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US Healthcare Results: Sicker Patients, Ailing Economy


Current policies and Washington, D.C.'s failure to address real problems in our healthcare system is literally making us sicker.

As one congress and administration after another rearranges the deck chairs on our titanic healthcare system, they are doing far more damage than running up massive debt for future generations. These policies and their failure to address the real problems in our system may be literally making us sicker. The facts are compelling:

• Statistics show that ours is not only the most expensive healthcare system in the world, it delivers only mediocre outcomes, lagging behind free market and socialized systems alike.

• The reason is not quality, accessibility, diagnostic technology, or pharmacology; we lead the world in advancements, safety, and technology. But, their cost is three or four times more expensive because we absorb the entire cost of research, development, and production for those advancements, and we pay for the right to sue the pants off of the providers and manufacturers if they are not. The rest of the world only pays for the product.

• The reason is not millions of uninsured not receiving care. They do. Everyone is guaranteed access to healthcare by law, albeit in the most expensive means possible …emergency rooms.

• The reason is not tens of millions of Medicaid and Medicare recipients. They have access to care, but it is so deeply discounted that virtually every Medicaid provider loses money and Medicare providers barely get their costs covered.

• The reason is that the great majority of us - the privately insured - increasingly delay or forego care because we are progressively more underinsured.

We subsidize the ever-increasing shortfalls caused by these programs and policies through ever- higher first dollars paid deductibles, care, and premium copays, to keep the costs of insurance from overwhelming ourselves and our employers.

The result: tens of millions of privately underinsured people for whom covering growing deductibles is a financial hardship or impossibility, delay, or forego care for financial reasons, allowing conditions, injury and disease to progress undiagnosed and untreated.

This is not speculation. HHS reports that overall 2010 healthcare spending increased at the second lowest rate in 51 years - the lowest being in 2009; because people are postponing or cancelling elective surgery, doctor visits, and even prescription refills. In summary, costs went up, so utilization, predominantly by the privately insured, went down.

Here is why we are getting sicker and the performance of our healthcare system lags behind others - undertreated, or untreated episodic conditions become chronic conditions, which become acute conditions. The cost in dollars, pain and quality of life for each progression is exponentially higher.

The cost to the people and families caught in this legislated morass of unintended and unforeseen consequences is a national tragedy in waiting. And, it is a money bomb in the bad sense. The fuse is lit, burning shorter every day our representatives fail to address the well-known root problems.

Early detection saves lives and treasure. Access has suddenly surpassed the reach of many working people, and the gap is widening by the day. Delaying for as long as possible, as so many families are deciding to do, or are forced to do, builds serious consequences. It is too often framed as a financial toll in the context of society. The human toll, to the victims and their families, to their quality of life, their family wealth, and eventually in life itself is far greater. It is far more immediate. It is founded in political expediency, special interests, and partisan politics.

We are not lacking real solutions that will result in real reform. We do not lack ideas regarding how to enact true reform: eliminate state border restrictions for private insurers, replace fee for service, reward wellness, enact loser pays tort reform, reform the FDA, spread the cost of testing outside of our borders, reform the Patent Office and enact laws to protect and speed new ideas, and dozens more.

Congress and the president know these things, and I am hopeful they will set aside special interests and partisan politics by implementing long-term solutions.

Find out more about James Doulgeris and our other Practice Notes bloggers.

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