Blog on the Run: Reloaded

Thursday, March 12, 2009 9:35 pm

Money for nothing

Filed under: Y'all go read this — Lex @ 9:35 pm

When the country last considered a serious makeover of the health-care system, big business was one of the forces arrayed to stop it. This time around, it is at least recognizing the problem:

If the global economy were a 100-yard dash, the U.S. would start 23 yards behind its closest competitors because of health care that costs too much and delivers too little, a business group says in a report to be released Thursday.

The report from the Business Roundtable, which represents CEOs of major companies, says America’s health care system has become a liability in a global economy. …

Americans spend $2.4 trillion a year on health care. The Business Roundtable report says Americans in 2006 spent $1,928 per capita on health care, at least two-and-a-half times more per person than any other advanced country.

In a different twist, the report took those costs and factored benefits into the equation.

It compares statistics on life expectancy, death rates and even cholesterol readings and blood pressures. The health measures are factored together with costs into a 100-point “value” scale. That hasn’t been done before, the authors said.

The results are not encouraging.

The United States is 23 points behind five leading economic competitors: Canada, Japan, Germany, the United Kingdom and France. The five nations cover all their citizens, and though their systems differ, in each country the government plays a much larger role than in the U.S. …

Higher U.S. spending funnels away resources that could be invested elsewhere in the economy, but fails to deliver a healthier work force, the report said.

“Spending more would not be a problem if our health scores were proportionately higher,” Dr. Arnold Milstein, one of the authors of the study, said in an interview. “But what this study shows is that the U.S. is not getting higher levels of health and quality of care.”

There’s a larger lesson here, and it needs to be hammered home because so many people don’t understand it, honestly don’t believe it or lie about it: The United States does NOT have the best health-care system in the world. Far from it.

The report addresses two separate but related issues: cost and effectiveness. Cost is driven by a number of factors, but one big one is profit-driven insurance companies — which play a much lesser role, or no role at all, in the countries that outperform us. The Business Roundtable, whose CEO members include at least one from the insurance industry, says private insurance should continue to play a role in the U.S. health-care system.

As for effectiveness, our system for too long has failed to gauge rigorously how effective health care is, both in absolute terms (Does any single drug or procedure really treat effectively and safely the disease or disorder it is supposed to treat?) and in relative terms (How do different drugs or different procedures for treating any specific illness or disorder compare to one another in terms of effectiveness and safety?). When I was still medical writer for the N&R, I wrote last August about this problem, which may constitute up to a third of the $2.4 trillion the U.S. spends annually on health care — and, worse, may be costing tens of thousands of lives annually.

It obviously is way too early to know what changes, if any, will emerge from the discussions the administration and Congress are having about U.S. health care. But it’s encouraging to know that some of the most influential stakeholders in the discussion are publicly acknowledging the nature and extent of our problem.

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