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Healthcare USA: Pricey, Preferential, and Provocative

Healthcare USA – Beyond the Politics

healthcare USA has a long way to go for true healthcare reformThis week’s report from the Organization for Economic Co-operation and Development (OECD) that the rate of growth in US healthcare spending has tapered off compared to that of other high-spending countries (Germany, France, the Netherlands, Switzerland, and Canada in this case).

This is considered a good thing, even though these other “high-spending” countries actually spend about half what we spend in America on healthcare.

Because they spend so much less on healthcare, their rate of growth could be expected to exceed that of the U.S., since they’re starting from a lower spending base. A few percentage points of growth on twice the spending level will be twice that of a few percentage point growth on only half that spending. So our increased spending is still twice their increased spending in absolute dollars (i.e., 3% of 200 is 6, while 3% of 100 is 3).

Still, this is certainly better than prior years when both our base of spending on healthcare in America was higher and our rate of growth was higher as well.

Nevertheless, it would take many decades for our spending on healthcare to ever approach that of these other “high-spending” countries. Indeed, it’s virtually impossible – all the more so if we ever get serious about addressing some of the disparities and inequities in our healthcare these other countries largely manage to avoid.

     Women and Minorities Left Out

The flip side of the OECD report is that despite spending twice as much as these other countries, the U.S. had by far the smallest proportion of its population with healthcare coverage. This obviously translates into a horrendous return-on-investment in terms of our national healthcare spending. As the OECD researchers put it:

“The U.S.A. is an outlier in the scenery of the OECD healthcare systems, for its staggering levels of expenditure, the extent of fragmentation of its system, and the sheer complexity of its administration, the power of vested interests, and the large number of people left without adequate health insurance coverage.”

And Obamacare isn’t likely to fix many of these structural defects, which I discuss in detail in Our Healthcare Sucks. A recent report in the journal Circulation on Massachusetts’ health insurance reforms – on which Obamacare is largely modeled  – revealed its failure to make a dent in the major disparities in cardiac healthcare delivered in that state.  As the lead researcher of that study commented:

“Despite healthcare reform, which mandates individual health insurance coverage in Massachusetts, disparities persist in an important area of cardiac care, such as performance of potentially life-saving coronary interventions in certain vulnerable groups, including blacks, Hispanics and women.”

If Massachusetts – with some of the highest quality care in America and after eight years of Obamacare-like coverage that now insures about 98% of its population – still can’t deliver life-saving medical interventions to critically ill women and minorities, what hope is there for the rest of the country in which 98% coverage is a distant pipe dream?

U.S. Healthcare’s Provocative Politics

Another distinction between the U.S. and these other countries is the degree of politicalization of our healthcare. Conservative and regressive political movements are surfacing around the globe, not just in the U.S. But nowhere else is healthcare the political tinderbox it’s become in America since Obamacare was first proposed.

We may be in a bit of a lull at the moment, but that will change soon enough as this fall’s campaign rhetoric heats up – and Obamacare will once again be front and center (much to the chagrin of most Americans fed up with the subject).

The irony, of course, is that the complaint is we’re heading down the road to socialized medicine, while this latest OECD analysis confirms how far removed American healthcare is from anything resembling anything socialist in nature.

The dismal performance it reports on, after all, is for years through 2011 – before Obamacare took effect only this year. So our wasteful and inequitable healthcare delivery had nothing to do with Obamacare – or with socialized medicine.

Indeed, it’s corporate healthcare that accounts for much of the fragmentation, complexity, vested interests and spotty coverage cited by the OECD researchers as driving our “staggering levels of expenditures” on healthcare.

This should serve as a reality test for the politically-charged claims we’ll soon be accosted with…claims of socialized medicine as the problem should be contrasted with this latest evidence that it’s corporatized healthcare that’s to blame for our healthcare dysfunction.

 Anyone claiming the contrary is either on the take or blinded by bigotry. The evidence allows for no other conclusion.

Of course, you may think otherwise…why not weigh in below?

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