By Andy Douglas
Though it hasn’t been so dominant in the news lately, the state of our country’s health care system continues to present a frustrating scenario. Iowa’s privately administered Medicaid system, for example, is struggling with great lapses in coverage.
My friend Mark Friedman is a sharp guy. He’s an economist by training, and teaches at a university in Mankato. He’s done a lot of work on this issue. Like me, he believes that the US health care system is seriously flawed, and that a good system should cover everybody, provide high quality care, and be affordable. Unlike me, he’s done the research (a few years ago) to show how the US system seriously lags behind other systems around the world.
Many of these statistics come from Kaiser Health. And although some of the citations are from a few years ago, I would venture that, if anything, the situation has worsened, especially after the pandemic.
Health care costs in the US are the highest in the world. Hospital charges in 2012 were $12,537 per day compared to France ($883) or Argentina ($479) and this continues to be the case.
The US is the only major industrialized country without universal care. There are still 31 million uninsured people in the US, with 36, 530 deaths in 2016 directly related to noninsurance. These are mostly low-income working families, who can’t afford coverage, many of them living in the several states that didn’t expand Medicaid. Mark calls it a crisis of the underinsured: high deductibles and co-pays making people reluctant to go to the doctor. This percentage of underinsured adults is growing, while the average deductible rises.
A rising number of people make no visit to the doctor in a typical year. US patients skip care more often than in similar nations. For those who do go, medical bills are now the most common reason for debt collection calls.
Americans spend more on prescription drugs than other citizens. An average of $1113 versus $620 in Canada, or $534 in Germany. US renal failure patients are less likely to get transplants than in other countries.
A lot of this comes down to the corporatization of care. A shocking graph Mark shared with me showed the growth of physicians and hospital administrators between 1970-2009. There was a 3000% growth in the number of administrators. This is compared to about a 100% growth in doctors. It all started to peak in the 1990s.
Despite a popular perception, overuse of the health system is not a driver of cost in the US. (The biggest drivers are drug costs; devices, at a significant markup; diagnostics; fees, especially for specialists; technology, including computerized medical records; fraud and malpractice; and preventable errors.)
Private insurance is central to the problem. Monitoring claims, sales, commissions and marketing, profits, and outrageous CEO salaries rack up costs while adding nothing to the quality of care. Just so you know, the CEO of United Health received a salary of $66 million in 2016.
Insurance overhead is about $806 per person in the US, compared with $141 in Canada, $209 in Holland, $255 in Germany, and $286 in Switzerland.
The American health field is also becoming notorious for doctor burnout. Doctors are needlessly engaged in record keeping for insurance companies, while dealing with insurance company meddling in medical decisions. US doctor satisfaction is low compared to Norway, UK, Canada and Australia.
In short, Mark says, the current system is bad for business, both employers and employees. It creates high costs, and distracts from a business’ core focus. It results in lower employee salaries, and prevents new business startups. It also makes it hard to compete internationally. Fifty percent of small business bankruptcies are due to health care crises. Of course, businesses pass their costs on to their customers, so anyone who buys goods or services is paying for all this.
What’s to be done? Mark believes a single payer system would solve many of these problems, something like Medicare for All. He sees the so-called Public Option, with its Medicare buy-in, as falling short, with premiums growing too high because of a smaller pool of insured.
Ongoing attempts to privatize Medicaid and Medicare simply exacerbate the problems.
Health care is a basic requirement of life. Why should the US fare so poorly compared to other nations, when there are viable alternatives?
Though it hasn’t been so dominant in the news lately, the state of our country’s health care system continues to present a frustrating scenario. Iowa’s privately administered Medicaid system, for example, is struggling with great lapses in coverage.
My friend Mark Friedman is a sharp guy. He’s an economist by training, and teaches at a university in Mankato. He’s done a lot of work on this issue. Like me, he believes that the US health care system is seriously flawed, and that a good system should cover everybody, provide high quality care, and be affordable. Unlike me, he’s done the research (a few years ago) to show how the US system seriously lags behind other systems around the world.
Many of these statistics come from Kaiser Health. And although some of the citations are from a few years ago, I would venture that, if anything, the situation has worsened, especially after the pandemic.
Health care costs in the US are the highest in the world. Hospital charges in 2012 were $12,537 per day compared to France ($883) or Argentina ($479) and this continues to be the case.
The US is the only major industrialized country without universal care. There are still 31 million uninsured people in the US, with 36, 530 deaths in 2016 directly related to noninsurance. These are mostly low-income working families, who can’t afford coverage, many of them living in the several states that didn’t expand Medicaid. Mark calls it a crisis of the underinsured: high deductibles and co-pays making people reluctant to go to the doctor. This percentage of underinsured adults is growing, while the average deductible rises.
A rising number of people make no visit to the doctor in a typical year. US patients skip care more often than in similar nations. For those who do go, medical bills are now the most common reason for debt collection calls.
Americans spend more on prescription drugs than other citizens. An average of $1113 versus $620 in Canada, or $534 in Germany. US renal failure patients are less likely to get transplants than in other countries.
A lot of this comes down to the corporatization of care. A shocking graph Mark shared with me showed the growth of physicians and hospital administrators between 1970-2009. There was a 3000% growth in the number of administrators. This is compared to about a 100% growth in doctors. It all started to peak in the 1990s.
Despite a popular perception, overuse of the health system is not a driver of cost in the US. (The biggest drivers are drug costs; devices, at a significant markup; diagnostics; fees, especially for specialists; technology, including computerized medical records; fraud and malpractice; and preventable errors.)
Private insurance is central to the problem. Monitoring claims, sales, commissions and marketing, profits, and outrageous CEO salaries rack up costs while adding nothing to the quality of care. Just so you know, the CEO of United Health received a salary of $66 million in 2016.
Insurance overhead is about $806 per person in the US, compared with $141 in Canada, $209 in Holland, $255 in Germany, and $286 in Switzerland.
The American health field is also becoming notorious for doctor burnout. Doctors are needlessly engaged in record keeping for insurance companies, while dealing with insurance company meddling in medical decisions. US doctor satisfaction is low compared to Norway, UK, Canada and Australia.
In short, Mark says, the current system is bad for business, both employers and employees. It creates high costs, and distracts from a business’ core focus. It results in lower employee salaries, and prevents new business startups. It also makes it hard to compete internationally. Fifty percent of small business bankruptcies are due to health care crises. Of course, businesses pass their costs on to their customers, so anyone who buys goods or services is paying for all this.
What’s to be done? Mark believes a single payer system would solve many of these problems, something like Medicare for All. He sees the so-called Public Option, with its Medicare buy-in, as falling short, with premiums growing too high because of a smaller pool of insured.
Ongoing attempts to privatize Medicaid and Medicare simply exacerbate the problems.
Health care is a basic requirement of life. Why should the US fare so poorly compared to other nations, when there are viable alternatives?