All thats wrong with US Healthcare

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This article in Saturdays Wall Street journal was mostly about healthcare industry stocks, but what blew me away was the chart that was included. I’ve long felt the US Healthcare system aka “industry” was not only too expensive, you can’t have a balanced discussion about it, people immediately get very defensive.

Once you’ve been treated a few times it becomes obvious that insurance is used as a blanket to cover

  • a vast array of unnecessary services, loads of extra tests, samples, examples, scans and xrays. Often because upfront you’ve paid your co-pay, pre-pay etc. so what do you care? The medical facility is paid for what they do, not their results.
  • Excessive administrative costs – for example, during my recent broken collarbone rather than visiting a single hospital and doctor/specialist, I had to visit 2-separate facilities, each duplicating the entire billing, insurance debacle, requiring many pages of documentation and background information. Every medical facility comes with it’s own army of billing and administrative staff to negotiate the insurance rules, claims and reclaims.
  • Inefficiently delivered services – Americans with insurance take great pride in the system as it delivers choice and prompt service and treatment. The reality it doesn’t, it does it through the illusion of choice based on whats available through insurance, and through a long list of appointments which are “first” available, but compared to a single payer system where you can move quickly and efficiently between providers, it isn’t efficient. For those without insurance there is little or no option but to sit in the emergancy room and hope for the best.
  • Prices are too high – because they have to cover an inefficient system and high administration costs.
  • Fraud – of course there is fraud, in any efficient system there are always those that seek to exploit the system; also in a system which excludes many, they look for a way to get what they can.
  • Missed prevention opportunities – and of course any system which generates huge amounts of money to deal with problems isn’t really focussed on prevention. While their are pockets of good practice in prevention, mostly there is a lack of priority in prevention.

Add up the numbers, you could pay for a single payer system with everything except the prevention missed opportunity.

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