The American Healthcare System: An Objective Evaluation

Most Americans believe that the U.S. healthcare system is the best in the world. Despite countless reports that ranks the U.S. near the bottom of modern countries, in terms of quality of care, access to medical services and cost, most Americans blindly believe that their overpriced, understaffed managed care organization is the best available. And while more medical professionals are likely to recognize the lagging standard of American healthcare, few will divulge this poorly held secret to their patients. There is one area in which the United States leads the world: money spent on healthcare.  Despite attempt after attempt by market and governmental forces to curb how much the country spends on healthcare, the U.S. still spends more per person-almost $8,500 annually-than any other nation in the world.  That equates to almost $2.8 trillion in 2014 and is 17.7 percent of the entire U.S. economy.  The next highest country is France which devotes only 11.6 percent of its economy to maintaining the health of its citizens-through socialized medicine. What is shocking is that the U.S. government actually spends more healthcare dollars than the nations of Canada, United Kingdom, Australia, and Japan which have universal health coverage. A surprising aspect of this enormous cost is that Americans actually seek care less often than residents of many other developed countries.  On average, Americans actually see a physician only about 4.1 times annually compared to 9.7 in Germany or 7.4 in Canada. It is just that receiving medical care in the U.S. is substantially more expensive than in other countries.  Although a physician visit is not cheap, this is a drop in the bucket when comparing to secondary costs including higher administrative fees, costly tests, exorbitant hospital fees, and higher medication costs. With the enormous price tag associated with our healthcare system, it is easy to buy into the misconception that all that money is buying incomparable medical services.  The reality is that many Americans are either being priced out of the system or receiving lower quality services than expected. In a study by the Organization for Economic Cooperation and Development, the life expectancy in the U.S. was 80.1 years, which makes it 26th, behind such nations as Israel, Greece and Slovenia. There are many variables which contribute to this poor showing.  One of the major factors is the lack of preventative care which could mitigate lethal outcomes in treatable conditions like asthma, diabetes or substance abuse.  Coupled with the skyrocketing costs of lifesaving pharmaceuticals-which are often price controlled in other nations-healthcare is too often considered a luxury rather than a necessity. Finally, the quality of care that is provided is often flawed. Despite an enormous amount of advanced diagnostic capabilities, many Americans receive care that is irrelevant or sub-standard.  According to 2010 study by the Department of Health and Human Services’ Office of Inspector General, almost 180,000 people on Medicare died from poor hospital care in a single year. Another study in the Journal of Patient Safety estimates that between 210,000 and 440,000 people may die annually from medical errors. These errors are related to a myriad of issues like professional incompetence, limited hospital resources, therapeutic complexity and unnecessary interventions. This is a byproduct of quantity rather than quality based healthcare system which emphasizes offering services without regard for the quality of outcomes.

Written by:  Robert Moghim, M.D., CEO- Moghim Medical Consulting Inc.

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