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America has the most expensive health care system in the world

2014-06-17

The NYT published an editorial about the results of a Commonwealth Fund survey of the health care systems of 11 advanced countries, which you can find here:

http://www.nytimes.com/2014/06/17/opinion/how-health-care-systems-stack-up.html

As expected, the United States finished last overall on a series of measures of health care quality and expense.  Our health care costs $8,508 per person per year, yet our life expectancy and infant mortality rates are worse than countries that spend half as much as we do.  We rate last in cost of care, efficiency, and fairness, as well as infant mortality, healthy life expectancy at age 60, and medically avoidable deaths.

We have repeatedly written about the corruption and unfairness of America’s medical system in these pages, and there has been no improvement in the last five years.  This is despite the passage of the “Affordable Care Act”, whose implementation has been uneven and held back by administrative bottlenecks.  For instance, California has a backlog of a million applicants to join its expanded Medicaid program (known as Medi-Cal here) apparently because administrators did not allow for an enormous increase in applications.  Despite the promises of generous coverage, many people are simply in limbo and unable to obtain needed medical care because they do not yet have coverage.  What is worse, once they do have coverage, they will have difficulty finding primary care physicians to attend them because of low reimbursement rates.  Most of the available primary care sources are simply Medi-Cal mills that take their cards and provide three minutes with a physician assistant.

The Affordable Care Act could have been an ideal vehicle for the institution of truly universal single payer health care but it was so laden with compromises forced by Congressmen with selfish agendas that it is almost useless.  Furthermore, the institution of voluntary buy-ins to expanded Medicaid programs has allowed 27 red states to turn down free expanded Medicaid, leaving eight million people falling through the cracks between paid insurance and subsidized Medicaid.

The medical system is a prime example of a serious societal problem in this country which has not been addressed because of conflicts of interest and lobbying by powerful profit making “free enterprise”, from drug companies to device manufacturers to “not for profit” hospitals.  If this is how we address our serious problems, you can expect more disruption and pain in the future.

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