Are we at the tipping point?

• Author: Riczo, Steve
• Position: Medicine & Health

WHILE THERE is much to admire in the U.S. health care system, including millions of dedicated workers and some exceptional quality of care, there is reason for significant concern. It is no secret that the system is wasteful and the most expensive in the world, but what is not as well understood is the irony of how our health care system actually is detrimental to the health and well-being of many Americans.

A study from the Kaiser Family Foundation indicates that one in four Americans struggle with medical bills, causing detrimental effects to patients and their families that range from disruptive to devastating. Our system of health care drives people into bankruptcy, poverty, and near-poverty, while contributing significantly to the stagnation of middle-income wages. Economic well-being closely is associated with physical and emotional health; the latter is deteriorating for many in no small part due to the financial and emotional stresses caused by the excesses of our health care system.

Health care's insatiable appetite for more money results in what the Department of Justice estimates is six percent to eight percent fraud and abuse, mostly in the form of egregious billing practices; that is a lot of fraud in a three-trillion-dollar system. The Institute of Medicine maintains that more than $200,000,000 worth of unnecessary tests and procedures are performed every year on patients that needlessly expose them to harm while taking their money that could be used for other necessities of life.

"I think there's no question that many of the things we do in the United States in medicine are increasing cost but not necessarily how long or how well people live," states family physician Mark Ebell, professor of epidemiology at the University of Georgia.

Furthermore, the Office for the Inspector General for the Department of Health and Human Services stresses that errors in hospitals contribute to the deaths of 180,000 Medicare patients each year. The Journal of Patient Safety pegs the number between 200,000 and 400,000 when considering all patients, not just those on Medicare.

Americans deserve a top-notch, cost-effective health care system, not an enormously wasteful one. The National Academy of Sciences, through its Institute of Medicine, professes in a report that 30% of U.S. health care spending is, "wasted on unnecessary services, excessive administrative costs, fraud, and other problems." IOM equates the 30% waste described in its report to a mind-numbing $750,000,000,000 each year, which is more than the gross domestic product of over 170 countries.

In the mid 1960s, approximately five percent of gross domestic product was used for health care, compared to 18% today. While it is true that wealthy countries tend to spend a higher percentage of their income on health care, Robert Guell, professor of economics at Indiana State University, points out, "That does not necessarily explain why we spend so much more than similarly well-off countries."

On a per capita basis, U.S. health care costs are about twice the average of other industrialized nations...