[Vision2020] US Health Care System Rated Low

[Nick Gier]

Greetings:

Our prison system is shameful and the most expensive health care system in 
the world is rated poor.  Hillary needs to try one more time.

Nick Gier

A Second Opinion
By BOB HERBERT
New York Times, June 28, 2004


In an article a few years ago in The Journal of the American Medical 
Association, Dr. Barbara Starfield of the Johns Hopkins School of Medicine 
took a look at the overall health of the American people, and compared 
conditions here to those in other industrialized countries.
What she found was disturbing.
"The fact is that the U.S. population does not have anywhere near the best 
health in the world," she wrote. "Of 13 countries in a recent comparison, 
the United States ranks an average of 12th (second from the bottom) for 16 
available health indicators."
She said the U.S. came in 13th, dead last, in terms of low birth weight 
percentages; 13th for neonatal mortality and infant mortality over all; 
13th for years of potential life lost (excluding external causes); 11th for 
life expectancy at the age of 1 for females and 12th for males; and 10th 
for life expectancy at the age of 15 for females and 12th for males.
She noted in the article that more than 40 million Americans lacked health 
insurance (the figure is about 43 million now) and she described the state 
of Americans' health as "relatively poor."
"U.S. children are particularly disadvantaged," she said, adding, "But even 
the relatively advantaged position of elderly persons in the United States 
is slipping. The U.S. relative position for life expectancy in the oldest 
age group was better in the 1980's than in the 1990's."
The article was published in the summer of 2000. At the time Japan ranked 
highest among developed countries in terms of health, and the United States 
ranked among the lowest.
Last week I talked with Dr. Starfield, an internationally respected 
physician, professor and researcher, and asked whether the situation had 
improved over the last four years.
"It's getting worse," she said, noting, "We've done a lot more studies in 
terms of the international comparisons. We've done them a million different 
ways. The findings are so robust that I think they're probably 
incontrovertible."
The U.S. has the most expensive health care system on the planet, but 
millions of Americans without access to care die from illnesses that could 
have been successfully treated if diagnosed in time. Poor people line up at 
emergency rooms for care that should be provided in a doctor's office or 
clinic. Each year tens of thousands of men, women and children die from 
medical errors and many more are maimed.
But when you look for leadership on these issues, you find yourself staring 
into the void. If you want to get physicians' representatives excited, ask 
them about tort reform, not patient care. Elected officials give lip 
service to health care issues, but at the end of the campaign day their 
allegiance goes to the highest bidders, and they are never the people who 
put patients first.
To get a sense of just how backward we're becoming on these matters, 
consider that in places like Texas, Florida and Mississippi the politicians 
are dreaming up new ways to remove the protective cloak of health coverage 
from children, the elderly and the poor. Texas and Florida have been 
pulling the plug on coverage for low-income kids. And Mississippi recently 
approved the deepest cut in Medicaid eligibility for senior citizens and 
the disabled that has ever been approved anywhere in the U.S.
Even the affluent are finding it more difficult to obtain access to care. 
For patients with insurance the route to treatment is often a confusing 
maze of gatekeepers and maddening regulations. The costs of insurance are 
shifting from employers to employees, and important health decisions are 
increasingly being made by bureaucrats and pitchmen interested solely in 
profits.
In the maddening din that passes for a national conversation in this 
country, distinguished voices like Dr. Starfield's are not easily heard.
Echoing so many other patient advocates, she continues to call for movement 
on two crucial needs: coverage for the many millions who currently do not 
have access to care, and the development of a first-rate primary care 
system, which would bring a sense of coherence to a health care environment 
that is both chaotic and wildly expensive.
"We don't have any national health policy at all in this country," said Dr. 
Starfield.
And there is no sign of that changing anytime soon.