Is U.S. Healthcare Truly “Broken?”

In response Obamacare: Will Someone Please Kill It Before It Kills Us, most agree that Obamacare must be repealed. Some people even question whether healthcare is actually “broken” in the first place. One responder wrote: “Where is the evidence of that? In what way is it broken?” This challenge cannot go unanswered.

Objective evidence-based analysis of the U.S. healthcare system leads to the well-worn doctor joke: ‘I have good news and bad news.’ Every assertion below has ‘hard’ scientific proof. What follows is fact, not unsubstantiated opinion.

First, the good news:
YOU HAVE A DATE WITH (fill in your favorite sex symbol).

Americans have better health care outcomes than most others: better survival rates for common cancers than Europeans; better preventative cancer screening than Canadians; better access to chronic disease treatments; greater and much faster access to new technologies; less waiting times for care than in either Great Britain or Canada; and higher patient satisfaction here than in most European “universal health care” countries.

Next, by any measure you choose–patents applied for; new drugs or procedures; Nobel prizes, etc.–the U.S.A. is the most medically innovative country on the planet.

Finally, American-trained providers are considered the best. The super-rich fly from all over the world to the U.S.A. for their medical care. They do not go to Rochester Minnesota (Mayo Clinic) for the weather.

Now, the bad news:

The ‘bad news’ is financial, provider shortages, and outcomes.

The U.S. spends more per capita on healthcare ($4, 631) than any other nation. Interestingly, eight countries have annual increases in national spending greater than ours. Until the recent U.S. real estate collapse, medical bills were the leading cause of personal bankruptcies.

Forty-five million American residents (13% of our population) have no health insurance. Interestingly, 24% are uninsured by choice: they qualify for government assistance programs but refuse to sign up. Also, 25% of the 45 million uninsured are illegal residents.

Healthcare is very inefficient with our dollars: almost 40% of the trillions we spend each year provides no care at all: it is consumed by the healthcare bureaucracy. Despite draconian cuts in reimbursements just passed by Congress, Medicare – the Program touted by Nancy Pelosi to be the model for our whole country – will go broke by 2017.

In addition to its financial woes, healthcare has personnel issues. There are not enough doctors and nurses for our current health care needs. What will happen when (if) Obamacare adds 30-45 million more people to the roles of the insured?

In 1972, 95% of U.S. physicians reported they were professionally satisfied. In 2004, that number was 26%. Applications to U.S. medical schools have fallen off roughly 20% over the past 15 years. Forty percent of doctors over age 50 are considering early retirement.

While the U.S. is first in per capita healthcare spending, we are either 33rd or 46th (depending on source) in terms of infant mortality. Though this fact is often used to attack the U.S. healthcare system, it is unclear how much is due to epidemiologic issues such as illicit drugs or genetics and how much can be squarely laid at the healthcare system’s doorstep.

Wait times for care in Emergency Rooms can exceed 13 hours. The reported drug error rate is 1.13 for each and every patient admitted to a U.S. hospital. The number of avoidable, doctor-induced U.S. deaths is estimated as high 98,000: that is equivalent to one jumbo jet liner crashing every day killing all passengers, each crash caused by pilot error.

Finally in terms of outcomes, people can be injured during health care. Our medical malpractice system fails to compensate the vast majority of injured patients. It is extremely costly (multi-billions a year at a minimum), produces defensive medicine, and does not improve medical quality.

While there are many good individual parts of U.S. healthcare, as a system it is critically ill. It does not produce the outcomes we want and produces many outcomes we do not want. Healthcare is incredibly inefficient, drives providers away, and is drowning our country in red ink. According to many U.S. business leaders, our healthcare so-called system is dragging down U.S. global competitiveness.

U.S. healthcare truly is a “broken” system.

System MD

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