Healthcare - The Facts

One of the problems with many discussions of health care policy is lack of a good information.  Tragically many conversations are based on hearsay, laced by philosophical statements and generally lack solid analysis and facts.  Many say that we have the best health care in the world.  Others decry the lack of coverage and point to a looming health care crisis due to rising costs.  I will try to lay out the current facts about health care in the US.

The fact is that it is true that the US leads the world in the technology of health care.  We have the most sophisticated treatments, the best trained specialists and are often the first to offer new treatments such as open heart surgery.  If having the most sophisticated technology is the mark of success, then the US is the most successful. 

The first problem is that we have the most expensive health care in the world.  In general we spend twice what the rest of the world spends as percentage of GNP.  Health care costs in the US are enormous at 16% of GNP (gross national product) and are expected to reach 20% of GNP by 2016.  In contrast, most of the rest of the world spends half or less of that amount. For example, France spends 9.5% of GNP, Canada spends 9.7% and Germany spends 10.7%.  More facts can be obtained at:

http://www.nchc.org/facts/cost.shtml

So the second question is what do we get for all of that money?  Is our care better than the rest of world? Sadly the fact is that many of our outcomes are actually worse than a number of these leading countries.   Here are a few of the facts that can be found at http://www.nchc.org/facts/quality.shtml :

• The U.S. is 33 percent worse than the best country on mortality from conditions amenable to health care - that is, deaths that could have been prevented with timely and effective care.
  
• The infant mortality rate in the U.S. is 7.0 deaths per 1,000 live births, compared with 2.7 in the top three countries.
  
• Recent studies show that only a little more one-half (54.9 percent) of adult patients receive recommended care. The level of performance is similar whether it is for chronic, acute, or preventive care and across all spectrums of medical care -- screening, diagnosis, treatment, and follow-up.
  
• Underuse of care is sometimes a greater problem than overuse. Patients do not receive recommended care (as prescribed in national medical specialty guidelines) about 46 percent of the time. Another 11 percent of patients receive care that is not recommended and potentially harmful, according to practice guidelines.

Further our coverage problems are significant and were alluded to in post on "Healthcare - The Problem".   The facts is that we do not have the best health care in the world when it comes to the actual health and care of those in the US.   The point is that if we look at what other systems have accomplished, it is clear that we can do better... much better.  Equally more critical is that the costs of health care threaten to destroy our economy if not addressed. 

The point is that we cannot afford to do nothing or to be complacent.  The question is what can we do.  In the next posts, I will go over some of the options and proposals.