A recent report indicates that the cost-benefit of healthcare in the US falls behind our leading economic competitors. The Business Roundtable concludes that “America’s healthcare system has become a liability in a global economy.” Spending on healthcare per person is about 2 ½ times more than any other advanced country such as Canada, Japan, Germany, the United Kingdom and France, where government involvement in health care is greater than in the US. Somewhat surprisingly, what we get in benefits for what we pay reveals an even greater discrepancy when the US is compared with developing countries like China, India and Brazil. Bottom line: “other countries spend less on healthcare and their workers are relatively healthier.”
The Rand Corporation concurs that our system is not just inefficient and ineffective. Their review of the scientific literature sums up the situation with words like “bizarre,” “weird,” and “staggeringly complex.”
David Eggert reports in USA Today that former Senator Newt Gingrich recently told Michigan state lawmakers that “the first step toward reducing healthcare costs and covering all Americans is getting people to change their behavior.” Gingrich also endorsed the “carrot over the stick approach,” and proposed to pay individuals for healthy behavior.
Great idea. Lots of luck with this one.
Certain factors are likely to doom any efforts at health care reform in this country, despite the outrageous price we pay for so little benefit. The most obvious to this observer are these:
• The complete disconnect between the person receiving the benefit and the person paying the bill.
• The “entitlement mentality” that when one has insurance, one is owed any test or procedure one wants. Americans are not ready to accept any limitation on access, availability, or applicability of what they want versus what they really need.
• The entrenched role of health insurance companies in acting as mediators between physicians and patients.
• The over-marketed “value” of drugs, many of which are insignificantly better than older medications, or no medication at all… especially when the cost/benefit ratio is considered.
• The inability and/or unwillingness of the majority of over-eating and under-exercising Americans to engage in healthy behaviors that would eliminate much of the chronic disease in this country.
Changing these will be difficult.
Here’s the problem. People speak of health care as a right. So is food, I suppose. What if we had “food insurance” with a model like that of our current health care system. The following scenario, played out in physicians’ offices daily, would then occur in restaurants.
“Hi. Welcome to Fat Charlie’s Dining Extravaganza. My name’s Jeffrey and I’ll be your server tonight. Have you had a chance to look at the menu? We have a wonderful lean meatloaf special, and the low-fat macaroni and cheese is delicious and very filling.”
“I’m sure that’s the case, Jeffrey, but my wife would like the deep-fried halibut in macadamia butter sauce, and I would like the well-marbled filet done medium rare. Could you ask the chef to leave the fat on? And please make that the 8 ounce, not the 4 ounce cut.”
“But the meatloaf and mac and cheese are my personal favorites and have a lot less fat and cholesterol. With some fresh vegetables and a green salad, they provide a perfectly balanced and healthy diet.”
“I notice that there are no prices on the menu, Jeff. How much does it cost for the meatloaf vs. the filet?”
“Well, I don’t really know. I do know that the filet is more expensive, but I’ve never seen a price list. You never know till you get the bill.”
“That’s OK, Jeff. I guess it really doesn’t matter. My wife and I have ‘food insurance’ through her employer, so our insurance company will be paying the bill. We’ll just have the halibut and the filet.”
“Well, that’s fine, sir, but my boss tells me that we never get to see the price list that the insurance companies use, and sometimes they don’t even pay us enough to cover the mac and cheese.”
“Thank you for that information, Jeff, but we really want the halibut and the filet.”
“But you don’ t need the halibut and the filet. You’d actually be better off with a simple meatloaf and the mac and cheese. You’ll be just as full, it’s quicker, you’ll be just as happy and even more healthy, and it will sure save your insurance company and this restaurant a lot of money.”
‘Thank you, Jeffrey, but we’ll have the halibut and the filet.”
“OK, but don’t blame me when your ‘food insurance’ premiums go up.”
“Oh, Jeff, we don’t pay for the ‘food insurance.’ My wife’s boss pays for it.”