US Health Care Sucks

But we all know that already.

Yet another report has been produced documenting just how dysfunctional the American health care system is. It makes for dismal reading. That the report has been issued during the great Obamacare launch fiasco means, most likely, that its conclusions will be glossed over by both our political parties. They will be too busy trying to score clever political points rather than actually fixing anything. Such is the way in Washington nowadays.

The report’s key findings are shocking:

• In 2013, more than one-third (37%) of U.S. adults went without recommended care, did not see a doctor when they were sick, or failed to fill prescriptions because of costs, compared with as few as 4 percent to 6 percent in the United Kingdom and Sweden.
• Roughly 40 percent of both insured and uninsured U.S. respondents spent $1,000 or more out-of-pocket during the year on medical care, not counting premiums. High deductibles and cost-sharing, along with no limits on out-of-pocket costs, may explain why even insured people in the U.S. struggled to afford needed health care, the researchers said.
• Nearly one-quarter (23%) of U.S. adults either had serious problems paying medical bills or were unable to pay them, compared with fewer than 13 percent of adults in the next-highest country, France, and 6 percent or fewer in the U.K., Sweden, and Norway.
• About one of three (32%) U.S. adults spent a lot of time dealing with insurance paperwork and disputes or were either denied payment for a claim or paid less than expected. Only 25 percent of adults in Switzerland, 19 percent in the Netherlands, and 17 percent in Germany—all countries with competitive health insurance markets—reported these problems. U.S. insurers spent $606 per person on administrative costs, more than twice the amount in the next-highest country. Such high costs result from a complex, fragmented insurance system, the researchers write.
• The vast majority (75%) of U.S. adults said their health system needs to undergo fundamental changes or be rebuilt completely.
• The U.S. spends $8,508 per person on health care. That is nearly $3,000 more per person than Norway, the second-highest spender.

The good news for Americans is that they can get to a specialist much more quickly than people elsewhere. I think this is a double edged advantage. Most people can get what they need from a generalist rather than a specialist. Generalists tend to cost less. And, I suspect, America has many more specialists than it needs precisely because they can charge more for their services.

This is the time of year when employees right across America have to go through the annual health care “election” process. This is when they choose the plan they will use – from amongst the list provided by their employer – during the upcoming year. More often than not the choices are exemplars of bureaucratic obfuscation. They are too complicated. They arbitrarily limit people to lists of doctors that the plan “covers”, so if the doctor down the road is not on the plan you might have to go across town to find one that is. Or, if you live in a less urban area, there may be no doctor in the plan at all.

Employer plans change at the whim of the employer. Driving down health benefit costs has become an annual rite for human resource departments everywhere, which means that an ever more Orwellian language is deployed to make the reductions look like benefits.

And, for those who staunchly defend the American system, given that employers look at “benefits” such as a health care plan as part of employee compensation, and given that the cost of said plans has soared over the past decade or more, the system is just one more reason that wages have languished. More and more compensation is being diverted into paying for health care plans and the administration thereof.

Indeed, I rather imagine that the ghastly cost of the US system, which the report puts at $8,508 peer person, is an understatement. I doubt it includes the administrative costs buried in every business large enough to offer a plan to its employees.

Setting all that aside though, the report is a stark reminder that the system sucks. There is no way to defend it other than via stubborn ideology. It fails over a third of Americans each and every year.

More to the point, well over two thirds of all Americans think it needs serious overhaul or perhaps total scrapping.

I was never a fan of Obamacare, it is a fudge designed to preserve part if not all the insurance industry’s profit base in health care. It is a kluge rather than a reform. It attacks some basic issues, but is not a thorough, nor a long term answer. Medicare for everyone would have been.

Obamacare’s appalling administrative foul-up is masking a real problem. A problem that the Republicans have no plan to solve, but who are now able to ignore as they gleefully attack Obama and his horrible plan.

Anyway, read the plan in full here.

Then start organizing to support the real fix: single payer insurance. Just like the civilized world.