-In 2008 America spent $2.4 trillion on health care. By way of comparison that number is approximately equal to the respective GDP of France, Germany or England. The US spending on health care is more than half of China’s GDP and is equal to two thirds of India’s entire output.
-Health care costs were equal to 17% of US GDP in 2008. That percentage is projected to rise to 20% by 2016. Germany and Canada spent 10.7% and 9.7% respectively on caring for its citizens. If US health care costs were to fall in line with Germany it would translate into a savings in excess of $1 trillion each year, significantly larger than the chronic US budget deficit.
-The United States spends six times more per-capita on the administration of the health care system than its peer Western European nations according to a McKinsey study.
On a per-capita basis we spend more on health care than any country in the world. The results are less than impressive.
-A Harvard study found that 50% of all personal bankruptcy were the result of a medical expenses. The study went on to conclude that every 30 seconds someone files for bankruptcy due to a serious health problem. About 1.5 million families lose their homes to foreclosure every year due to unaffordable medical costs.
-The World Health Organization reports that the UK spends less than half as much on its population than does the US. However one can expect to live two years longer in the UK than America. The infant mortality rate is 50% higher in the USA.
-The Center for Disease Control estimates that 15% of all American have no health insurance. If you add to that number the illegal population in America, the result is that approximately 60 million people living here have no health benefits. That is more than the population of Italy. One in ten children under the age of 18 have no benefits at all. That means ten million children.
-According to WHO the US ranks 28th globally in a statistic they refer to as Healthy Life Expectancy. Japan is on the top of that list. America is tied with Slovenia.
-The CDC estimates that on average, 75% of an individual’s lifetime health care cost is realized after age 65. The American population is rapidly aging. The percent of the population that is older than 65 will double from 10% to 20% in less than 20 years.
If the conclusion is made that we must cut health care cost as a percentage of GDP in order to maintain our global competitive position it is clear that the bulk of those cuts must come from those that are now and or will soon be 65 years old. That will be a difficult bridge to cross for the current administration and our society.
White House OMB Director, Peter Orszag, is leading the Administration’s health care initiative. Mr. Orszag is a proponent of “comparative effectiveness,” comparing various treatments — an idea that the drug industry is largely resisting and that some doctors fear could force them to follow treatment rules. The President recently announced that technology (HIT) would provide a key role in reducing future medical expenses. On that topic Mr. Orszag commented in 2007*:
“Simply installing an HIT would be unlikely to significantly reduce medical expenses”. “Claims that it would are very substantially exaggerated”.
In the same 2007 presentation Mr. Orszag also said:
“I have not seen a credible plan for Medicare solvency”. “We should have started this 15 or 20 years ago.”
The Obama administration will kick off its grass roots effort to achieve, “Real Health Care Reform” on June 6th. It should be an interesting debate.
*The comments by Mr. Orszag are on the following video link.
http://video.google.com/videosearch?q=peter%20orszag&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wv#
The success of any health reform effort will depend on having a strong primary care workforce, whose levels will fall dangerously low in the next five years. A major difference between health care in the US and European nations (and some 3rd world nations), is the relationship with a primary care provider. Those with access to PCPs get diagnosed earlier, have lower mortality rates, and better birth outcomes.
ReplyDeleteIn a recent survey, 49% of primary care physicians report plans to reduce the number of patients they see or stop practicing entirely in the next three years. Reimbursement rates for primary care vary drastically from those of specialists, and as practicing PCPs pull back on patient care, fewer medical students are entering primary care; seeking more lucrative specialty care fields to pay for skyrocketing medical education costs.
In Massachusetts, the implementation of universal insurance coverage without ensuring an adequate workforce led to primary health care bottlenecks and costly consequences, especially in low-income communities. Though the number of uninsured adults dropped, they reported an inability to find a primary care provider and went without care. At the same time, the rate of people seeking non-emergency care in ERs remained unchanged. The average wait time for a new patient appointment with an internist jumped from 33 to 50 days in two years.
The dwindling supply of primary care providers, and their shortage in underserved communities, is compounded by the fact that not enough providers are willing or able to treat Medicaid patients and the uninsured. Without plans to locate primary care providers in undereserved areas, the numbers of medically disenfranchised and underserved will continue to rise
The healthcare crisis won’t be solved at a national level alone. It will require state and local involvement and a fundamental change in the way Americans perceive health care.
http://opinionator.blogs.nytimes.com/2009/08/07/weekend-opinionator-a-sick-debate/
ReplyDeleteAugust 7, 2009, 8:13 pm
Weekend Opinionator: A Sick Debate
By Tobin Harshaw
Comments:
12. August 8, 2009 1:57 am Link
I have lived in Europe, the USA (NYC and FLA) and currently live in Canada. I am a reasonably well-informed financial executive. I make my living as a capitalist.
I wouldn’t know where to begin re: the health care debate but I will make a couple of observations:
1. The USA has the finest health care in the world — bar none — provided that you have a no-limit gilt-edged money is no object health plan. Or you are rich. In my experience the 2 go hand in hand.
Failing such insurance or such boundless wealth how any rational human being with an IQ over 75 and an income below, say, $250k (forget the social compassion argument) could defend the existing system is beyond comprehension.
2. The outright lies — yes lies — that critics of health care reform spew is disturbing. The intentional misrepresentation of the Canadian and European models is outrageous. The Canadian model is flawed. There needs to be greater access to ‘private-delivery’ alternatives (which currently exist in some fields.) Having said that, since I returned to the province of Ontario in the late 1990’s until now the improvement in standards and care is staggering and in most cases matches anything I witnessed or experienced in NYC. Yes, health care is rationed here (hence a need for ancillary private care) but it is rationed everywhere — including the US. The exception being as per point #1 above. Per capita Ontario spends approximately 65% of what the consumers/taxpayers of the US/NY spend. However Ontario delivers 90% — or more — of the US standard. That is one very big financial/efficiency/productivity gap. That money gap goes to the US insurance companies, doctors, malpractice lawyers and lobbyists. The common canard about Canada etc is that “faceless bureaucrats make life or death decisions” (as opposed to, say, faceless HMO clerks). The truth is that in Canada the ‘gatekeepers’ who allocate critical care are the physicians themselves — the specialists.
3. Aside from private-payment plastic surgeons it is true you will not see many doctors in Canada driving a Rolls Royce. But you will see an awful lot driving a Benz or a Jag. Doctors here work hard and are well compensated. What we lack here is the concept that a medical degree should be attributed Venture Capitalist returns.
4. Lastly, a general observation/question (again, I really am a capitalist). Why is it that in the USA (a country I genuinely love) millions of people who barely make a living or are working class and/or just holding on to the ‘middle class’ are the most vocal — hysterical wouldn’t be an exaggeration — in defending the privileges of the rich and the corporate? Against their own self-interest I might add. Anywhere else in the western world the existing US health care tyranny would have people in the streets demanding reform — not ‘debating’ it.
— jon c
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