THE STORY SO FAR: PART 223

OUR HEALTHCARE SYSTEM—AN AMERICAN HORRROR STORY IN COST TERMS

AND NOT SO GOOD WHEN IT COMES TO QUALITY

It is nothing new to say we have an extraordinarily expensive system which not only fails to cover something like 40 million Americans, but also has severe quality problems. At its best, it is the best—which is wonderful (if you can afford it). For most people it does not show up too well compared to other developed nations. When it comes to longevity, we do not fare well—and we tend to be sicker that the populations of other nations as we age. In short, not only do Americans have shorter lives, but the quality of those lives is not what it might be.

Why is this? Healthcare deficiencies are not the only cause—lifestyle choices, the poor quality of our food, and environmental pollution are factors—but healthcare is still a serious cause for concern.

We know all this—it is certainly publicized well enough—and yet we seem incapable of doing anything about it. As with so many other issues, the richest nation in the world—famous for its “can do” attitude—seems caught in the greed of vested interests.

Recently I ran across some graphics which ram home just how out of line we are. In cost terms alone, it is a horror story.

What is particularly striking is just how out of line U.S. costs are. The differences are so extreme—even compared to high cost European countries like Switzerland—that it is hard not to suppress the feeling that something is very wrong; that greed, both corporate and personal, has got completely out of hand.

By the way, these graphs come from a commendable site called Priceonomics.com There are many more graphs on the Priceeconomics site and they make chilling reading.

 

 

 

Coincidentally, an excellent article by Jeffrey Pfeffer appeared in the Business Week of May 10 2013. He places the blame on the administrative costs imposed by insurance companies. I doubt that he is entirely right--there are other culprits ranging from over-priced drugs to for-profit hospitals—but he is certainly partially right.

The following is an extract from his article.

More than 20 years ago, two Harvard professors published an article in the prestigious New England Journal of Medicine showing that health-care administration cost somewhere between 19 percent and 24 percent of total spending on health care and that this administrative burden helped explain why health care costs so much in the U.S. compared, for instance, with Canada or the United Kingdom. An update of that analysis more than a decade later, after the diffusion of managed care and the widespread adoption of computerization, found that administration constituted some 30 percent of U.S. health-care costs and that the share of the health-care labor force comprising administrative (as opposed to care delivery) workers had grown 50 percent to constitute more than one of every four health-sector employees.

Pfeffer is the Thomas D. Dee II Professor of Organizational Behavior at Stanford University's Graduate School of Business, where he has taught since 1979. He is the author or co-author of 13 books, including his latest, Power: Why Some People Have It—and Others Don't (HarperCollins, 2010).

THE STORY SO FAR: PART 199

DO WE REALLY HAVE A HEALTHCARE SYSTEM—OR IS IT MISNAMED?

For some time I have been subscribing to a free newsletter on health matters put out by a Dr. Mercola. Reportedly, nearly two million others do the same thing.

His main business seems to be marketing supplements of various kinds—which I have never bought, (as yet)—but but I do read his mailings and have long thought they, mostly, make a great deal of sense—though I debate his views on vaccinations.

Is he controversial? Of course. Anyone who is so opposed to the status quo could scarcely be otherwise. But, fundamentally, he seems sound; and he backs his opinions with a great deal of data.

I speak, as a layman, of course—albeit I have researched the healthcare area for my book, TITANIC NATION: HOW TO AVOID ICEBERGS—so take my opinions as no more than that.

Here are Dr. Mercola’s beliefs in his own words:

• The US does not have a health care system; we have a disease-management system that is dependent on expensive drugs and invasive surgeries. It’s a system rooted in an ideal of maximized profits, opposed to helping people maintain or regain their health
• The US spends more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia, yet the US ranks last in health and mortality analysis of 17 developed nations
• Integrative medicine (IM) is a better alternative to the current system, as it offers a combination of conventional medical therapies and complementary or alternative therapies "for which there is some high-quality scientific evidence of safety and effectiveness"
• The Affordable Health Care Act is likely to make matters far worse rather than better, as the Act does not include any strategies to prevent illness. Nor does it contain any measures to rein in or reduce out-of-control health care costs related to overcharges. Instead it expands an already flawed model of “care” that has been and continues to be one of the leading causes of both death and bankruptcy in the US.

Harsh words—but look at the evidence. You’ll find him at www.mercola.com

 

 

 

TRUE GRIT

Image via Wikipedia

"Eight Portraits of Courage! We need room for a Ninth."

Department of Courageous People, & Death With Dignity

I spent the latter part of yesterday afternoon in a meeting. Its purpose was the notarizing of various documents to do with a truly remarkable woman who I shall, for the moment, merely refer to as 'A.' She is a friend, a neighbor whom I have grown to respect and admire. 

She is only in her sixties. She has had an astonishing life. 'A' is not the initial of her first name. I have chosen it because it stands for 'Adventurer.' 

She is, as we speak – bar a miracle - dying of cancer; so the meeting was mainly to do with her will and what she wanted done if she was rendered incapable: 

“Pull the plug!” conveys the essence of her message.  

The affair could have been tense and generally miserable. In fact, it was surprisingly cheerful, largely thanks to A’s vibrant personality – despite her pain – and the presence of another remarkable woman, B., who happens to be the condo president. It also went on much longer than expected because the notary got stuck in traffic.  

I felt very peculiar when I was asked to witness A.’s request to obtain the medication necessary “to die with dignity.” I was brought up a Catholic and to believe that life is sacred. On the other hand, if your cancer is so pervasive and severe that your death is certain within weeks, and your pain unimaginable, don’t you have the right to determine the time and manner of your passing?

I have no doubt at all but that you do. 

I signed willingly; but inside I confess I just wanted to cry. I still do. Death is as normal as sunrise; but we need all the people of courage that we have. Sadly, the world doesn’t work that way.

Today, I feel a true mixture of emotions; but dominating all is a sense of real hope about the human condition. 

We seem to be remarkably inept at the political level, but down in the weeds, where real people live - and die - there is true grit.