend wisely. Health-care dollars
in this country are gobbled up by red tape. Money that could be spent directly on helping people is eaten up in the administrative costs and high profit margins of a fragmented and gap-riddled system.
The best system in the world, huh?
http://desmoinesregister.com/apps/pbcs.dll/article?AID=/20040510/OPINION03/405100303/1035/OPINION
Health Affairs: How Does The Quality Of Care Compare In Five Countries?:
http://content.healthaffairs.org/cgi/content/abstract/23/3/89
Rand Corporation: The First National Report Card on Quality of Health Care in America:
http://www.rand.org/publications/RB/RB9053/
Health Affairs: Medicare Spending, The Physician Workforce, And Beneficiaries’ Quality Of Care (An alarming report that finds that “states with higher Medicare spending have lower-quality care.”):z
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.184v1
Comment: Read them and weep. Then get to work on fixing our system! Now!
