Damned Market, Stop Ruining Medicine!

One of the key issues leading up to the 2008 elections in America is health care. I know I have written on this topic, but I find it to fascinating not to write again. I heavily lean towards a single-payer system, or in other words: universal health care. Honestly, when people think of this system there are two major concerns: waiting time and quality. So I would like to lessen both of these worries and then present a short list of amazing benefits.

Waiting Times:

I know, Canada is a bad example of waiting times. The problem is notorious, however, who says Canada should be the benchmark for universal health care. A Commonwealth Fund study of six highly industrialized countries, the U.S., and five nations with national health systems, Britain, Germany, Australia, New Zealand, and Canada, found waiting times in the U.S., a system that boasts prompt and responsive health care, were severely lagging. One of the saddest statements made about the report includes this terrible news:

“The Commonwealth study did find one area where the U.S. was first by a wide margin: 51% of sick Americans surveyed did not visit a doctor, get a needed test, or fill a prescription within the past two years because of cost. No other country came close.”

Quality:

The same commonwealth report also noted that “one-third of U.S. patients wih health problems reported experiencing medical mistakes, medication errors, or inaccurate or delayed lab results—the highest rate of any of the six nations surveyed. While sicker patients in all countries reported safety risks, poor care coordination, and inadequate chronic care treatment, with no country deemed best or worst overall, the United States stood out for high error rates, inefficient coordination of care, and high out-of-pocket costs resulting in forgone care.”

Benefits:

Single-payer health care systems have some indisputable benefits: two in particular stand out in my mind. First, no one is denied health care: the unemployed, the terminally ill, the poor, the rich, the young, and the old all have access. It is a beautiful thing. Nothing frustrates me more than the idea that insurance companies are have profit margins at the forefront of their agenda, and thus must discriminate who they cover and what procedures they cover. Second, universal access leads to more preventive health care. Because people will not pay out of pocket for examinations, men and women from all elements of the economic spectrum will be more likely to get check ups and seek advice for little problems before they become bigger. This could be the possible solution to America’s shameful ranking among the World Health Organization’s Healthy Life Expectancy rankings.

In conclusion, I think it is criminal to have profit-based health care. Market incentives have no place in the personal and beautiful practice of medicine.

I'm so frustrated with Health Care in America

Although I heavily lean towards single-payer systems of health care, I am always open to solutions involving the private market that promise fair and accessible coverage for everybody. However, today I just want to put little fact on the market. I have been spouting off recently to friends how frustrated I am about something I heard on NPR. Rudy Guliani's policy advisor recently said something to the effect that the U.S. government spends more per capita on health care than Canada. To it was very well known that the U.S. spends more, as a nation, per capita by a long shot but to actually hear that government spending was more per capita as well was a shock. Well today, I'm backing this radio message I heard with hard data. Here's the table:

From this table we glean to main fact in our comparison between Canada and the United States. First, Canada and the United state have about the same percentage of GDP spending per capita on health care, but once you look at the actual amount of money spent, the United States spends over 50% more than Canada per capita!

I think this should frustrate any American paying for health insurance. Per capita the government is spending $36,006 but you still have need of your own private insurance on top of that? There must, MUST be a better way!

For example, for me this is what I demand: universal health care. There are two main reasons why: 1) the moral argument and 2) the practicality.The moral argument needs little elaboration, so I will just quickly elaborate on practicality. Do not look at Canada as an example for universal health care. There are problems, and it can be done better. For example, encourage and allow greater role for physician assistants and nurses in primary care and encourage doctors to continue training for more specialized roles. That's just one of my great ideas. Check out this article for more good reading.