Thursday, July 14, 2005

Big-payer health care

Per capita costs for health care in the US are the highest in the world ($5267 compared to $3446 in Switzerland, the next highest and the median of $2193 for the 30 countries from the Organization for Economic Cooperation and Development (OECD) for the year 2003). Thus our costs are more than double those of most of Europe and 50% higher than the next most expensive nation. A new study from Johns Hopkins School of Hygiene and Public Health (so far I have successfully resisted calling it the Bloomberg School, although Bloomberg bought the naming rights a few years ago; good think it wasn't bought by Tampax), shoots down two reasons apologists for the US health care industry have given in the past, rationing of elective procedures through waiting lists; and "defensive medicine" practiced because of excessive malpractice litigation. Neither factor is capable of explaining more than a small portion of the difference (the paper is in the July/August 2005 issue of the journal Health Affairs and was reported in Science Daily).
“We can’t blame the United States’ higher health care costs on limiting procedures in other countries or the elevated number of law suits filed in the United States,” said Peter S. Hussey, PhD, co-author of the study . . . .

"[I]t comes back to the fact that we are paying much higher prices for health care goods and services in the United States. Paying more is okay if our outcomes were better than other countries. But we are paying more for comparable outcomes,” said [ lead author Gerard] Anderson, who is also the director of the Johns Hopkins Center for Hospital Finance and Management.
So that's the Bottom Line. We pay more and get about the same. So where does the huge amount of money that represents the difference go?

Without speculating whose pockets are being lined here, the inescapable conclusion is that the US privatized health care system is wildly inefficient and wasteful. Thus one of the main props for continuing it is gone.

Regarding other objections to a government (i.e., community) supported system, they make also little sense. Most americans have an instinctive resistance to the notion that "the government will be telling your doctor how to practice medicine" but on reflection almost everyone knows that instead it is some 19 year old clerk working for an insurance company in a cubicle in Kansas City who is currently deciding what treatment we can or can't get. And as for "waiting lists," ever tried to get an appointment with a dermatologist lately?