Rich Country, Poor Healthcare

By Kai Wright Oct 11, 2006

by Kai Wright They say money can’t buy happiness, but apparently it can’t buy America quality healthcare either. Two new studies add to a building mound of evidence that our wildly expensive, market-based healthcare system is deathly ill. The U.S. ranks last or near last among industrialized countries on a disturbing range of health indicators, according to a recent study by the Commonwealth Fund, published in the online version of the journal Health Affairs. Researchers looked at 37 measures of how well healthcare systems perform – from how the patients fare to how efficiently the system runs – and gave each of the almost two dozen industrialized nations it studied an overall grade. The U.S. scored a dismal 66 out of 100. Worse, we had the highest infant mortality rate of all 23 countries and the lowest life expectancy for people over the age of 60. Our preventable deaths are more than 50 percent higher than those in France. A third of U.S. patients report having suffered a medical or lab error in the last two years. What researchers couldn’t find was the efficiency a market-based system is supposed to create. Less than a fifth of U.S. doctors use electronic health records – an innovation that among other things would help cut down on all those medical errors. A quarter of U.S. patients say they have to wait at least six days to get care. What’s all this cost us? We shell out twice the median spent by the other industrialized countries studied, measured against gross domestic product. For all that money, we still can’t manage to provide coverage for the growing ranks of uninsured Americans, which range from 40 million to 60 million, depending on which estimate you use. And according to a second study, our costs are still climbing every year. Privately insured Americans spent 7.4 percent more on healthcare in 2005, roughly the same growth rate seen in the previous two years, according to an Oct. 3 Health Affairs report. Not only does that spike nearly double last year’s increase in workers’ pay, it also runs far ahead of overall economic growth. That means both employers and employees are bleeding to their financial deaths from healthcare costs. The healthcare industry’s cost drivers, from specialists to drug makers to insurers, are doing what they’re supposed to do in a market: make a profit. But healthcare consumers aren’t anything like their counterparts in department stores. They’re buying something they desperately need and face an impossible learning curve in order to make wise decisions. That’s a recipe for predation – for unnecessary treatments, price gouging on drugs, inflated insurance premiums, and more. All of this is the predictable result of allowing healthcare to become a commodity that’s bought and sold like a home appliance. As long as we cling to the myth that something so critical to public well-being can be left to the unrestrained whims of the marketplace, America’s health will lag sickeningly behind the rest of the industrialized world.