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<DIV><FONT size=2>From : <EM>New Scientist</EM> 08/01/2009</FONT></DIV>
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<H1>Insight: Why dollars alone won't fix US healthcare </H1></DIV>
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<P class=infuse>"WE'VE got healthcare that is better than anywhere else in the
world," boasted conservative US pundit Rush Limbaugh in an <A
href="http://www.foxnews.com/story/0,2933,534701,00.html"
target=nsarticle>interview with Fox News</A> on 23 July. Many politicians have
been echoing this claim in recent days, as Congress debates reforming the
nation's healthcare. Sadly, it is not true.</P>
<P class=infuse>Compared to other leading nations, <FONT color=#ff0000>the US
spends vastly more per head on healthcare, while often getting worse outcomes.
Despite these high and rising costs, which have </FONT><A
href="http://www.newscientist.com/article/mg19926744.700-condition-critical-the-medical-crisis-facing-america.html"><FONT
color=#ff0000>set the nation on course for bankruptcy</FONT></A><FONT
color=#ff0000>, the US lags behind other countries on measures such as life
expectancy at birth <FIGREF refid="mg27194101.jpg">(see graph)</FIGREF> and
infant mortality.</FONT></P>
<P class=infuse>People who have health insurance get excessive medical
interventions, escalating costs so that tens of millions can't afford it. Those
left uninsured have minimal access to healthcare, and are likely to contribute
significantly to the country's relatively poor health outcomes. Even the insured
could be sent to an earlier grave by risky interventions they don't need.</P>
<P class=infuse>Research at the Dartmouth School of Medicine in New Hampshire
shows how <A href="http://www.dartmouthatlas.org/"
target=nsarticle>high-spending regions</A> of the country are driving the
spiralling costs. Insurers and the government pay set fees for each medical
intervention performed. In some regions, doctors in institutions that are
competing to become "centres of excellence" in high-paying fields may use
unnecessary diagnostic tests, and surgeons often perform expensive procedures
when <A href="http://www.dartmouthatlas.org/atlases/Spending_Brief_022709.pdf"
target=nsarticle>cheap drugs may be a better option</A>.</P>
<P class=infuse>The main proposals now before Congress won't do much to tackle
this problem. Rather, they concentrate on the important issue of expanding
access to health insurance, and the Congressional Budget Office calculates that
they will increase spending by <A
href="http://www.cbo.gov/publications/collections/health.cfm"
target=nsarticle>hundreds of billions of dollars over the coming decade</A>.</P>
<P class=infuse>Cutting costs would involve more research into the comparative
effectiveness of different tests and treatments, and giving doctors incentives
to deliver quality care, not just paying them more for doing more.</P>
<P class=infuse>Why the reluctance to tackle these issues? Partly it's because
no politician wants to be accused of rationing healthcare. One way forward might
be to inform the public that sometimes less can be more. "When people
understand, they're less likely to choose expensive, invasive procedures," says
<A href="http://www.newamerica.net/people/shannon_brownlee"
target=nsarticle>Shannon Brownlee</A> of the New America Foundation a think tank
based in Washington DC.</P></DIV></DIV></DIV></DIV></BODY></HTML>